It has been over a year since the August 31, 2024, closure of a beloved community hospital in Ayer, Massachusetts following the bankruptcy of the private equity-backed Steward Health Care system. The impacts of the Nashoba Valley Medical Center closure continue to reverberate across this rural working-class region, adding to a growing sense of abandonment and frustration that has accumulated over waves of health care service cuts.

Although the United States is a high-income nation, it experiences a significant burden of maternal mortality incidence relative to other countries. In 2023, non-expansion Medicaid states had 27.7 percent higher pregnancy-related deaths than expansion states. The COVID-19 pandemic also exacerbated racial disparities in pregnancy-related deaths. Historically, marginalized populations, including low-income populations and Black and Indigenous communities are more vulnerable to preventable pregnancy-related deaths.

Disparities in access to health care persist for individuals with low incomes and Black, Hispanic/Latinx and Native American/Native Alaskan individuals and are particularly acute in behavioral health. Behavioral health care utilization rates among Black, Hispanic, and Asian adults are less than half those of White adults. These disparities exist because of barriers in access such as limited provider networks, poor language access, a lack of culturally-aligned services, and technological barriers to telehealth. Working with health providers to create inclusive and accessible services is essential to building more equitable access to behavioral health care, and to healthier and happier families and communities.