BIPOC & HEALTHCARE

Problem

BIPOC communities in Oregon and across the country experience devastating health consequences because healthcare systems were built on exclusion, neglect, and racism.

Disproportionate Harm

• Black women die during pregnancy over 3x more often than white women.

• Native American and Alaska Native life expectancy remains about 11 years lower than that of white Americans, underscoring a critical and urgent disparity.

• Black infants in Oregon are more likely to be underweight and face lower survival rates.

• During COVID, BIPOC Oregonians saw higher infection and death rates.

• A 2024 survey found BIPOC Oregon residents:

  • Skipped care more often

  • Held more medical debt

  • Reported more discrimination in clinics

Systemic Underfunding & Barriers

• Indian Health Service: ~$4,078 per person
  U.S. average spending: > $13,000

• BIPOC communities are underrepresented across licensed healthcare professions.

• Language, cultural relevance, and trust remain major barriers.

• Bias and racism drive mistreatment and gaps in prenatal care, pain management, and emergency response.

Result: Maternal deaths increase, chronic illnesses go untreated, life expectancy plummets — and trust collapses.

Solutions

1. Treat racism as a public health driver

• Require federal health agencies to track and close racial health gaps.

• Tie funding to measurable progress on equity.

• Protect and expand diversity and equity programs instead of defunding them.

Result: Equity plans ensure accountability, not just slogans.

2. End preventable Black & Indigenous maternal and infant deaths

• Guarantee continuous Medicaid throughout pregnancy + 12 months postpartum.

• Expand insurance reimbursement for doulas, midwives, and community birth centers.

• Require hospitals to publish racial outcomes, correct bias, and protect reproductive and emergency pregnancy care nationwide.

• Protect reproductive and emergency pregnancy care nationwide.

Result: Safer pregnancies and lives saved.

3. Close life expectancy gaps for Native communities

• Fully fund the Indian Health Service — permanently, and at parity with other systems.

• Support universal, no-cost coverage for American Indian and Alaska Native people.

• Direct federal funds to tribal and urban Indian clinics for expanded care.

• Tie healthcare funding to improvements in housing, clean water, and air.

Result: Tribal communities receive promised care.

‘4. Make care affordable, accessible, and respectful

• Expand Medicaid/Medicare eligibility regardless of immigration status.

• Ban aggressive medical debt collections for lifesaving care.

• Expand culturally specific community clinics and mental health providers.

• Enforce language access standards in any federally funded healthcare facility.

Outcome: People get care when they need it—not when they can finally afford it.

5. Build a workforce that reflects the community

• Fund scholarships, training, and loan forgiveness for BIPOC students in healthcare; support college pipelines and publish diversity plans.

• Support community college + tribal college pipelines into nursing, behavioral health, and midwifery.

• Require health systems receiving federal funds to publish diversity plans.

• Make interpreters + community health workers permanent, paid roles.

Result: Care reflects patients' culture, language, and experiences.

Bottom Line

BIPOC communities are dying younger, facing higher maternal risk, and skipping basic care — not because of biology, but because the healthcare system was not built for them.

Real equity requires:

• Targeted investments

• Accountability

• Funding Native treaty obligations

• Protecting maternal health

• Language rights

• Workforce transformation

A healthcare system that works for Black, Indigenous, and other communities of color is one that finally works for everyone.