‘Women’s health care is in a vulnerable position’ – Florida women dying from preventable causes

Florida women are dying from preventable causes, including breast and cervical cancer, pregnancy complications and mental health problems, according to a new national women’s health scoreboard.

The Commonwealth Fund Scoreboard assessed women’s health and reproductive health in the United States over the past two years, measuring the impact of state policies and court decisions that limited women’s access to health and reproductive services.

The 2024 Scorecard on Women’s Health and Reproductive Care was released after the National Center for Health Statistics concluded in March 2024 that women’s life expectancy will be at its lowest level since 2006.

Using 32 metrics, The Commonwealth Fund, a private health care research foundation, ranks Florida in the bottom third of the country (39th) for how well the state’s health care system works for women ages 15 to 44. Overall, Florida has a higher-than-average rate of women without insurance who die during pregnancy, give birth without prenatal care, and succumb to breast and cervical cancer.

“We hope that state policymakers can use this scorecard to identify and address gaps in care to ensure that all women in the United States can live healthy lives with access to quality, affordable care, regardless of where they live or what their background is,” said Joseph Betancourt, President of the Commonwealth Fund.

One of the biggest concerns highlighted by Florida’s low ranking is its high rate of uninsured women ages 19-64. It is one of 10 states that have not expanded Medicaid eligibility and has had a problematic pandemic-era Medicaid coverage wind-down, leaving thousands of women either newly uninsured or with significant gaps in their coverage.

Women in states like Florida that haven’t expanded Medicaid eligibility report skipping health care more often than those in states with expanded eligibility. The Scorecard shows that 22% of women ages 18-44 said they needed to see a doctor at some point in the past 12 months but couldn’t because of cost.

“One in six women in Florida does not have health insurance,” says David Radley, senior scientist, Tracking Health System Performance, The Commonwealth Fund. He notes that the state also has a high percentage of women who do not have a primary care physician. A regular provider can help manage chronic medical conditions, perform screenings and test for diseases.

“To me, the bottom line is that if you have access to the health care system in Florida, you can probably get pretty good care. But if you don’t have access, it’s going to be noticeable in your health and life expectancy. If you can’t go to a doctor who understands your circumstances, you’re less likely to get the things you need to live a long life,” Radley said.

Overall, the scorecard’s findings raise concerns about the ripple effects of the Supreme Court’s 2022 decision to overturn Roe v. Wade and access to reproductive health services. A recent South Florida Sun Sentinel series, Born to Die, found that expectant mothers in Florida, particularly those without insurance, are forgoing prenatal care, leading to high rates of infant mortality and premature births.

Key takeaways from the Scorecard include several health trends impacting women’s care in Florida:

• States like Florida with abortion restrictions tend to have fewer maternity care providers. Several dozen hospitals in Florida have already closed their maternity wards.
• Women of childbearing age in states like Florida, where Medicaid eligibility has not been expanded, were at greatest risk of going without coverage and missing out on needed care due to cost.
• Since 2019, nearly all states have seen an upward trend in syphilis among women of childbearing age, with Florida reporting rates higher than the national average.
• Maternal mortality rates are highest in the Mississippi Delta region, which includes Arkansas, Louisiana, Mississippi and Tennessee. All four states had abortion restrictions before the Supreme Court struck down the constitutional right to abortion, and all now have complete abortion bans. Florida’s strict six-week abortion ban went into effect May 1. It’s too early to gauge how it might affect maternal mortality rates.
• Deaths among women ages 15 to 44 were highest in southeastern states (including Florida). Leading causes of death were preventable factors such as pregnancy complications, substance abuse, COVID-19, and breast or cervical cancer. All-cause death rates per 100,000 women of reproductive age ranged from 70.5 in Hawaii to 203.6 in West Virginia. Florida’s death rate is 114.

“Overall, there are increasing disparities in women’s health and reproductive care in the United States,” Radley said.

“Some states have policies that allow for access to health care, and some don’t. Florida is a state with a large low-income population and a lot of people without health insurance. And they’re less likely to get the care they want or need. What we’re finding is that the state’s health care for women is in a vulnerable position.”

2024 South Florida Sun Sentinel. Distributed by Tribune Content Agency, LLC.