Shementé Jones knew something wasn't right. Her back hurt. She felt pain during sex.
Her doctor told her,"Just wash your underwear in Dreft," Jones said, referring to a brand of detergent.
"They desperately need help there," said Otis Brawley, a professor of oncology at Johns Hopkins School of Medicine and an expert on health disparities.
The high rates of poverty contribute to the high cervical cancer mortality, health experts said. About 19% of Mississippians—nearly 1 in 5—live in poverty, while nationally it is about 13%. In her case, Jones said, she could not get her doctor's office to return her calls in a timely manner. She was concerned about her symptoms.
Low-income rural residents often lack reliable transportation, she said, and even if they own a vehicle, they lack gas money. They often can't find—or pay for—someone to take care of their children so they can go to the doctor. Women with low-paying jobs often lack the time to drive to a clinic in a distant town, or the ability to take off from work without losing pay.
Without expansion of Medicaid, people who have low incomes are often left to decide between forgoing insurance and purchasing a policy through the Affordable Care Act marketplace if they cannot get insurance through employment. Even if they qualify for subsidized marketplace plans, they may face high deductibles or copayments for visits, health experts said. That often means going to the doctor only when sick. Preventive care becomes a luxury.
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