Reproductive justice, according to the definition used by SisterSong Women of Color Collective, is defined by the ability of a person to decide if and when they will have a baby, choose the conditions under which they will give birth, access prevention and termination if they do not wish to have a baby, and parent the children they do have with the necessary social supports in safe environments and healthy communities, without fear of violence from individuals or the government. Because Dallas County is responsible for public health and safety, the Texas Equal Access Fund and Texas Freedom Network believe that it is imperative that the County adopt a reproductive justice agenda to ensure that residents are living in communities where health and safety are supported in equitable ways. If people are going to feel supported in making the reproductive decisions they feel are best for themselves, we must create true justice.
The key to healthy and safe people, families, and communities is to adopt policies regarding family planning, abortion access, health care access, sexuality education, discrimination, policing, immigration, and housing that are truly comprehensive and recognize bodily autonomy and individual decision-making power.
Between 6 and 7 million Texans do not have health care coverage. As of 2014, 22 percent of the residents of the City of Dallas were uninsured. Beyond a lack of health care coverage, there are other barriers to health care access. There are approximately 1.6 million undocumented immigrants in Texas, and 16 percent of those live in Dallas County. Undocumented people may experience a variety of barriers when attempting to access health care, including the fear of deportation. A lack of public funding for abortion creates a barrier between those on Medicaid and other forms of federal health insurance and access to a truly comprehensive set of health care options. Research has shown that Texas has a higher premature birth rate than the national average, and that the rate is twice as high for babies born to black women than it is for babies born to white women or Latinas. People of color disproportionately face barriers to all forms of health care and are at greater risk of negative consequences from policies such as bans on public funding for abortion or lack of access to insurance coverage.
In Texas the state of health care access generally, and reproductive health care access specifically, is in bad shape. Statewide family planning budget cuts, the unwillingness of state officials to expand Medicaid coverage or create a statewide insurance exchange, and unnecessary restrictions on abortion providers have devastated Dallas County residents’ ability to access comprehensive health care. Rates of teen pregnancy and sexually transmitted infections (STIs) illustrate a need for age-appropriate, fact-based sexual health education. Incidents of police brutality have created tensions between communities of color and immigrant communities and the police and contribute to unsafe communities for people of color, and housing discrimination in Dallas County for those seeking low-income housing has been acknowledged by the Supreme Court of the United States.
There are policies that Dallas County can adopt that will help improve access to health care, economic security for families, safety, and fair housing for all.
Reproductive and Sexual Health Care Access as a Public Health Imperative
Dallas County is responsible for overseeing the public health needs of those living within the county. Public health concerns include access to services that can prevent serious health problems and contribute to communities being healthy overall. It also includes access to reproductive and sexual health care, including family planning services such as contraception. Abortion care serves these public health goals. While some may fail to acknowledge abortion as health care, and reproductive health care is often treated as specialty health care that only affects a segment of the population, the truth is that access to a full spectrum of reproductive health care, including abortion, contributes to the health of the entire family and community.
All restrictions on access to reproductive health care hurt Dallas County families. Dallas County residents should be treated justly, with fairness, respect, compassion, and dignity, regardless of income, gender identity, sexual orientation, immigration status, ability, age, or any other factor.
- Dallas County residents deserve access to abortion clinics. The Dallas County Commissioner’s Court and the Dallas County Health and Human Services should work to expand access to abortion in Dallas County.
- Plan B is a safe form of contraception. It should be available, affordable, and easily accessible to those who need it. The County Commissioner’s Court should work to ensure that all County health care facilities that treat women after sexual assault inform them about Plan B as part of this care and provide Plan B upon request. The County Commissioner’s Court should work with the Department of Health and Human Services to create programs promoting public awareness about Plan B and take steps to encourage all health care providers to inform their patients about Plan B. Lastly, all publicly funded health care facilities should provide Plan B free of charge or on a sliding fee schedule.
- No one should be denied access to safe abortion care services just because they can’t afford to pay. Funding for abortion care should be available at county hospitals for low-income women who are residents of Dallas County. Dallas County should act to provide funding for abortions or absorb the cost of the procedure that falls beyond what patients can pay. Dallas County Health and Human Services, in conjunction with nonprofits currently providing financial assistance to Dallas County residents in need of abortion care, should conduct research to develop a strategy to ensure that low-income Dallas County residents are able to secure adequate funding for safe abortion care in Dallas County.
