NEW YORK – The New York state budget now allows low-income mothers to get donor breast milk for premature babies through Medicaid. Low-weight, premature infants are at high risk of dying from necrotizing enterocolitis, or NEC. The best food to help them ward off the disease is human breast milk, but some mothers don't produce enough.

According to Julie Bouchet-Horwitz, executive director of The New York Milk Bank, it costs about $3,200 to supply enough donor milk for each premature infant while he or she is in the hospital. But treating NEC can cost $350,000.

"For every six babies that you treat with donor milk, you save one incidence of NEC, so it's definitely cost effective for them to prevent this disease," she said.

Pasteurized donor human milk costs $4.50 an ounce. The nonprofit New York Milk Bank is the only donor milk bank operating in the state.

About 3,300 premature infants are born in New York each year, and the availability of Medicaid coverage could increase the demand for donor milk. Although the New York Milk Bank just opened last September, Bouchet-Horwitz says they're ready.

"We knew that about 200,000 ounces would be needed to feed these babies," she added. "We planned to meet that need and have everything in place for when this happened so that's what we prepared for."

Private insurance doesn't pay for donor breast milk, but some infants are being covered on a case-by-case basis.

Bouchet-Horwitz thinks the availability of Medicaid coverage may spur insurance companies to add breast milk to their policies and lead to an overall increase in breastfeeding.

"We're hoping that this will infiltrate down to the public in general the importance of human milk and how species-specific it is, what a specialized food it is and first food for all babies," she explained.

Several other states already provide Medicaid coverage for donor breast milk.


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Nurses are on the forefront of patient outcomes, and experts say a workforce that better reflects the population it serves can help reduce healthcare disparities.

In Ohio, people of color are under-represented in the nursing workforce. The percentage of nursing school graduates who are Black or Hispanic is lower than the percentage of the general population.

Associate Provost for Social Mission and Academic Excellence at Chamberlain University Dr. Kenya Beard has studied the issue of improving diversity in the nursing profession.

"Diversity among health professionals is associated with improved access to care, and the two overarching issues is access and quality," said Beard. "So, greater patient choice and satisfaction when we have a diverse workforce; it's better patient-clinician communication."

Beard noted that diversity is multi-dimensional, and includes race, ethnicity, socio-economic factors and gender. For example, men represent only 12% of nurses.

Beard said improving diversity in the profession starts with a more inclusive learning environment. She explained that when students sees themselves represented among the faculty, they realize a nursing degree is something they can achieve as well.

Beard explained that unconscious attitudes among medical professionals can impact patient outcomes.

For example, because of their own life experience, a nurse might assume incorrectly that a patient has the resources to drive to a pharmacy and purchase a medication when they leave a hospital.

"When you bring people into a learning environment that have different experiences," said Beard, "not just based on race but based on socioeconomic factors as well, these different experiences create a rich, robust dialogue that helps everyone understand how these social determinants of health impact patient outcomes."

Beard added that with culturally responsive teaching, nursing educators strengthen students' ability to recognize and respond in an inclusive way to diverse perspectives.

"When these students graduate," said Beard, "they are better positioned to have a conversation with patients and their colleagues in a way that shows cultural humility and a greater degree of understanding the difficulties of navigating healthcare and achieving your best level of health."

Chamberlain University, which has locations in Columbus and Cleveland, has what's called a Social Determinants of Learning model.

Beard said it addresses disparities and expands opportunities by focusing on barriers to student success, including economic, housing, and transportation insecurity, and psychosocial health

Many New Yorkers will be shopping for new health insurance plans this month, when open enrollment begins. If you are among them, experts advise it is important to be aware of exactly what you are getting.

New Yorkers pay some of the highest health care premiums in the U.S., second only to Alaska.

According to a study by the Empire Center, insurance costs here average more than $8,500 a year, which is more than $1,000 higher than the national average. No matter the cost, every health plan has its limitations.

Dr. Rhonda Randall, chief medical officer for UnitedHealthcare employer and individual, noted it is up to you to ask about what the plans cover, including any mental-health options.

"In addition to in-person mental health care, you might have access to a very large virtual network of licensed mental health professionals, like therapists and psychiatrists," Randall pointed out. "Some insurers also offer digital tools for mental health, and advocacy services to help you navigate those needs."

She stressed adding dental, vision or hearing coverage is another consideration, as well as double-checking whether the plan covers prescriptions. In short, she recommended people do their homework, as enrollment dates are fast approaching.

There are some elements of a plan Randall acknowledged people do not typically consider, but should. For example, how would the plan handle a significant health event, or a chronic health condition? And she added the pandemic has also influenced the services many insurers provide.

"Plans that include virtual care services for both medical conditions as well as behavioral health conditions have become very popular," Randall observed. "We've seen the utilization of those increase. You're also looking for a plan that has not only virtual health options, but a connection to in-person care as well."

Above all, Randall emphasized having health coverage is the most important thing, including the kinds of care you and your family need.

COVID upended many routines, including Texas parents getting kids in for regularly scheduled childhood vaccines. Data from the Texas Department of State Health Services showed the childhood vaccination rate dropped during the pandemic.

Starting in June, the Hispanic Access Foundation partnered with the U.S. Department of Health and Human Services to bring COVID-19 vaccine clinics to Latino churches in three Texas communities.

Aurie Garcia, secretary of Hope of Life Church of God in Houston, said COVID is still top of mind for many people, but children need protection from a variety of potential illnesses.

"And it's very important to protect the children," Garcia stressed. "Because they go out, they go back to school, so it's very important for them to have the COVID vaccine and the other vaccines."

If you have not kept track of immunization records, they're available from state-run immunization information systems.

A study published in the journal Vaccine found from 2019 to 2020, immunization rates fell 47% among five-month-olds and 58 % among 16-month-olds.

Garcia noted some Hispanic people avoid doctors because they're worried materials won't be available in Spanish and a translator will not be on site. She added it is a way the Hispanic Access Foundation can help.

"We explain to them that we partner with the Health Department in Houston," Garcia remarked. "I am bilingual, I speak Spanish; that's my primary language, and Harris County Department, they also have some of their people that speak Spanish."

Health care providers say many families skipped doctor's visits during the pandemic to avoid exposure to the COVID virus. Other parents do not immunize children for religious reasons, and still others are worried about potential health problems associated with some vaccines, although the risks are reported to be extremely small.