Ruth E. Zambrana on Health: "Real Change, Not Reform!"

October 24, 2008 posted by Linda Basch

I'm pleased to share with you the following exchange with Ruth E. Zambrana, Professor in the Women's Studies Department and the Director of the Consortium on Race, Gender and Ethnicity and Interim Director of the US Latino Studies Program at the University of Maryland, College Park and Adjunct Professor of Family Medicine at University of Maryland Baltimore, School of Medicine. Ruth has worked in the areas of health and educational disparities of low-income and Latino women, children and families for three decades. She is recognized by her peers as an expert in the field of Latino health, racial and ethnic health disparities, institutional access barriers to health care and disparities in education. In 2007 she was honored by Hispanic Business Magazine as 2007 Women of the Year, as one of 15 Elite Hispanic women in the US for her commitment and dedication to improving the Hispanic community through her service and scholarship. We are honored to feature her here at THE REAL DEAL.

Linda Basch: From where you sit, do the candidates' healthcare policies affect men and women differently? If yes, how so?

Ruth E. Zambrana: Lack of equitable health care policies affects all Americans as few can afford them. For women and men who are partnered/married and have access to employer based insurance, the chances of having health insurance coverage is higher. For low-income and working class families who have no employer based insurance BOTH MEN AND WOMEN are more likely to be uninsured. Since more women than men work in labor sectors that do not provide insurance, women disproportionately lack health care insurance coverage if they are low-income, single, Hispanic/Latina, African American, female head of households, and or with partners in a similar low-wage or seasonal labor market. Geographic location, level of education, occupational sector, historically underrepresented groups and residence in rural areas show different levels of health care coverage for women.

LB: With just 3 weeks left in the campaign, what would you like to say directly to the candidates regarding the future of women's health?

RZ: Job security is essential to all Americans and especially family economic providers (men and women).  Today dual-earner income couples are important to assure family economic security. Women's role as both earner outside the home and reproductive worker inside the home as mother contributes to both adverse physical and mental health outcomes when work supports in particular are not available. JOB SECURITY AND BENEFITS CONTRIBUTE TO A HEALTHIER AND MORE PRODUCTIVE SOCIETY. HEALTHY PEOPLE ARE STRONGER AND ARE THE FOUNDATION OF A STRONG ECONOMY.

LB: Is there any message you'd like to send them in particular about the importance of sick leave / family leave /paid maternity leave to women's lives?

RZ: To the candidates: paid maternity leave is a negotiated benefit for high level and well-paid professional women. Paid maternity leave is critical to the well being of our families, mothers and children. We are the only industrialized nation that does not provide paid maternity leave. Legislation needs to be passed to assure to assure an equitable paid maternity leave for all women and , sick and family leave for all women and men. SICK LEAVE AND FAMILY LEAVE ARE CENTRAL BENEFITS THAT MAINTAIN A HEALTHY WORK FORCE AND IN THE LONG RUN ARE A POWERFUL INVESTMENT IN OUR NATION AND OUR ECONOMIC GROWTH. I share with you this quote: "The problem, the enormous problem for Americans in the 1990s, is that we have not devised any equality-respecting system to replace the full-time caretaking labor force of women at home. We have patchwork systems, but we have come nowhere near replacing the hours or the quality of care that the at-home women of previous generations provided for the country. And the social ills that follow from this incalculable loss of care are all too familiar" (Harrington, 2000, 17).

LB: Thinking ahead to the new administration, what changes would you like to see implemented in the first 100 days around issues of health?

RZ: Knowing the unsettling economic situation we are in, I would say that first and foremost, legislation needs to be passed which acknowledges the following 5 items: 1. Access to health care and mental health care is a right and the health care organization, financing and delivery system will need to be restructured to assure that all Americans have basic preventive services, clinical management of pre-existing conditions and interventions with quality of care and dignity within 2 years. 2. Prescriptions medicines (generic and brand name) must be made immediately available at a low, affordable cost so that poor, elderly and uninsured families can manage their health conditions while we implement health access for all. 3. TANF guidelines need to be reversed to assure that individuals who have health problems themselves or their children can continue to get access to health care services and benefits. 4. State children's health insurance program needs to be expanded to all children who meet basic eligibility in all states. 5. Eliminate all public policies that target women, especially pregnant women for punitive actions such as prison terms for pregnant women who use drugs. The last 4 items will be a cost savings for the United States.

LB: What would you like to see from the next Secretary of Health and Human Services?

RZ: Our next Secretary of Health and Human Services needs to know the effects of the dismantling of all health and human services systems over the last 20 years (yes, including Clinton and his passage of TANF, mandatory sentencing and the three strikes ruling . New administration needs to assure the overturning of these discriminatory mandates). S/he must be well informed on our dual service class system for the professional and wealthy class and a low quality of care system permeated with discriminatory and punitive practices for all others (child welfare, health (Medicaid, SCHIP, underfunded public clinics), mental health services, juvenile and criminal (in)justice, public housing, public assistance. Knowledge and understanding without compassion serves no one. Thus s/he must have compassion; integrity and hands-on/witness of and to the inequalities in our nation and a determination and willingness to initiate a process of real change not reform!

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