Mississippi’s Health Rankings: The Good, the Bad, and the Ugly

“Alabama’s got me so upset,

Tennessee’s made me lose my rest,

and everybody knows about Mississippi

goddam”

Nina Simone 

 

 

“Alabama’s got me so upset,

Tennessee’s made me lose my rest,

and everybody knows about Mississippi

goddam”

Nina Simone 

Mississippi made headlines this week by boasting that they are soon to become the first state in the nation that will have no (that’s right, zero) abortion clinics. They did it by passing a law that requires all abortion providers, including the three doctors affiliated with the only remaining abortion clinic in the state, the Jackson Women’s Health Organization (JWHO), to be board certified in ObGyn (they are) and to have hospital privileges (they don’t).

Some public officials have made a half-hearted attempt to frame this as a patient safety issue, but Mississippi Representative Bubba (for real!) Carpenter tells it like it really is in this video:

Here is what he said:

“We have literally stopped abortion in the state of Mississippi. Three blocks from the Capitol sits the only abortion clinic in the state of Mississippi. A bill was drafted. It said, if you would perform an abortion in the state of Mississippi, you must be a certified OB/GYN and you must have admitting privileges to a hospital. Anybody here in the medical field knows how hard it is to get admitting privileges to a hospital…

It’s going to be challenged, of course, in the Supreme Court and all — but literally, we stopped abortion in the state of Mississippi, legally, without having to– Roe vs. Wade. So we’ve done that.  I was proud of it.  The governor signed it into law.

 And of course, there you have the other side. They’re like, ‘Well, the poor pitiful women that can’t afford to go out of state are just going to start doing them at home with a coat hanger.’ That’s what we’ve heard over and over and over.

But hey, you have to have moral values. You have to start somewhere, and that’s what we’ve decided to do. This became law and the governor signed it, and I think for one time, we were first in the nation in the state of Mississippi.”

And here are the words of Governor Phil Bryant who signed the bill into law: “Today you see the first step in a movement, I believe, to do what we campaigned on — to say we’re going to try to end abortion in Mississippi,” and “If it closes that clinic, so be it.”

Although eight other states have similar laws or regulations, Mississippi is the first state that could end up with no abortion clinics as a result.  And they are, according to the NY Times, the first state where this approach was an explicit publicly articulated strategy to eliminate abortions without going up against Roe vs. Wade.

The JWHO docs have applied to seven hospitals for privileges, including one named St. Dominics (what are the chances of an abortion doc getting privileges at that one?).  Health Department spokesperson,  Liz Sharlot, told the press that the clinic could be inspected on Monday, July 2 (the day after the law goes into effect).  She went on to say that if the clinic is found not to be in compliance, it gets 10 working days to submit a plan of corrections, outlining how it would meet the requirements of the law.

So congratulations, Mississippi.  You are very close to achieving a “First” in health care.  And, lord knows, you need a first to offset your rankings in other publicly reported health statistics. According to American’s Health Rankings 2011 report, Mississippi ranks dead last in overall health outcomes in the nation and they have held this coveted position since 2002 (see  graph).

The Good

When you look at individual measures you find a few bright spots.  The state has fewer binge drinkers than other states, ranking 4^th best in the country.  They also have pretty good child hood immunization rates, with almost 90% of children 19-35 months being immunized.  That places them at #10. In recent years, Mississippi violent crimes have been declining so that the state ranks 16 in the nation on this measure.

The Bad

Mississippi is at or near the bottom in so many measures that I will only list some:

Measure	Ranking
Smoking	46
Obesity	50
Diabetes	49
High blood pressure	49
Cardiovascular deaths	50
Stroke	47
Cancer deaths	48
Premature deaths	50
Poor physical health days	46
Poor mental health days	41
Health status	50

 

The Ugly

OK, so Mississippi politicians and policymakers really, really care about keeping fetuses alive (some, even if they were conceived as a result of a man forcing intercourse on a woman or girl who may or may not be related to him (e.g., his own child).  They may well have earned the bragging rights to “First in the Nation” to eliminate abortion clinics in their state, but, they don’t seem to care much what happens to those fetuses (or any other Mississippi fetus) when they eventually get born:

• Infant mortality ranking = 50
• Preterm birth = 50
• Low birthweight = 50

Nor do the rankings suggest they care much about how they grow up:

•  Children in poverty ranking = 50
• High school graduation rate = 47
• Teen birth rate = 50

Or what happens to them if they survive their childhoods and become adults:

• Personal income per capita income = 50
• Median household income = 50

Would it be presumptuous of me to suggest that these public officials consider changing their priorities? I am, of course, assuming that they were elected by the good people of Mississippi not only to look after the “right” of the pre-born to be born, but also to do their best to look after inalienable rights of the already-born, including the right of pregnant women to make decisions that are appropriate for themselves and their families and the right of all Americans to the pursuit of happiness (e.g., good health, good education, good housing and good jobs)?   Given that health outcome rankings in the state are mostly pretty bad, if not downright ugly, it doesn’t seem to me that it is asking too much of Bubba and his colleagues to give this suggestion some considerable thought.