A report by the research and advocacy group Human Rights Watch this week, Alabama is betting on the highest rate of deaths in cervical cancer in the nation.
Cervical cancer mortality rates are not as high as many other cancers could be much lower, according to the report.
Cervical cancer is very curable if it is caught and treated early. And it should be easy to catch: it takes 10 to 15 years for a virus to develop that causes HPV to develop into cancer. Early detection leads to a survival rate of 93 percent.
But cervical cancer kills more than 1
The report condemned what he called the "Alabama patchwork health care system," citing in particular the government's refusal to expand Medicaid as a major cause of the problem.
Alabama joins Texas with the most stringent Medicaid authorization levels. Unlike many other statesmen, most low-income Alabamians are not eligible for Medicaid unless they are pregnant or disabled.
Gov. Kay Ivey's new proposal to supplement Alabama Medicaid with work demands could launch another 8,700 Alabamians ahead of Medicaid, according to the report. This is partly because janitors – who are currently insured under Alabama Medicaid – would have to work at least 20 hours a week, and if that were the case for minimum wage, most would go beyond income limits and not qualify for coverage.
Alabama has a collection of public programs that can help low-income women carry out screening, diagnosis or treatment of cervical cancer. However, according to the report, these programs suffer from underfunding.
They also cover different aspects of care, have different eligibility requirements or require long-distance travel for women in rural areas. This means that for women, especially those living in poor rural areas, it can be complicated to get all the services they need.
According to the report, Alabama is unique because it has high cervical cancer screening rates, but also the highest cervical cancer mortality rate in the nation. According to the report, inequality in diagnosis and treatment after screening varies widely.
Approximately 82 percent of Alabama women eligible for early detection of breast cancer and cervical cancer under the Alabama program are reportedly ineligible. And those who often do not get the required follow-up examinations or treatments.
To fix this problem, Alabama has a lack of OBGYNs. More than half of Alabama's counties have none, and many are bundled in and around the Black Belt.
The state is taking some steps to investigate the problem.
This year, the state has set up the Alabama Study Commission on Gynecologic Cancer, which will report on the findings and recommendations by March 2019.
There is also a growing chorus of voices calling for Medicaid expansion in Alabama, including retired legislators and Alabama hospitals.