Not everything that matters in life can be counted, and the value of good health is difficult to quantify. I grew up in Nigeria and was fascinated by the prospect of living in a community that gives everyone an equal opportunity to wellbeing.
I now live in Minnesota, one of the healthiest states in the United States (U.S.), yet it is tinged with one of the highest health inequalities in the country — including sexually transmitted infections (STIs).
Chlamydia, the most commonly reported STI in Hennepin County, has had higher and faster-rising rates among Black women than White women. In 2017, chlamydia was reported as 9.7 times higher in Black women than in White women in Minnesota.
Although Minnesota has a sex education policy, it lacks cultural appropriateness, as it does not require schools to teach sex education in languages that are best understood by a growing segment of Black women whose first language is not English and in tandem with their religious beliefs.
There is also a high out-of-pocket cost for screening and treatment, such that the majority of uninsured Black women cannot afford to pay. But there are much higher costs to pay chlamydia is left untreated.
If the infection goes undetected and untreated, it can lead to serious health issues such as ectopic pregnancy, and some women may never be able to get pregnant again. However, the financial cost implication of chlamydia is also high, at a staggering $3.1 billion annually.
Prevention of chlamydia in Black women who are most affected will help reduce the overall health care spending in Minnesota.
In a diverse society, the policy-making body plays a role in the wellbeing of the citizens, irrespective of their race. Unfortunately, the Minnesota legislature isn’t as diverse as the population and there has always been a low representation of Blacks in government, hence a lack of commitment to this population.
Structural racism in employment predisposes Blacks to an unemployment rate three times the rate in Whites. Black women in Minnesota have systematically had fewer employment opportunities. And, there is evidence that women who are financially constrained are more likely to engage in risky sexual behaviors, hence an increased exposure to STIs.
In addition, young women are still having unprotected sex, and so the number of people affected with chlamydia infection will continue to increase. Considering the rising rates of chlamydia among Black women, there is a need to act fast and now.
A policy that will revise the sex education curriculum in schools to include cultural appropriateness, especially in languages that are best understood by diverse populations of Black women and that is void of religious bias would go a long way toward helping increase awareness, and reduce infections.
If young Black women are informed about how to prevent chlamydia infection, then the overall health burden will ultimately reduce. Hennepin County’s share of the total health care spending in Minnesota would also decrease, and Minnesota would be able to maintain its sovereign status as one of the healthiest states in the U.S.
Taiwo Aremu, MD, MPH (C) is a graduate student of the Public Health Administration and Policy Track at the University of Minnesota School of Public Health.