Family Health Corner

News That Affects Your Family's Health

FAMILY HEALTH CORNER
News That Affects Your Family's Health

Staff Reporter

Opinion | Advocacy work and awareness are key in children’s health

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Advocacy work is key in bettering pediatric cancer outcomes.

 

While fundraising initiatives are essential, advocacy work is key in bettering children’s health outcomes. With September being childhood cancer awareness month, we should be looking at ways we can advocate for accessible health care and awareness in childhood pediatric cancer.

Although pediatric cancer treatment is always developing and changing as research is being done, childhood cancer rates have been rising slightly over the last ten years. With that, cancer is the second leading cause of death in children up to the age of fourteen.

In advocating for pediatric cancer, we cannot ignore and should address disparities that exist within the health care system. We should be asking questions about where these disparities come from and what steps can we take to confront them.

Even though pediatric cancer continues to alter the lives of many children and families, only four percent of federal cancer research funding is allocated to pediatric cancer. This makes advocacy work crucial in the fight against pediatric cancer.

The end goal should be universal health care. However, families struggling to pay for their child’s treatment need small steps to take place.

While pediatric cancer has reached an 83 percent survival rate, we have a long way to go when it comes to accessible health care. Children coming from low-income households make up 43 percent of pediatric cancer diagnoses, meaning they will face significant financial stress.

Maximum out-of-pocket limits are essential for families going through pediatric cancer treatment. These limits prevent families from spending a certain amount on medications and procedures through treatment. Each year, this limit changes. For 2021 it’s $8,550 for individual insurance plans and $17,100 for family plans.

Most families will reach this limit within the first three months of treatment. This protection is essential for these families, but many still struggle affording costs up to these limits. These maximum out-of-pocket spending limits need to be lowered and adjusted to meet family’s needs.

But financial stress is not the only barrier families dealing with pediatric cancer face.

Race and socioeconomic status have an effect on cancer treatment and outcomes. Non-Hispanic white children are most likely to be diagnosed with cancer. However, the number of children who die of cancer is similar across these three groups. This indicates Black and non-white Hispanic children diagnosed with cancer are less likely to survive.

Along with findings showing that race affects the statistical outcomes of pediatric cancer, the Centers for Disease Control and Prevention has evidence suggesting location plays a role. There are several things that could influence rates of cancer varying by geographic location. For example, increased exposure to carcinogens with air pollution and genetic variation in some populations.

On top of families bearing the weight of cancer treatment, COVID-19 is another worry. Children now account for almost 25 percent of COVID-19 hospitalizations in Iowa. Children with cancer have a 20 percent chance of having severe symptoms with COVID-19, while other kids have a 1 to 6 percent chance of severe infection.

It is especially important to do this advocacy work now as this vulnerable population is facing the pandemic and rising threats with COVID-19.

These issues go beyond accessibility to health care and funding for research; however, these are still things we need to be advocating for. One thing that is essential in effective treatment is early diagnosis. Findings show that higher income countries with accessible health care generally have a pediatric cancer survival rate that is over eighty percent.

All children and families facing pediatric cancer deserve access to safe and affordable health care. Getting a diagnosis as early as possible and having the means to advocate for the best care possible are crucial. Advocacy work is a huge part of how the doors to better care can be opened.

Columns reflect the opinions of the authors and are not necessarily those of the Editorial Board, The Daily Iowan, or other organizations in which the author may be involved.

 

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College-educated women more likely to have a first child outside of marriage

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College-educated women are much more likely than ever before to have a first child outside of marriage, a new Johns Hopkins University study finds.

Women with degrees are also more likely to be married at the time of their second birth, suggesting a historic shift among the educated away from starting families with marriage to starting them with a baby. The findings by Johns Hopkins University sociologist Andrew Cherlin are published by Proceedings of the National Academy of Science.

“I project that among college-educated women currently in their thirties who will ever have a first child, 18% to 27% will be unmarried at the time of the birth,” Cherlin said. “The place of marriage in the sequence of life events for emerging adulthood may be shifting among college graduates.”

Cherlin compared demographic data from three major surveys, the National Longitudinal Survey of Youth, the National Longitudinal Study of Adolescent to Adult Health, and the National Survey of Family Growth.

The proportion of first births outside of marriage has increased at all educational levels but the increase has been greatest among women with college degrees, he found.

The overwhelming majority of women without a high school degree or a general equivalency diploma were unmarried at first birth, Cherlin found. Women with a high school degree were less likely to be unmarried than were women with no degree; at least half of the high school educated women were unmarried at first birth.

In 1996 only 4% of college-educated women in their 30s had their first babies while unmarried. Twenty years later, that percentage has increased six-fold to 24.5%. Among all women in their 30s who have a first birth outside of marriage, women with college degrees are more likely to be married at the time of their second birth. College educated women are also somewhat more likely than women without bachelor’s degrees to have had the same partner for both children – in more than half of those instances of babies born outside of marriage, the women were cohabiting at the time of the birth.

For a growing number of college-educated young adults in the U.S, their family life courses will eventually result in marriage but, for increasing numbers, marriage would follow a first birth rather than precede it. This suggests a potential change in the role of marriage among college-educated emerging adults – although not necessarily a decline.”

Andrew Cherlin, Sociologist, Johns Hopkins University

Cherlin points to several likely reasons for the marked change, chiefly: money problems, including college debt and lower economic returns from a college degree, and the widespread cultural acceptance for single parenthood and unmarried couples living together.

