Health Disparities in Minority Communities

Floor Speech

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Mr. FIGURES. Mr. Speaker, I rise today to speak on an urgent issue that affects the health, well-being, and prosperity of Black families, not just across the State of Alabama that I call home, but across this country, the staggering healthcare disparities that persist across this country and across too many counties in districts like mine, the Second Congressional District of Alabama.

Let me be clear at the outset: I do not subscribe to the notion that healthcare is a luxury, that healthcare should be available to those who can afford it, that healthcare should be dependent on where you come from, where you were born, the ZIP Code that you reside in. I believe that healthcare is a basic human right. We know Jesus gave it for free.

I subscribe to the notion that no one should be left without access to a doctor, a hospital, or an ambulance simply because of where they are from. The disparities should not be as drastic as they are for people of color. Yet, in places like Barbour County and Washington County and Conecuh County across my district, the data tells the devastating story about who has access to care and who has historically been left behind.

I know this is not just unique to Alabama. We see it in South Carolina. We see it in Massachusetts, as my colleague just spoke about. We see it in Mississippi, Georgia, and other places as well, where Black residents face higher rates of those chronic, preventable diseases and illnesses such as hypertension and diabetes. They suffer disproportionately from things like stroke and heart attack.

Too often, they live miles from the nearest hospital or clinic, particularly in these rural areas, these rural parts of America, where we are seeing hospitals closed. We are seeing them shut down. We are seeing it more difficult for them to even access basic care.

We see in places across Alabama where maternal mortality rates for Black women are more than double that of White women. I am proud to be from the State of Alabama, but I am not proud of all of its health statistics. In fact, I am not proud of most of them.

Alabama is America's worst State for maternal mortality. More women die after childbirth in the State of Alabama than anywhere else in America, period. That is not just Black women, that is women in general. The disparity for Black women is alarming, more alarming in that context. It is just unacceptable.

We are seeing across the State of Alabama, particularly in our rural counties, which if you know anything about the South, those rural counties in the South typically have higher Black populations, going back to the historical role and the historical place that they were for slavery, and the descendants stayed there. We are seeing hospitals in these rural communities shut down.

This leads to cuts in just general healthcare services, and they create healthcare deserts, forcing folks to drive in some cases, literally, hours for basic care, in some cases well over an hour to be able to get to a hospital.

Just in my home State alone, in this district that I ran in, we saw several hospitals close just across the 13 counties that compose my district, just while I was running for office. Just while I was running for office, we saw at least four shutter.

We are on pace in my district alone to see every single hospital close within the next several years that are not located pretty much in just Mobile or Montgomery. That is unacceptable because it creates conditions that make it tougher for Black people to be able to receive care, for all people to be able to receive care.

The disparities in access we know are well documented, so we know that that burden will disproportionately hit the African-American community. This is places that have contributed so much to this Nation, places like Tuskegee, Alabama, that gave us so much, places like Troy, Alabama, that gave us John Lewis, places like Montgomery, Alabama, where their largest hospital is in bankruptcy right now.

We have to be cognizant of the impact that this is going to continue to have on the African-American community, and we have to be focused on solutions, but we also have to understand how we got here. This is not just something that we stumbled upon. It is not that the data didn't show us that this was coming. This is the result of historic underinvestment and the direct result of policy choices historically and policy decisions that we continue to make to this day.

I am in Alabama. We are one of just 10 States that has not acted on the common wisdom of expanding Medicaid, and that is exacerbating the issues that we have from a healthcare standpoint. We haven't expanded Medicaid. This is in a State that for all intents and purposes has pretty much the lowest life expectancy in America. I think we are technically third by some decimal points, so congratulations, we live a few weeks longer in the State of Alabama than, say, West Virginia and Mississippi.

It is nothing to really be proud of. We are at the bottom of the barrel. Yet, we haven't expanded Medicaid, which is one of the reasons that the first piece of legislation that I joined when I was fortunate enough to be sworn into this body was the COVER Now Act, which would allow counties and cities to be able to get Medicaid expansion funding directly and get through the resistance that the State has put up now for well over a decade.

We have got to do better than that. We can continue to ring the alarm, but we have to do better. We have to. We have to address the underlying causes and the underlying issues here. We have to understand that these counties where these hospitals have been closing that insurance remains out of reach because the jobs aren't there. We have to understand that preventative care in many of these places is also just a dream because the condition of the communities don't warrant healthcare practitioners setting up shop there or staying there.

I don't care who you are. I come from Alabama, we treat Nick Sabin, and rightfully so, as the greatest college football coach of all time, but I can tell you one thing about this: Nick Sabin could not close a recruiting pitch to a business to come relocate in a county that does not have a hospital. I don't care who you are. Businesses don't want to relocate there. Hell, businesses don't even want to remain there.

How do you get retirees to want to come back home where they grew up and set up shop, and you tell them, we don't have a hospital, we don't have a geriatrician? Seven of the thirteen counties in my district don't even have a pediatrician. We have to get serious about addressing this issue in the community. It is an existential threat, it truly is.

We know the other statistics: Black Alabamians are more likely to suffer from diabetes and amputations that result from them or to die from untreated cancers or undiagnosed cancers or late-diagnosed cancers and experience preventable complications from just general chronic illnesses.

When it comes to kidney disease and dialysis access, the results are alarming. People in the State of Alabama have been trying to get me to come visit as many healthcare facilities as possible to shed light and to give more context behind what's really happening in the healthcare system in the State of Alabama. The dialysis community brought me in for a tour last week in Montgomery, Alabama, at the DaVita Center.

You see these nurses and technicians that are doing God's work in keeping people alive, but one thing jumps out at you. You can't help but see that every patient in there looks like me. Every kidney dialysis patient looks like me, and so I asked: Is this just a certain day or is this how it goes? They had representatives from five or six facilities there, and all of them said the same thing: No, our patient rolls are about 90 percent Black. That is because this is impacting people of African-American descent and Black people in this country in the way it is not impacting other races.

We have an obligation, a moral duty as a nation to figure out why. That is why cuts to things like NIH aren't productive. It is not helpful. It is harmful. If you ever want your conscience to be shocked, walk into a dialysis treatment facility in probably any community in this country, then do the statistics yourself. Ask yourself why that is and why can't we figure that out. Why are we not investing more resources, more time, and more attention and focus on trying to improve healthcare outcomes for Black people in this country? We have to. We must.

We must start this process by expanding Medicaid in States like mine, the State of Alabama. We must do that. Nobody should have to choose between getting treatment and putting food on the table. There are too many people who should be able to go see a doctor who are not because they refuse to expand Medicaid.

We also have to invest in our healthcare infrastructure, particularly in our rural healthcare infrastructure, bringing back those hospitals and clinics and bringing in telehealth hubs, leveraging every resource we have to improve healthcare outcomes. We have to increase funding for Black maternal health initiatives because these are problems we should not be having in 2025.

In 2025, we should not be having nearly as many women die from childbirth complications and pregnancy-related causes as we do. When you look at the disparities racially, it is stark. It is shocking. We have to get to the bottom of why that is.

We have to continue to address those environmental health threats in places like Alabama and across the country, where you see disproportionately higher rates of cancer in certain communities because they are located in certain places. We have to be serious about this.

It is a privilege to be able to speak on the importance of this issue, especially under the leadership of Representative Clyburn.

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