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The Health 202: Buttigieg courts African American and Hispanic voters with a focus on their health

with Paulina Firozi


Pete Buttigieg unveiled a proposal this morning to correct troubling health disparities among African Americans and Hispanics — a crucial constituency to win over to have any hope of securing the Democratic presidential nomination.

The South Bend, Ind., mayor's eight-page proposal pledged to even the playing field for minorities who typically have worse access to medical providers and much higher rates of obesity, diabetes, heart disease and other chronic health conditions compared with white Americans. 

Buttigieg has surged in the polls to lead the Democratic primary contests in Iowa and New Hampshire. But he’s in trouble in subsequent primaries in Nevada and South Carolina, where strong support from African American voters has given former vice president Joe Biden a strong lead.

Buttigieg has been criticized for his handling of racially-charged incidents within his city’s police department and has only a smattering of endorsements from black or Hispanic elected officials. That could be a huge stumbling block for his campaign, considering no Democrat in the last three decades has secured the party's nomination without a majority of black support.

Even the Onion has mocked Buttigieg’s struggles:

Buttigieg is hoping to help correct this problem with promises to make the health of minorities — both through direct medical care and indirect aspects such as housing, food, education and access to clean water — a top priority. 

He promises that in his first 100 days as president his administration would develop a “National Health Equity Strategy.” He also vows to help particular geographic areas combat the worst disparities and to support programs to train the health-care workforce to overcome racial bias when treating patients.

The disparities are particularly stark when it comes to life expectancy. A black man living in a rural community is likely to live seven years less than a white man living in a city. Black life expectancy at birth is about three and a half years lower than that of whites. The mortality gap between black and white Americans been cut in half since 1999, but the United States still has a long way to go before it’s eliminated.

“Millions of Americans today still find their health determined by who they are or where they live,” the paper says. “Systemic discrimination takes the form of a doctor who takes a Black person’s pain symptoms less seriously … it manifests in a hospital system that breaks ground only in a predominantly white neighborhood.”

The paper also calls for improvements in black maternal health, an area that has recently undergone increased scrutiny as celebrities including Beyoncé and Serena Williams have spoken out about their own struggles with pregnancy and childbirth. Black women are three to four times as likely to be at risk of pregnancy-related deaths as white women, according to Centers for Disease Control and Prevention data.

It’s hard to overstate Buttigieg’s need to inspire confidence among black voters in particular. They’re only a tiny sliver of the electorate in the earliest primary states, but they’re much larger voting blocs in nearly every primary that comes after. Minorities comprise more than one-third of Democratic voters in the 16 states with primaries on March 3, known as “Super Tuesday.”

For now, Buttigieg is focusing on South Carolina. He’ll meet with Latino community leaders and locals in Okatie, S.C., at noon today to discuss health equity, a spokeswoman said. On Sunday, the mayor attended services at a church led by the Rev. William J. Barber II, who revived a campaign originally started by Martin Luther King Jr. to combat economic inequality.

Afterward, Buttigieg told reporters that he believes he is making progress with black voters, including those “who may yet not feel that they know me,” per the Associated Press.

“Part of what I’m trying to do is talk about these issues, including specific racial issues around voter suppression and systemic racism, in a way that helps everyone in the country understand why we all have a stake in dealing with it,” Buttigieg said.

The campaign is opening four offices and hiring 40 staffers in the state. The campaign launched its first ad there yesterday, spending $2 million on a spot that features the mayor listening to a racially diverse group of voters.

The ad:

By releasing yet another health-care proposal among the many coming out of his campaign over the last few months, he seems to be adopting the sort of “plan for everything” style his opponent Sen. Elizabeth Warren (D-Mass.) was first known for. 

One of his other proposals is “Medicare for all who want it,” which would retain employer-sponsored coverage while allowing anyone to buy a public plan if they preferred. The approach, which the mayor rolled out over the summer, is strikingly similar to the public option plan championed by Biden — so much so, that Biden accused Buttigieg yesterday of stealing his idea.

“[Buttigieg] doesn’t have the enthusiasm and the moderate — moderate plan,” Biden said in an interview with Politico. “It’s the Biden plan.”

My colleague Matt Viser:


AHH: Three state lawmakers published op-eds attacking Medicare-for-all that were written with the help of lobbyists that either wrote drafts or made extensive edits, our Washington Post colleague Jeff Stein reports, citing emailed obtained by The Post.

Montana state Rep. Kathy Kelker (D) and Sen. Jen Gross (D) said op-eds they wrote about single-payer health proposals included language from lobbyist and consultant John MacDonald. Meanwhile, an aide to Ohio state Sen. Steve Huffman (R) told The Post the lawmaker published an op-ed with assistance from lobbyist Kathleen Deland.

“None of the lawmakers’ columns discloses that they were written with the help of a lobbyist,” Jeff writes. “The emails show how, even at the state and local levels, lobbyists are trying to bend public opinion away from an idea that has seized much of the debate during the current Democratic presidential primary. … The documents were provided to The Post by the nonprofit advocacy group Medicare for All Now, which supports the single-payer system. The group obtained the documents through Freedom of Information Act requests.”

Jeff adds that neither of the consultants would say whether they had been hired by the Partnership for America’s Health Care Future, a group that’s spent more than $1 million on ads warning against Medicare-for-all and other overhauls to the nation’s health-care system. A spokesman for the group also wouldn’t confirm or deny having hired MacDonald or Deland.

