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Patricia Goodhines is an assistant professor of clinical psychology at the University of Maine, specialized in behavioral medicine and social determinants of health. This column reflects their views and expertise and does not speak on behalf of the university. They are a member of the Maine chapter of the national Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications. Members’ columns appear in the BDN every other week.
As reproductive freedom and LGBTQIA+ rights face continued threats across the nation, Maine has emerged as a leader in defending our rights to healthcare. However, despite major strides for individual and community wellness, some of our most vulnerable neighbors remain unprotected.
Our health and well-being depend on good social policy. “Social determinants of health,” or the conditions in which people live, work, and play, directly influence our physical and mental health. For example, the conditions of living in poverty have been directly linked to mental illness. Policy reform is therefore the most impactful way to improve overall public health. Even economic or environmental policies can ultimately have far-reaching effects on individual and community health.
Social policy restricting access to healthcare is extremely dangerous. For example, people denied abortion care suffer from more anxiety, health problems, financial struggles, and risk of domestic violence – especially people of color and individuals living in poverty. Additionally, restricting access to gender-affirming care has been linked to depression and suicide, particularly for youth in otherwise unsupportive environments. These healthcare restrictions can be especially harmful in rural areas like Maine, given elevated risks of drug overdose and suicide combined with lack of access to behavioral healthcare. When lawmakers make healthcare difficult to access, they are directly contributing to the ongoing mental health crisis.
The Maine Legislature passed several landmark healthcare policies this session. I believe expansion of abortion access later in pregnancy is a major win for reproductive justice, empowering pregnant people to make healthcare decisions directly with their providers. We also saw several groundbreaking wins for transgender health, enshrining MaineCare coverage of gender-affirming care into state law and protecting gender-affirming care for older teens. Additional policies that will benefit community health include funding for paid family and medical leave, increased access to the Medicare savings program, and expanded access to substance use treatment and overdose protection. Legislating access to healthcare is life-saving community care and suicide prevention.
There is no health equity without racial justice. Lawmakers this session failed to pass critical bills which would have allowed Wabanaki Tribes self-determination to fully participate in federal law, as well as New Mainers access to MaineCare regardless of immigration status. Further, an act to prevent opioid overdose deaths by authorizing harm reduction health centers failed to pass, which would have benefited rural communities devastated by the opioid crisis. When policies fail to address the diverse needs of everyone in a community, inequality becomes entrenched within the very systems meant to protect us. Health policy is social justice and must be intersectional.
When it comes to Mainers’ health, the personal is political. This year’s legislative strides demonstrate that Mainers value the freedom to make their own decisions about their healthcare. When healthcare policies place decision-making power in the hands of individuals, communities are healthier and function better for generations to come. Unfortunately, racial justice activism in predominantly White spaces often falls short. Be sure to thank your representatives for standing up for your rights and freedoms, but also continue demanding social policy centering the needs and voices of Wabanaki and New Mainer communities. In the words of civil rights activist Fannie Lou Hamer, “Nobody’s free until everybody’s free.”
