/Inform[H]er Roundup Study highlights lacking reproductive health access for Black women in Mississippi

Inform[H]er Roundup Study highlights lacking reproductive health access for Black women in Mississippi

After the Supreme Court ruled that employers can ignore federal law and not cover birth control, reproductive health access is once again in national news. The pandemic has impacted funding and priorities at the Mississippi State Department of Health locally. Last week, Thomas Dobbs, the State Health Officer, stated that “we are going to have less reproductive health work… (like) service provision in certain communities.” It is important to prioritise our activities according to the realities of the resources we have. As state and national resources are limited, studies that examine pre-existing barriers to care will be more valuable than ever. Tanya Funchess, University of Southern Mississippi public-health professor, said that insurance is not the same as health care. This is especially true for Black women who often turn to family doctors or health departments for their reproductive care. The research reveals the complexity of barriers to culturally-appropriate reproductive health. This goes beyond the obvious barriers such as insurance and OB/GYN shortages. Funchess says that while public health professionals are aware of the health inequalities when it comes to reproductive health, there is less consensus about how to reduce them and effectively pool resources. She said, “We have a lot national data, sometimes statewide. But we don’t always have the money to go into the problems and ask: ‘Where can I penetrate ?’,”? We want to help everyone, but we also want the areas most in need of services to be targeted. “A lot of public health work happens in silos,” this and other research suggests that education should be a priority, such as sex-ed or family planning counseling, which often informs choice. The study found that Black women were more likely than white women to use birth control, and to say that their prescription was fully covered. However, they were also more likely not to have intended pregnancies. Funchess says income inequality is an important part of understanding this finding. Nearly all the 1,600 women included in the study were employed. However, Black women were nearly three times more likely than white women to have an annual income below $25,000 — almost three quarters of Black women compared to less than one third of white women. Although the income gap is not new, Funchess said that the statistically significant differences are a layer that must be removed when looking at health disparities. This is especially true for those who depend on intimate decisions like birth control. “When you have to choose between paying food, bills, and dealing with everyday problems, poverty can alter your priorities and how you access information. These things are ranked and studies have shown that people who live below the federal poverty level prioritize different decisions. Funchess hopes providers will pay more attention to provider training. “All of us have implicit biases. We have to be more open to admitting them so that we can provide the best care. Funchess recognizes that it is counterproductive to impose the “most effective” method on women, especially Black women who have been subject to discrimination in health care and involuntary sterilization. However, she wants women to be able to access all options and choose what works best for them. This will help reduce unwanted pregnancies as well as poor outcomes. “We don’t want to push any method on minority women because there has been a history of distrust there. But we want to understand that if women see family doctors or the health department, they are more likely to be prescribed moderate- to least-effective methods of contraception. This is not true for all levels of care. “Insurance does not provide health care. Women who aren’t provided with education about contraception and maternal care before, during, and after pregnancy will use what they know. – Tanya Funchess is the lead author of the study. As for the moment when the national reckoning on racial disparities takes place: “I hope people see a different lens now. They are peeling back layers, and seeing how social determinants and health can play a role in disparities. She says that unless we do something, we’ll be around for 100 more years. “But we don’t want to do that. We want to check those big boxes like women below the federal poverty threshold receiving the services they need.”