Rick Allgeyer, former director of analysis on the Texas Health and Human Services Commission (HHSC), turned a casualty final yr of raging political battles between Texas anti-abortion and abortion-rights advocates. During 2015, Allgeyer labored with a workforce of researchers from UT Austin’s Population Research Center to see what occurred after Texas ousted Planned Parenthood from the state’s Women’s Health Program in 2013.
The research examined state program claims between 2011 and 2014 to seek out modifications in contraceptive use for 2 years earlier than and after the exclusion. To measure the impact, the research in contrast common charges of Long Acting Reversible Contraception (LARC) use in counties with Planned Parenthood clinics towards these and not using a clinic earlier than and after the the state’s coverage change. Results revealed an affiliation between the change in coverage and decreased LARC use coupled with a rise in childbirth coated by Medicaid.
The analysis met criticism and anger from Texas Republican legislators when it was revealed by the New England Journal of Medicine in early March 2016. Allgeyer’s sudden retirement after serving the state for greater than 20 years was coated by by a gamut of nationwide information retailers starting from the Washington Post to Breitbart.
Episodes like this affecting health coverage are among the many causes we commonly monitor and replace a collection of statistical indicators on the standing of women’s health. In reality, this yr’s version expands the geographical protection of the ASU Women’s Health Index (WHI) to match circumstances in eight West Texas metro areas. Twenty-one city counties mix to make up the eight metro areas, which embrace the core cities of Abilene, Amarillo, El Paso, Lubbock, Midland, Odessa, San Angelo and Wichita Falls.
We rating every metro space on a 100-point scale based mostly on 18 statistical indicators regarding women’s health. Scores depend upon how every metropolis compares to the opposite seven, in addition to to the state general. Higher scores imply higher native health circumstances for women.
The Midland metro space ranks first on the health standing of women with a mean rating of 70 on the 18 indicators. San Angelo follows with a mean of 66, and the Odessa metro ranks final.
Highlights from the WHI present that West Texas metro areas usually produce constructive outcomes on offering main look after women throughout being pregnant and childbirth. Women in the regional metros are well timed in beginning prenatal care, and toddler dying charges are usually decrease in comparison with the state.
Of course, these spectacular accomplishments of San Angelo and different West Texas metros don’t imply that women face no difficult public health circumstances. Ironically, for example, obstetricians, gynecologists and pediatricians are in brief provide in six of the eight metro areas of West Texas. San Angelo and Odessa are exceptions. Given the dimensions of their respective feminine populations, these metros have a bigger provide of main care maternal and baby health suppliers than the state general.
Still, being pregnant charges amongst teenagers are almost 30 % greater throughout the metro areas of West Texas in comparison with the state, and publicity to sexual violence is bigger in most West Texas communities. In addition, West Texas metro areas usually have greater charges than the state on every of the 5 main causes of dying for women.
One silent public health challenge in West Texas is larger publicity to sexually transmitted illnesses (STDs; additionally referred to as STIs, or sexually transmitted infections). Many STDs/STIs are “silent” illnesses as a result of people could be contaminated for lengthy durations of time with out demonstrating critical signs. Epidemiological proof signifies that charges of widespread STDs corresponding to chlamydia, gonorrhea and syphilis are greater in the metro areas of the area.
Indeed, the newest report from the STD/STI Epidemiology and Surveillance Branch on the Department of State Health Services (DSHS) reviews that eight of 21 counties included in West Texas metro areas are among the many prime 25 statewide locales with the very best charges of chlamydia, gonorrhea and first and secondary stage (P&S) syphilis.
Combining instances of those STDs/STIs exhibits that Texas had an incidence price of 630.2 recognized instances of chlamydia, gonorrhea and syphilis per 100,000 residents of the state throughout 2015. The similar mixture for every of the eight West Texas metro areas yielded a better common of 731 per 100,000.
The San Angelo metro space, together with Irion and Tom Green counties, was larger nonetheless at 801.three incidents of chlamydia, gonorrhea and syphilis per 100,000 inhabitants. San Angelo residents expertise excessive danger of publicity to widespread STDs/STIs — greater danger than common for city areas in West Texas, and better danger than Texans in common.
During October 2016, the Centers for Disease Control and Prevention (CDC) launched its most up-to-date info displaying that nationwide charges of chlamydia, gonorrhea and syphilis reached an all-time excessive. The abstract reality sheet from the report warns, “Both young men and young women are heavily affected by STDs/STIs — but young women face the most serious long-term health consequences. It is estimated that undiagnosed STDs/STIs cause infertility in more than 20,000 women each year.”
Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, added in an OpEd following the report, “Many Americans face barriers in accessing STD prevention and treatment — from embarrassment to limited access to STD testing services; from financial obstacles to stigma. These barriers are even higher for young people. As a nation we don’t do enough to protect teens from STDs.”
These information level to the significance of what prompted Rick Allgeyer to stir controversy resulting in his departure from HHSC. Rough politics and actual finances cuts clearly broken women’s health services in the early years of this decade. Now, making certain that women have entry to high quality health services, together with STD/STI testing, remedy and prevention, is precedence enterprise for Texas. This applies particularly for women with low incomes in their teenage or younger grownup years.
Credit the place credit score is due — leaders have made critical efforts to shore up women’s health services in the newest years. In 2014, the State’s Sunset Advisory Commission advisable combining women’s health packages to realize improved service and effectivity. It took two extra years for HHSC to launch the brand new Healthy Texas Women (HTW) program in July 2016, with a $285 million finances.
Most lately, throughout June this yr, the State utilized for particular federal Medicaid funds over the subsequent 5 years to reinforce services by growing entry and participation of low-income Texas women in the HTW program. Financial projections in the appliance estimate serving greater than 1.eight million further women in this system between 2019 and 2023. The funding would offer STD/STI testing, remedy and prevention, together with a strong array of different women’s health services.
Of course, all efforts to revive and broaden high quality services for low-income Texas women should adjust to the present Texas regulation forbidding public spending to pay for performing or selling elective abortions, or contracting or affiliating with any entities that interact in such actions. No doubt, heated political clashes between anti-abortion and abortion-rights advocates will proceed to be a drive in Texas politics.
Still, it’s encouraging to see any chief striving to rise above the fray in help of wholesome Texas women.
An entire copy of the 2017 ASU Women’s Health Index is on the market for obtain at www.angelo.edu/dept/cdi/projects.php.
Kenneth L. Stewart is director of Community Development Initiatives on the ASU Center for Community Wellness, Engagement, and Development. Casey Jones is retired professor of political science at ASU. Contact them at firstname.lastname@example.org or email@example.com
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