OOF: The stigma of addiction and criminal activity related to opioid abuse remains a barrier for victims seeking damages, our Post colleague Christopher Rowland reports, citing alleged victims, plaintiff lawyers and legal specialists.

“Prescription opioid abusers often are perceived to share the blame for the serious harm they experienced through addiction to prescription pills, recovering users contend,” he writes. “Unlike those injured by asbestos, medical implants or faulty automobile bags, courts have been reluctant to accept their claim that their addiction was the result of a dangerous, improperly marketed product.”

Christopher writes the settlement reached between OxyContin maker Purdue Pharma and Oklahoma directed $200 million to the University of Oklahoma for a research and addiction treatment program, with another $12 million to local governments and $60 million for legal expenses.

“None of the settlement money was earmarked directly for victim compensation,” he writes. “Victim-compensation funds also have not yet been floated as part of the national-level settlements being negotiated by governments and manufacturers. The most tangible benefit for victims so far has been proposals for free anti-addiction and overdose-rescue drugs to individual communities.”

OUCH: About a fifth of adolescents ages 12 to 18 in the United States are now prediabetic, as are nearly a quarter of young adults ages 19 to 34, according to a new study published in the journal JAMA Pediatrics.

The data found the rising rate of young people who are prediabetic, meaning their blood sugar levels are elevated but not quite high enough to be diagnosed with Type 2 diabetes, means the age groups are at risk for developing the condition, CNN’s Michael Nedelman writes.

“Until recently, young children and teens almost never got type 2 diabetes, which is why it used to be called adult-onset diabetes,” according to the Centers for Disease Control and Prevention. “Now, about one-third of American youth are overweight, a problem closely related to the increase in kids with type 2 diabetes, some as young as 10 years old.”

“Prediabetes was also more common among young people with obesity, which is also closely linked to Type 2 diabetes in adults. More than a quarter of obese adolescents and more than a third of obese young adults were found to have prediabetes — versus less than 17% of individuals with normal weight in both age groups,” Michael writes.


— A bicameral group of Democrats have filed an amicus brief urging the Supreme Court to block a restrictive Louisiana abortion law that would require doctors at abortion clinics to have admitting privileges at nearby hospitals.

House Speaker Nancy Pelosi (D-Calif.) and Senate Minority Leader Charles E. Schumer (D-N.Y.) announced the brief that includes 161 House Democrats and 36 Senate Democrats.

“Lawmakers said the case still represents a direct challenge to the landmark abortion case Roe v. Wade, even though Louisiana and its supporters have not asked the Court to formally overturn Roe,” the Hill’s Nathaniel Weixel reports. “The Democrats said upholding Louisiana’s law would allow states to effectively eliminate abortion.”

“While Act 620 purports to improve women’s health and safety, the law will actually make it more difficult for women in Louisiana to obtain safe medical care,” the lawmakers wrote. “As with other statutes targeting abortion providers and facilities, the actual legislative intent here is to mandate requirements so difficult to fulfill that the inevitable outcome is the shuttering of abortion clinics and elimination of safe and legal abortions. Indeed, if Act 620 goes into effect, Louisiana will have only a single clinic providing abortion services in the entire state.”

The Supreme Court is scheduled to hear oral arguments for the case in March.


— Michigan Gov. Gretchen Whitmer (D) wants state lawmakers to work with her to halt the implementation of the state’s Medicaid work requirements amid concerns that people will lose health coverage,’s Malachi Barrett reports.

“Starting next year, most able-bodied adults between the ages of 19-61 who are enrolled in Michigan’s Medicaid expansion will have to work an average of 20 hours per week or 80 hours per month,” Malachi writes. “Whitmer said pausing the ‘punitive’ requirements is the ‘most reasonable thing’ to prevent people from losing health care coverage.”

A coalition of state and national health groups last month filed a lawsuit against the Trump administration to stop Michigan from implementing its work rules. Other legal challenges have been filed against work requirements in Kentucky, Arkansas and New Hampshire, as well as in Indiana, which said it would pause its requirements until the case is resolved.


— And here are a few more good reads: 

Samoa government to close for two days amid measles outbreak that has killed dozens of children (Kayla Epstein)

Supreme Court debates whether gun restrictions case is still worth considering (Robert Barnes)


Amazon Web Services launches Transcribe Medical speech recognition service for clinicians (FierceHealthcare)


Uncharted Territory on Abortion Politics (New York Times )


Medicare open enrollment ends soon; here’s what you need to know (Thomas Heath)


The Class of 2000 ‘Could Have Been Anything.’ Until Opioids Hit. (New York Times)



  • The Senate Health, Education, Labor and Pensions Committee holds a business meeting to consider nominations, including Stephen Hahn to lead the Food and Drug Administration.

Coming up

  • The House Energy and Commerce subcommittee on oversight and investigations holds a hearing on flu season preparedness and response on Wednesday.
  • The Senate Armed Services subcommittee on personnel holds a hearing on “servicemember, family, and veteran suicides and prevention strategies” on Wednesday.


White House video shows first lady Melania Trump walking through the monochromatic wonderland she designed for the 2019 holiday season. (Video: The White House)