As a Black physician, I’m acutely aware of what Medicaid expansion would mean in NC

Welcome to NC Voices, where leaders, readers and experts from across North Carolina can speak on issues affecting our communities. Send submissions of 300 words or fewer to opinion@charlotteobserver.com.

Medicaid in NC

North Carolina’s missed opportunity — and, in my opinion, our shame — is our ongoing failure to expand Medicaid under the Affordable Care Act.

By expanding Medicaid, more than 620,000 people in our state would be able to see a doctor, get medications and get the affordable treatment they need to live full lives.

As a family physician and a Black mother, I am acutely aware of the role that lack of access to a continuum of care plays in our nation’s ongoing Black maternal mortality crisis.

Compared with white women, Black women are less likely to get some or any of the 13 to 14 prenatal visits that are recommended. Black women die at a rate 2.5 times higher than white women.

In states that expanded Medicaid, the mortality rate among Black infants fell by more than twice the rate in states that refused to expand Medicaid.

Expanding access to care is important, but only part of the solution. Because of implicit bias among healthcare professionals Black mothers often don’t have their pain or other concerns taken seriously.

I know that to be true because it happened to me. Despite being a healthy practicing physician in Charlotte, when I presented to the ER just 10 days postpartum with chest pain, I was initially misdiagnosed. I was almost sent home before thankfully being correctly diagnosed with an acute heart attack from Spontaneous Coronary Artery Dissection, a condition associated with the postpartum period for some patients.

If this can happen to someone like me — educated and with private insurance — I can only imagine what others may face.

For pregnant women and hundreds of thousands of North Carolinians, Medicaid expansion would mean healthier, longer, more fulfilling lives. Our elected officials should move to expand Medicaid now.

Dr. Jonisha Brown, Charlotte

Rural broadband

The writer is a Mooresville native who is an economic development specialist in Beaufort County.

I grew up in suburban Charlotte where the solution to internet trouble typically required a simple restart of the router or switching to one of many other providers. I never realized there were people in my home state unable to access the digital world because they lack broadband infrastructure.

According to the N.C. Department of Information Technology and the Pew Research Center (2015) seven out of 10 teachers nationwide give homework assignments that require the internet. Yet, an estimated 5 million households with school-age children lack access to the internet, often due to the absence of rural broadband infrastructure.

Lack of rural broadband is contributing to younger generations leaving rural N.C. for better opportunities. Out-migration impacts our workforce, often eliminating rural N.C. areas from consideration by companies seeking expansion and relocation destinations.

That’s why the N.C. Economic Development Association is advocating aggressively for broadband solutions that ensure businesses, residents and students across the state have access to the ever-increasing global economy.

Just as digital educational resources help prepare students for sustainable careers, telehealth applications have the potential to improve healthcare access for rural patients and save lives.

I suffered a COVID-19 infection in February. Thanks to telemedicine and broadband access, I was able to access my doctor virtually three times without exposing an emergency room or doctor’s office. Rural America needs this option.

The American Rescue Plan is extending massive federal resources to states and communities for broadband, with additional appropriations likely when Congress passes an infrastructure bill.

Lack of broadband is a solvable problem. The time is now. NCEDA and other organizations are urging governing entities to create a bold, specific plan with American Rescue Plan allocations designated for connectivity.

Achievable solutions are critical for students and schools, for telehealth, business creation, economic growth and sustainable prosperity.

Elizabeth Underwood, Greenville