Health Inequity & Zika Virus
OpEd by Feygele Jacobs

Published Friday, March 3, 2017
El Nuevo Día Digital
Online Edition of Puerto Rico’s Main Daily Newspaper

Much has been said about the importance of local community health centers in providing essential healthcare access and resources to our most vulnerable populations. For a first-rate example, we can look to Puerto Rico, where community health centers today are on the front lines of responding to the Zika outbreak.
Operating more than 80 sites across the island, Puerto Rico’s community health centers (CHCs) served nearly 350,000 people in 2015, according to a recent study by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative. The report found that approximately 1 person in 10 on the island depends on community health centers for healthcare.

Nonetheless, Puerto Rico’s health centers are facing major challenges, resulting from the high need for services, the general deterioration of the economy amidst the island’s fiscal crisis, and underfunding. Over 75% of those served by Puerto Rico’s health centers are covered through public health benefits such as Medicare and Medicaid, but at reimbursement rates far lower than those stateside, and 12 percent remain uninsured; there are no tax subsidies for private coverage.

Building on their anchor role as high-quality community-based providers, CHCs have become PR’s first responders in the fight against Zika. Health centers are working closely with other agencies to conduct direct outreach to educate the public about the dangers of Zika and to connect people with testing, screening, family planning services, contraception and treatment. “Asociación de Salud Primaria de Puerto Rico” (ASPPR), the Primary Care Association that represents the island’s health centers, is working with the Puerto Rico Health Department to develop a strategic plan that is responsive to the continuing threat.

The Federal Zika Emergency Declaration, which allowed additional resources to be targeted toward combatting Zika locally, and subsequent federal funding approved by Congress last September, provided some measure of relief. But funding delays have had a cost to both services and research. Now, with the potential repeal of key provisions of the Affordable Care Act and changes to Medicaid and other vital federal health program, health centers in Puerto Rico and across the U.S. mainland may be facing an environment of extraordinary fiscal uncertainty and deepened scarcity.

For PR’s health centers to continue to play a vital role in the fight against Zika, and protect the health of the public, they must be continuously supported through appropriate funding and reimbursement. The Island’s health depends on it.

Feygele Jacobs is the President and CEO of RCHN Community Health Foundation.

For the original Spanish-language text:
Find the policy brief, “Puerto Rico’s Community Health Centers in a Time of Crisis,“ here