By the time the worst of COVID-19 subsided in 2022 and trigger laws banning most abortions were put into place following the repeal of Roe v. Wade, Kentucky was already one of the worst-performing states when it came to women’s health.
The insights come from the Commonwealth Fund’s 2024 Women’s Health and Reproductive Health State Scorecard, the first ranking to examine health outcomes, insurance coverage, abortion restrictions and other measures for every state and Washington, D.C.
The data is primarily from 2021 and 2022 and was primarily collected from public agencies such as the Centers for Disease Control and Prevention.
The report released Thursday found that Kentucky has far fewer obstetric care providers in 2022 than the national average, with 69 per 100,000 women ages 15-44, well below the national average of 79.
According to the report, Kentucky women ages 18 to 44 are less likely than the national average to visit a health care provider for regular screening.
“Based on the evidence and data, one thing is clear: the health of women in the United States is in a very vulnerable state,” Dr. Joseph BetancourtThe Commonwealth Fund president said this at a press conference on Wednesday.
“There are significant disparities in women’s access to quality health care across states and across racial, ethnic and socioeconomic lines,” Betancourt said. “While these inequities have undoubtedly existed for many years, recent policy choices and judicial decisions that limit access to reproductive health care have exacerbated and may continue to exacerbate them.”
Betancourt said the report’s purpose is to provide states and the country with “an important baseline to track the ripple effects” of a 2022 U.S. Supreme Court decision overturning constitutional abortion rights and “the impact of new policy restrictions on reproductive health care.”
Where a woman lives can say a lot about her ability to access any kind of medical care and afford it, the researchers said Wednesday at a national press conference.
“Geographic disparities among U.S. women, particularly those of reproductive age, appear to be deepening and widening in their ability to access important health care services and stay healthy,” said Sarah Collins, one of the study’s authors.
Kentucky enacted a “trigger” law after the Supreme Court overturned Roe, and abortion is now banned in most cases in the state.
Also in 2022, Kentucky voters rejected an anti-abortion amendment that would have clearly stated that there is no right to abortion in the Kentucky Constitution.
Kentucky has no exceptions for rape or incest, but Republican and Democratic lawmakers have introduced unsuccessful bills in recent years to change that. Exceptions are allowed if the pregnant woman’s life is at risk.
The Scorecard report “broadly reflects what was happening in 2022,” explained one of the study’s authors, David Radley, “that is, after the main impacts of COVID, but before or roughly contemporaneous with the implementation of state abortion bans immediately following the Dobbs decision.”
“We will be updating this report over time to track how state policy actions, particularly new restrictions on access to abortion services, affect women’s health and the care they receive,” Radley said at a press conference Wednesday.
Kentucky’s maternal and infant mortality rates are higher than the national average
Key takeaways from the report include:
- From 2020 to 2022, Kentucky’s maternal mortality rate during pregnancy or within 42 days of an abortion was 31.4 per 100,000 live births, higher than the national average of 26.3.
- In 2021, Kentucky had a higher infant mortality rate than the national average, at 6.2 deaths per 1,000 births compared to the national average of 5.4.
- The all-cause mortality rate for women ages 15-44 in 2022 is 176.3 deaths per 100,000, well above the national average of 110.3. Kentucky is one of the worst states in the country in this regard. “Suicide, cancer and pregnancy complications are the leading causes of death for women in this age group,” Radley said. If you or someone you know is thinking about suicide, please call or text the Suicide Prevention Lifeline at 988.
Some data was unavailable for Kentucky, including the percentage of women who were asked about depression during postpartum care and the percentage of women who received a flu shot before or within a year of giving birth.
The report also did not provide information on the percentage of women who self-reported symptoms of postnatal depression or the percentage of women who experienced intimate partner violence during childbirth.
Other takeaways from the report include:
- Seventy-three percent of Kentucky women ages 50 to 74 reported having a mammogram in the past two years, compared with the national average of 77%.
- Eighty percent of Kentucky women ages 21-65 reported having a Pap smear in the past three years, compared with the national average of 82%.
- Among Kentucky women age 65 and older, 69% had received the pneumonia vaccine, compared with the national average of 73%.
- Thirty-three percent of Kentucky women ages 18-64 have been tested for HIV or AIDS, compared with 44% nationally.
- Sixty-five percent of Kentucky women ages 45-74 reported having had a sigmoidoscopy or colonoscopy in the past 10 years or a fecal occult blood test in the past two years, compared with a national average of 60%.
A silver lining
Although Kentucky performed poorly overall, the data shows there are some areas in which the state performed better than the national average.
For example, in 2022, 6% of Kentucky women ages 19-64 reported not having health insurance, lower than the national average of 10%.
Additionally, in 2022, 12% of Kentucky women ages 18-44 said they needed to see a doctor in the past year but couldn’t afford it, lower than the national average of 17%. Kentucky women in this age group are also more likely to identify someone who they consider their health care provider.
“It’s disheartening to see growing health disparities for women across the country,” Dr. Laurie C. Zephirin, senior vice president for advancing health equity at the Commonwealth Fund and one of the study’s authors, said in a statement.
“Our nation’s fragmented access to reproductive health care will make closing these widening disparities even more difficult, especially for low-income women and women of color in states with limited access to reproductive health care,” Zephirin said. “Rather than restricting care, federal and state policymakers should work to ensure women have full access to health care throughout their lives.”
Founded in 1918, the Commonwealth Fund is a charitable foundation focused on promoting “a high-performing, equitable health care system that improves access, improves quality, and increases efficiency, especially for the most vulnerable in society: people of color, low-income people, and the uninsured.”
This story originally appeared on kentuckylantern.com.
