CCLP works on the intersection between poverty and access to health care that so often results in disparities in health outcomes. Certain groups of people and places across the state have less access to health coverage and services and consistently have worse health outcomes. CCLP focuses on efforts to improve health equity so all Coloradans have the opportunity to achieve health and wellbeing.

Income and health status in Colorado

Health equity goes beyond health care access and affordability. Individual and community health and wellbeing are inextricably linked to social and economic factors. The issue of health disparities often emerges in our work given its deep connection to poverty. 

75% of American Indian adults are overweight or obese in Colorado, compared to 64% of African American adults, 61% of Latino adults, and 54% of white adults.

Improving health equity through increased income

The Earned Income Tax Credit (EITC) is widely recognized as one of the most effective anti-poverty tools and the increase in income resulting from the EITC correlates with improved health status.  CCLP has been a core champion of the EITC since 1999, when the organization worked on legislation to establish the state EITC. In 2000, CCLP worked to increase the amount available to families and flew around the state to promote the program. In 2013, CCLP played a key role in the coalition that pushed for passage of SB13-001, which will permanently eliminate the structural problem with our state EITC that restricted it to years that have huge revenue surpluses.  At some point in the next few years, the state EITC should become a permanent tax credit available to low-income families every year.  A 2013 CCLP publication, Income boosts provided by EITC can help improve health outcomes for low-income families, summarizes the literature linking the EITC to improved health status. The EITC will continue to have a positive impact on the social determinants of health including food access, housing, transportation and the toxic stress of living in poverty. 

Alleviating health disparities based on immigrant status

The Hepatitis B rate for Asian Coloradans is almost 50 times
higher than the rate for white and Latino Coloradans.

In 2003, the Colorado General Assembly passed a bill eliminating Medicaid eligibility for a group of legal immigrants. Thirty-five hundred people were affected; a significant number were very low-income people on the Old Age Pension program and people living in nursing homes. Many of the Old Age Pensioners were frail, elderly Russian Jews who had fled their own country as a result of discrimination. Some were holocaust survivors. Working with colleagues and allies in the Jewish community and senior advocates, CCLP organized the effort to use the judicial process to stop the termination of Medicaid eligibility to this group of immigrants. At the same time, CCLP worked with advocacy colleagues to secure support to fund Medicaid for the affected population through Amendment 35 (A35). CCLP was able, through the legal effort, to hold off implementation of the bill because the state had failed to properly notify people of the termination of Medicaid benefits. During this hiatus, A35 passed and Medicaid for this group of immigrants was funded. As a result of these efforts, no immigrants lost access to health care.

While 10% of white pregnant women smoked during the last three months of their pregnancy, only 4% of Latino women did so.

Breaking the cycle of health disparities through early intervention

No program is more directly linked to mitigating the effects of health disparities for low-income children than Medicaid’s Early Periodic Screening Diagnosis and Treatment (EPSDT) program.  Congress established EPSDT because it recognized that early intervention for low-income children was critical in alleviating the long term health and social effects of poverty. EPSDT is specifically designed to ensure Medicaid conducts outreach activities, delivers recommended health screenings and provides access to all medically necessary services and supports. When the EPSDT program was established, lead paint was beginning to be identified as a hazard to low-income children. A significant benefit of the program is the requirement that Medicaid enrolled children have access to lead screenings.

13% of Latino children have untreated cavities or decay,
compared to only 5% of white children in Colorado.

Roughly one out of three Colorado children – 418,000 – receive health care through the Medicaid program.  While certain demographic data for the Medicaid population is not available, other data shows that nine percent of all Colorado children under 139 percent of the federal poverty level are African American and 52 percent are Hispanic. EPSDT has enormous potential to improve the health and wellbeing of low-income children. Yet, in 2011 only 63 percent of Colorado’s three to five year olds received the expected ratio of EPSDT screenings and only 47 percent of all Medicaid children received recommended annual screenings. CCLP has focused on making EPSDT more effective in Colorado. Examples of CCLP’s work include:

  • educating the Colorado Department of Health Care Financing and Policy (HCPF) about its responsibilities under EPSDT, particularly with respect to outreach to low-income families;
  • securing access to certain audiology equipment for hearing impaired low-income children;
  • persuading HCPF to fulfill its obligation to provide personal care services to children when necessary; and
  • assisting the disability community in persuading HCPF to revise a dysfunctional Pediatric Assessment Tool.

A striking 41% of LGBQ students in Boulder County reported being current
smokers, compared with only 12% of heterosexual students.

 

There is still much to be done to ensure that the benefits of EPSDT are maximized in Colorado. CCLP will continue to ensure that EPSDT is clearly understood and low-income children have access to appropriate screening and services.

Health Equity Partnerships

CCLP’s staff works closely with several coalitions that directly inform our work and ensure that development of our legislative and policy priorities are grounded in the needs of low-income Coloradans.  These coalitions are comprised of poverty advocacy organizations, direct service providers and state and local government stakeholders.

64% of people living in Colorado communities
where drinking water exceeds the standard for
radium and uranium are Latino.

Our key partners include organizations that work with individuals, including Colorado Legal Services and the Colorado Coalition for the Homeless; consumer-driven advocacy organizations such as the Colorado Cross-Disability Coalition; advocacy organizations that represent direct service providers including the Colorado Community Health Network; and advocacy groups including the Colorado Consumer Health Initiative, Colorado Coalition for the Medically Underserved, Colorado Children’s Campaign, and The Bell Policy Center. Health Equity Partnerships

Note: Statistics courtesy of the Colorado Department of Public Health and Environment’s 2013 Health Disparities report: Exploring health equity in Colorado’s 10 winnable battles, which can be accessed here.