Harrison Epstein, Daily Herald file photo

On this week’s Utah County Commission agenda was an item authorizing the signing of an amendment titled “COVID-19 Health Disparities and Advancing Health Equity Amendment 2.” The amendment was moved off the consent agenda by Commissioner Tom Sakievich as the body’s most senior member sought more discussion.

When the item came back up for discussion, Sakievich brought discussion back to last year.

In May 2022, Sakievich took issue with the word “equity” as it was used in an amendment extending a program between the Utah County Health Department and the Department of Public Health at Brigham Young University.

After much discussion in which Sakievich said equity was “renamed on something based on historical racism,” commissioners approved the resolution after changing the term to “outcomes.” On Wednesday, language was again central to the commissioner’s complaint.

“The problem I have is that there’s concurrent publications where health equity is based on the inequitable access to health care’s racist roots. To me that is as misleading as to say that all cops are bad or all military people, all they want to do is kill women and children,” Sakievich said.

Isaac Hale, Daily Herald file photo

His stated goal was to include the word “access” in brackets in the title, making it “COVID-19 Health Disparities and Advancing Health Equity [Access] Amendment 2.” This change, he argued, would better define the mission to “reach all people for health access.” To make the change, though, would require approval from the Utah Department of Health and Human Services because it is a state contract, not a county program.

“The implication at the national level because we’ve been racist is completely wrong,” he said.

The item was accepted by unanimous vote with a caveat that the Utah County Attorney’s Office contacts the state in an effort to change the name to include “access.”

Wednesday’s amendment extends the program’s end date from May 31, 2023, to May 31, 2024. Under the contract, Utah County can collaborate with the state to address health disparities among “high-risk and underserved” populations, including racial and ethnic minorities.

According to a 2021 report from the Utah Department of Health, people of color are unable to access health care due to costs at significantly higher rates. Only 10.99% of white adults were unable to access health care compared to Native American (29.7%), Hawaiian/Pacific Islander (26.4%), Black (22.9%), Hispanic (20.0%) and Asian adults (13.3%). Of 77 health indicators measured in the report, 55 showed worse health outcomes among racial minorities.

“We’re trying to close disparities so that we don’t pick and choose what public citizens we will serve. That’s the pure intent of this is to make sure no one’s left to fall through the cracks,” said Eric Edwards, Utah County Health Department executive director. “We want to do everything we can to ensure that, maybe it’s a hearing-impaired mother that lives in Cedar Valley that has poor access to care, something like that. Whatever we can do to close gaps in health improvement, we want to do that.”

As she did when Sakievich raised an issue with the word equity in 2022, Commissioner Amelia Powers Gardner mentioned the higher rates of maternal mortality for women of color in the United States as opposed to white women “even after we have adjusted for socioeconomic status, zip code, neighborhood, health insurance, etc.”

According to data published in March by the Centers for Disease Control and Prevention, there were 69.9 deaths per 100,000 live births among non-Hispanic Black women compared to 26.6 deaths for non-Hispanic white women in 2021. Hispanic women, meanwhile, had a maternal mortality rate of 28.0 deaths per 100,000 live births.

“About 20% of our population is Hispanic here in our county. Over the next 20 years that is projected to go up to a third of our population and I would love (for) a Hispanic women to be able to walk into Utah Valley Regional Medical Center and know that she is going to have the same care when she delivers a baby as a Caucasian woman, and today that’s simply not the case,” Powers Gardner said.

A study from the National Bureau of Economic Research analyzed income tax data with birth, death and hospitalization records and demographic data for nearly all the infants born to first-time mothers from 2007 to 2016 in California.

The study determined, among other things, that the maternal mortality rate among high-income Black women was similar to that of low-income white women. The mortality rate for high-income white women was less than half of the other groups.

“Even as much as I agree with you in theory, the facts do not show in health care that there isn’t a bias. There absolutely, statistically, scientifically is a bias,” Powers Gardner said. “As much as I totally agree that we should not assume that every person is racist and as much as I do not agree with (critical race theory), in this case, the science and statistics show that women of color die twice as often.”

Sakievich responded anecdotally to Powers Gardner, saying that whenever he went into a medical facility for himself or a family member, everyone “appears to be treated equally” and that disparities were rare and quickly addressed when pointed out to practitioners.

“I wish the statistics showed it,” Powers Gardner said.

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