Safety Net Hospitals: Why BIPOC Wealth Creation is Needed to Achieve Health – Non Profit News – Nonprofit Quarterly
Image Credit: Unsplash, Jimmy Woo
Hospitals offer unique windows into society. Their proximity to and interactions with the populations they serve provide insights into health disparities, revealing how lived experiences in disparate environments affect health. Urban safety-net hospitals offer even more unique insights into populations, places, and health. Such hospitals, including the one in which we work, Boston Medical Center (BMC), are often located in low-income neighborhoods and serve largely BIPOC populations. They are regularly challenged to provide high quality care with limited resources.
Our hospital, for example, is much more likely than other hospitals to care for the uninsured or those who have limited Medicaid coverage. In our work, we experience the intersectionality of health and wealth every day. Daily, we see in our patients how individuals’ economic positionality converges with economic structures, predictably determining who thrives and reaches their full potential, and who does not.
Boston, like many urban areas around the country, has a deep history of racism and segregation. Consistent with the legacy of redlining, new research shows that racist real estate and housing practices continue to perpetuate wealth differences across races. In 2015, the Boston Federal Reserve Bank released the Color of Wealth report, which highlighted the widening wealth gap between white and nonwhite people. The report stated that millions of BIPOC individuals don’t have enough assets to pass down to future generations. Meanwhile, white Bostonians are more likely to own every type of liquid asset than Black and Latinx Bostonians. “White households have a median net worth of $247,500, while Dominicans and U.S. Blacks have a median wealth close to zero. Out of the nonwhite households, Caribbean blacks have the highest median net worth with $12,000, which is only five percent of the wealth credited to white families.”
In Boston, as in most US metropolitan areas, BIPOC communities are disproportionately served by certain medical centers. A few years ago, the Boston Globe reported that, “When looked at citywide, the data show that Black Bostonians are more than three times as likely to get care at Boston Medical Center.” Though other academic medical centers also serve large BIPOC populations, at Boston Medical Center (BMC) our safety net hospital status and physical location within these segregated communities bear unique witness every day in how these race-based wealth differences impact disease morbidity and mortality.
Given longstanding trust issues between health providers and BIPOC communities—the product in significant part of decades of misinformation and/or lack of information—safety-net hospitals can serve as bridges between healthcare providers and marginalized communities while supporting such communities’ existing assets and strengths. But doing so requires more than medical intervention. It requires an all-encompassing approach that focuses not just on the provision of excellent medical care, but also …….