A group of health care providers. (Getty)
The Alabama Department of Public Health has launched a campaign against cervical cancer, which recently drew praise from New York Times columnist Nicholas Kristof.
“Blue states would save lives if they followed Alabama on that one,” he wrote.
Raising awareness of cervical cancer is undoubtedly good. But blue states aren’t in the same situation as the Yellowhammer State.
Women’s health: An Alabama struggle
Stories in this series:
- Alabama women’s health outcomes trail the nation. Systemic problems and a lack of access play a major role.
- Abortion is banned in Alabama. But Alabama women are still seeking abortions.
- Cervical cancer rates are unusually high in the state. These women are trying to raise awareness of it.
- Intimate partner violence is a problem in the state. And victims struggle to access resources.
- Why are maternal units in decline in Alabama?
- Heart disease hurts Alabama. Alabama women face major challenges.
- In a state with a near-total abortion ban, access to contraception is critical. Alabama makes it hard.
Alabama has some of the worst cervical cancer rates in the nation. It stood at 8.9 per 100,000 in 2020, according to the Centers for Disease Control and Prevention. Only Oklahoma had a higher rate.
And why is that?
Women in Alabama — particularly women in minority groups and women in rural areas — have a harder time getting to screenings that could catch cervical cancer early. There are just four gynecologists in the Black Belt. Many women don’t have access to or simply don’t know the options available to them.
It’s good that ADPH is launching a campaign against cervical cancer.
But the recently-approved General Fund budget allocates about $600,000 for breast and cervical cancer screenings. That same budget gives $750,000 to the U.S.S. Alabama Battleship and $932,000 to the Governor’s Mansion Authority.
I’m sure those last two causes are worthy. ADPH works with what the state government gives them. And every health care provider in the state has to confront centuries of racism and poverty that have led to appallingly divergent health care outcomes.
But if screenings are an effective way to save women’s lives, shouldn’t we be pumping a lot more into them?
This Legislature has no hesitancy banning gender-affirming care because of some uncle’s Facebook post. Yet they shrug in the face of a health care crisis. And sometimes, they create crises.
The toll on women
In Dobbs vs. Jackson Women’s Health Center, the U.S. Supreme Court used tendentious logic to strike down federal protections for abortion rights. Alabama Attorney General Steve Marshall ran so fast to enact the state’s near-total ban on abortion after the ruling that you’d think someone was trying to ask him about the January 6 attack on the U.S. Capitol.
It wasn’t easy to get an abortion in Alabama before Dobbs. There were three clinics offering abortion services at the time, and none south of Montgomery. The state also imposed waiting periods and building requirements on abortion clinics that other health care facilities did not have.
But when Alabama and most of its neighbors cut off abortion services last year, it not only burdened women – grown, adult women who can make their own choices – who wanted to end pregnancies. It also burdened pregnant women who want to have children but suffer life-threatening complications that require abortions.
Defenders of the abortion ban point to language in the law that allows abortions for life-threatening emergencies. But if you’re a doctor, are you going to want to test a law that could put you in prison for 99 years for trying to save a woman’s life? (Some of our lawmakers would like to throw the woman in prison, too.)
Abortion is health care. So is cervical cancer treatment. And maternal health care. And medication for heart disease. And contraception. And resources for women suffering from domestic violence.
Looking at women’s health
This week, in commemoration of the Dobbs anniversary, we’re looking at the state of women’s health care in Alabama. If there’s one theme you’ll see, over and over again, it’s how health care outcomes are so much worse for Alabama women because of a lack of resources, a lack of access to care, and, perhaps, a lack of interest.
Alabama women are more likely to be without health insurance than the rest of the nation, and more likely to report fair to poor health care outcomes. Those numbers are significantly higher for Black women.
A lack of access to health care, especially in rural areas, takes a major toll. The difficulties women can face getting cervical cancer screenings is a big reason cervical cancer is a problem in Alabama. The state doesn’t have nearly enough shelters for domestic violence victims. And closing hospitals and shuttering health care centers take an endless toll on women in rural areas.
There are solutions. You can put more money into cancer screenings. Spreading the HPV vaccine will go a long way toward cutting cervical cancer rates. (The ADPH recommends making the vaccine available at pharmacies without standing orders.)
Medicaid expansion would improve health care access for all Alabamians. A new pool of insured people would shore up the state’s rural hospitals and create more demand for providers.
But none of this can happen without lawmakers who take the real health care problems in Alabama as seriously as the ones they make up.
If they could panic a little less about those and a little bit more about the problems staring them in the face, we might be a state worth emulating.
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