All Dallas County families should have the opportunity to raise their families in a healthy and safe environment. Dallas County should pass and enforce policies that allow for families to thrive by protecting access to health care, ensuring that new parents have job protections and addressing discrimination in public places, housing, and the workforce.
- Dallas County should expand its nondiscrimination policy for county workers to include gender identity, sexual orientation, religion, marital status, and veteran status. Currently, the Dallas County Human Resources policy protects county workers on the basis of color, national origin, sex, age, or disability. We believe that to achieve true equity for all, these protections should be expanded to include some of the most marginalized in our community. By doing so, the county sets an example for municipalities in Dallas County, as well as for the rest of the state.
- Dallas County residents should be able to access health care before, throughout, and after pregnancy. Dallas County Health and Human Services should ensure that all low-income Dallas residents have access to comprehensive prenatal and postpartum care.
- All Dallas County residents should have access to family planning, prenatal care, and other basic health care services regardless of financial or immigration status. The appallingly high uninsured rate in Texas ranks first the nation. Because our state has refused to expand Medicaid coverage, Dallas County continues to have a high percentage of people who cannot access coverage. Dallas County should make free or low-cost health care services available to all who cannot access insurance on the federal health exchange or other means, as well as to undocumented immigrants. Undocumented immigrants should be able to access health care without fear of their status being reported to the authorities.
Supporting Teens and Young Parents
Texas has one of the highest teen birth rates and the highest repeat teen birth rate in the United States, owing in large part to the lack of comprehensive sexuality education in most Texas schools. Research shows that comprehensive, age-appropriate sex education provides young people with the tools to protect themselves from unintended pregnancy and HIV/STI-related risk behaviors. Despite Texas having one of the highest teen birth rates in the United States, the state provides little support to teen parents who struggle to navigate the balance of raising a child and pursuing an education. Pregnant and parenting students need support and respect in order to succeed in school and graduate.
- All Dallas County school districts should provide evidence-based sex education from middle school through high school. Middle school students should receive tailored, age-appropriate sex education, and young people should have access to contraception.
- Dallas County school districts should empower pregnant and parenting students by providing excused absences and medical leave (protected under Title IX), childcare, breastfeeding and pumping rooms, staff training on providing nonjudgmental support, and information about resources for young families.
- Dallas County Commissioner’s Court should pass a resolution strongly condemning HB 3994, which has made abortion inaccessible for many Dallas County teens. HB 3994, which was passed by the Texas Legislature in 2015, created several onerous restrictions on judicial bypass, a court procedure designed to protect abused and neglected pregnant minors considering abortion.
Safe Environments for All Families
Reproductive justice is about ensuring that people of all races can raise families in communities that are safe. For families of color and undocumented people, a major concern when considering family safety is protection from police brutality and the threat of deportation. Instances of police brutality create tension between police and the communities they should be serving and protecting, and often they highlight racial bias in our criminal justice system. The threat of deportation causes families to live in fear of being separated, and it also impedes people’s ability to safely move about their own communities. Finally, unfair housing practices cause Dallas to be one of the most racially segregated communities in the United States.
When people do not have the ability to live safely in the communities of their choice, they do not have true reproductive freedom.
- The district attorney’s office should be required to name a special independent prosecutor in cases where the offender is a police officer acting in the line of duty. Because the police department and the district attorney’s office work closely together on cases in the community every day, they have a relationship that could impair the district attorney’s office from being impartial in prosecuting issues of possible police brutality.
- All officers with the Sheriff’s department should have to undergo psychological evaluation and cultural competency training. All new hires should be subject to complete psychological evaluation, which includes an officer’s attitudes and emotions concerning people of different cultural, linguistic, national, religious, and ethnic backgrounds, and people of different gender identity and sexual orientations. All officers should receive periodic cultural competence training before assuming regular duty and then once a year after that.
- The Dallas County Sheriff’s Department should cease holding people on ICE detainers and inquiring about the immigration status of anyone they encounter. ICE does not have to have any presence in our jails, and their presence is at the discretion of the Sheriff. We call upon the County Commissioners and the Dallas County Sheriff to end 287(g) agreements between ICE and the Dallas County Sheriff’s Department.
- Dallas County should provide “Know Your Rights” information to undocumented people who are arrested.
- Dallas County should administer its housing programs in a way that affirmatively furthers fair housing and dismantles the region’s long history of racial and ethnic segregation.
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