Access, education part of improving maternal health in the Delta

The Arkansas Delta might be the “bread basket” for the state, meaning food is grown there at the highest rates in the country. But it also one of the most impoverished regions in the country with some of the lowest health outcomes.

Heart disease, cancer, diabetes, infant mortality, maternal mortality and others afflict people in the Delta at much higher rates. There are efforts underway to change those metrics.

Part of the problem is a lack of doctors, nurses, and other healthcare workers in rural areas. About 10 years ago the New York Institute of Technology College of Osteopathic Medicine at Arkansas State University (NYITCOM at A-State), opened in Jonesboro, and it became the first medical school to open in Arkansas in more than 130 years. 

Since then, hundreds of doctors have been trained and have remained in the region.

“Opening a medical school is not just a process to make licensure and receive accreditation,” said Founding Dean Dr. Barbara Ross-Lee. “It is dependent upon the people and organizations that involve themselves in the process, and we’re fortunate to have had a group of forward-thinking, determined individuals and groups that made this idea a reality.”

Another organization that is fighting for better health outcomes is the University of Arkansas Medical Sciences Center Northeast Arkansas Regional Campus. UAMS Dr. Olivia Ostermann told Talk Business & Politics that women in the Delta face unique health challenges. Many are unaware of contraceptive options, lack training when it comes to sexually transmitted infections and have higher breast cancer rates than in other parts of the country.

“We are not where we need to be,” she said.

Dr. Brittany Carmack, an associate program director with UAMS Northeast, said women in the region have a hard time finding gynecologists (OB/GYN) and other specialists. The wait lists for contraceptive surgeries such as tubal ligation can be as long as six months in the region.

Many of the poorer health outcomes for women involved STI’s and unplanned pregnancies, Carmack said. About half of all pregnancies in Arkansas are unplanned, and the state ranks 49th in teen pregnancy rates, according to the U.S. Centers for Disease Control. Arkansas ranks last in terms of maternal mortality rate.

The UAMS Arkansas Center for Women’s and Infants’ Health Director Kelly Conroy said many women have a misconception that the only medical advice they can get is through an OB/GYN. There has been an effort through doctor residency programs to incorporate more training with family medicine physicians to deal specifically with women’s health issues. When a woman has a baby or is getting treatment at one of the clinics, nurses employ what’s called “the rooming process,” where information about contraceptive options is given, Conroy said.

“The main focus of that program is contraceptives, “ she added.

Many don’t realize that pharmacists are allowed to provide birth control without a doctor’s prescription.

A significant number of women in the Delta suffer from obesity which can lead to diabetes, and that makes pregnancies high risk, Carmack said. Hypertension is also an issue for expectant mothers in Arkansas. About 5.8% of pregnant patients in the state suffer from hypertension.

Another serious issue that mothers in the state face is preeclampsia, Ostermann said. Preeclampsia is persistent high blood pressure that develops during pregnancy or the postpartum period and is often associated with high levels of protein in the urine or the development of decreased blood platelets, trouble with the kidneys or liver, fluid in the lungs, or signs of brain trouble such as seizures and/or visual disturbances, according to preeclampsia.org.

Exact causes aren’t known but it impacts about 35 per 100,000 births. It’s a serious condition that can be deadly, Ostermann said.

Among the other issues cited by Ostermann, Carmack and Conroy in the Delta were a lack of transportation for those who live in rural areas, and a lack of prenatal care.

What proactive steps could be taken to prevent some of these issues before they start?

Ostermann said she thinks one of the larger issues is the lack of sex education in middle and high school. Many schools offer little to none, and an understanding about how STIs, contraceptives and other topics would be a boon to public health, she added.

“I think it would help a lot,” she said.