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Turning Point: Providing Equitable Healthcare Services

Turning Point: Opinions from the St. Louis Community

Written by Yamelsie Rodriguez, President and CEO, Planned Parenthood of the St. Louis Region and Southwest Missouri 

When I reflect on the past 12 to 16 months, what is evident are the compounding traumas that people of color, people with low incomes, and women have and continue to endure. From senseless police brutality that has taken the lives of far too many Black and Brown people to COVID-19, which has disproportionately killed people of color and burdened the lives of frontline workers, our country is going through a long overdue reckoning with the impact of racism, class, and privilege.

This is the reality I confront everyday at Planned Parenthood of the St. Louis Region and Southwest Missouri. Before patients walk through the doors of our eight health centers in Missouri and Illinois, they are first people with layered identities that too often threaten their existence in a white dominant world. What is basic health care to privileged communities -- birth control, cancer screenings, the choice of a safe and legal abortion, or just the ability to stay home in a pandemic -- becomes complicated if you’re a person of color with income insecurity and no insurance. Racist and discriminatory policies have built a system in which people of color, women, and people with low incomes disproportionately depend on publicly funded programs like Medicaid for health care. Meanwhile, rooted in racism, those same programs are targeted and attacked by politicians, pushing the same people into a never-ending cycle of poor health outcomes. In Missouri, this means Black women are three times more likely to die from childbirth than their white counterparts. Thirty-eight percent of Missourians who have died from COVID-19 are Black while Black people make up just 12% of the state’s population.

With the recent decision by the Supreme Court to hear a case involving a 15-week abortion ban in Mississippi -- a direct challenge to Roe v. Wade -- Black, Indigenous, people of color once again stand to lose the most. If Roe is overturned, the reality is the “haves” will be able to exercise their right to an abortion while the “have-nots” will not. This critical inflection point in our history also comes at a time when the overwhelming majority of Americans -- including Republicans, Independents, and Democrats -- support safe, legal abortion. But the threats to patients don’t stop at abortion access. The right to choose the full suite of basic health care like access to birth control, cancer screenings, STI testing and treatment, and other preventive care are also under attack. Missouri politicians recklessly disregarded the state’s constitution when it refused to fund voter-mandated Medicaid expansion, which would’ve expanded access to these basic health care services to those who need them the most. 

These compounding crises mean PPSLRSWMO’s responsibility isn’t just to provide essential health care. They demand we consider the many facets of trauma and inequity that impact our patients. It also requires our community to join in our advocacy with a shared understanding that our mission doesn’t exist in a silo. We can’t advocate for reproductive freedom without also pushing for a living wage, police reform, immigration reform, and economic justice. If you believe Black Lives Matter; if you reject the transphobia pervasive in our state legislature; if you denounce xenophobia and misogyny; then I challenge you to see the intersecting impact each of these issues have on a person’s ability to achieve equity in a changing world.

As a Latina born and raised in Puerto Rico, a mother to a Brown girl, and a wife of a man who lived in this country as an undocumented immigrant, I am intimately aware of the countless life circumstances that stand in the way of a person’s ability to live free and thrive. I celebrate my layered identity while knowing so many do not. And it is that lived experience that has called me to lead an organization that centers the needs of marginalized people in our community. Whether you’re a mom considering an abortion or adoption so you can care for the children you already have, or you’re a transgender person who needs gender affirming care to live authentically, PPSLRSWMO is fighting for a world where every person can experience health equity and true liberation.

I look forward to seeing how the conversations and lessons over the past year push us to be better allies, to think expansively about what it means to support reproductive freedom, and more importantly, what it means when we don’t. Our community is at a turning point. The time is now to use our privilege to influence the change we need to transform the course of history. People’s lives depend on it. Let’s get to it.