“Young adults may postpone or forgo marriage until and unless they have attained certain economic markers such as home ownership or an income comparable to the married couples around them,” Cherlin said, adding that studies of less-educated women show that when the actual or perceived support for marriage declines, some women postpone marriage but still have a first birth and this same dynamic could be emerging among better-educated women.

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How long does recovery take?

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Share on PinterestRecovering from a period of sleep deprivation takes longer than scientists expected. Protonic Ltd/Stocksy United

  • A recent study investigated how quickly people can bounce back from sleep deprivation.
  • Following 10 days of sleep deprivation and 1 week of recovery sleep, most measures of cognitive performance had not yet returned to normal.
  • The study authors conclude that catch-up sleep is not an efficient way to counteract sleep restriction.

It is common knowledge that sleep is essential for health. This is true for virtually all living creatures. However, new research suggests that the ability to readily “catch up” on lost sleep later is more myth than fact.

Investigators at Jagiellonian University in Kraków, Poland, carefully examined changes in functioning associated with sleep loss among adults. Their results appear in the journal PLOS ONE.

Participants spent 10 days experiencing partial sleep deprivation, getting about one-third less sleep than usual. This was followed by a full week of recovery.

The researchers’ findings suggest that sleep deprivation takes a lingering toll on functionality. Deficits in people’s ability to think clearly tended to accumulate as “partial sleep restriction” progressed.

The participants did not easily recover from these sleep deficits — not even after extra “make-up” sleep on subsequent days.

The amount of sleep that people need varies widely. On average, however, adults require at least 7 hours every day to maintain peak functionality.

Dr. Stephanie M. Stahl is an assistant professor of clinical medicine and clinical neurology at the Indiana University School of Medicine in Indianapolis.

Dr. Stahl, who was not involved in the research, specializes in sleep medicine. In an interview with Medical News Today, she commented on the importance of this and similar studies.

“This study adds to a large body of evidence that insufficient sleep has detrimental effects on our daytime functioning,” she said. “This study in particular highlights that even a short duration of obtaining only 1–2 hours below our goal of 7-plus hours of sleep caused persistence of impairment, even after 1 week of obtaining sufficient sleep.”

In today’s busy world, it is exceedingly common for adults to sacrifice sleep for work, entertainment, and other reasons.

Many people underestimate the effects of this low-level, chronic sleep deprivation on their mental and physical health. A lot of people believe that they can “make up” for lost sleep by sleeping longer on the weekends, for example. However, the new research suggests that we may be greatly overestimating this ability.

In their paper, the researchers note that disrupted sleep has always been common in certain professions and industries, such as healthcare, entertainment, and transportation. However, many dayshift workers are now working from home, resulting in a “blurring of the boundaries between work and private life.”

Although the ability to work remotely has been a boon for many during the global pandemic, all is not well. “The disruption of the rest-activity rhythm is one of the common side effects of remote work,” the investigators note.

Modern life is increasingly fast paced, and the pressure to perform, produce, and achieve is ever-present. Although that may be good for worker productivity, it ignores a fundamental fact of human biology: We are diurnal creatures.

We have evolved to sleep at night and to be alert during daylight hours. Furthermore, we need a minimum amount of sleep every 24 hours.

“Chronic sleep deprivation is a very under-recognized problem in our society,” said Dr. Stahl. “Sleep deprivation is a very common cause of poor concentration, inattention, and daytime sleepiness, increasing [the] risk of accidents, including motor vehicle accidents.”

The problems linked to sleep deprivation do not end there. “Many people do not realize how insufficient sleep can affect our health. Insufficient sleep can increase [the] risk of heart disease, stroke, cancer, infection, and dementia,” Dr. Stahl noted.

“A large study was published earlier this year in Nature Communications, showing that 6 hours of sleep or less on a regular basis [at the age of 50 and 60 years] increased risk of dementia by 30%.”

The common belief that a little shortchanging of sleep will not influence one’s health is incorrect. Recovery from sleep loss is what interested the research team most.

In the new study, the investigators used sophisticated measures of wakefulness. One such measure was continuous actigraphy, wherein body sensors monitored the participants’ activity levels.

The scientists also monitored EEG brain activity each day and employed various tests of subjective and objective cognitive performance. They found that, among these measures, only reaction speeds recovered to baseline after 1 week of catch-up sleep.

The study authors write:

“The current study suggests that 7-day recovery following 10-day sleep restriction is sufficient only for the reaction speed to reverse to baseline, while the other behavioral, locomotor, and neurophysiological measures do not show such improvement.”

Sample sizes were relatively small, however, so the study was “somewhat underpowered,” according to Dr. Stahl.

In conclusion, the investigators found that the “neurobehavioral consequences of chronic partial sleep deprivation cannot be overcome easily and last much longer than one expects.”

In other words, we should not assume that one will easily and quickly recover to baseline following a period of sleep restriction by sleeping longer later. It may not be that simple. Deficits in our ability to think clearly and to function optimally may suffer.

Dr. Aric Prather, Ph.D., is an associate professor of psychiatry at the University of California, San Francisco. In an email to MNT, Dr. Prather noted that this research adds to mounting evidence regarding the importance of sleep.

“This study provides further evidence that there may be a significant cost to prolonged sleep loss that is not easily recouped,” Dr. Prather wrote.


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Barro says raising health care costs for unvaccinated employees not ‘a great road’ to go down

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Columnist Josh Barro says that charging employees who are not vaccinated against the coronavirus more for health insurance is not “a great road” to go down.

Barro made the comment on Hill.TV’s “Rising” on Monday, as the panel was discussing Delta Airlines’ recent decision to subject unvaccinated employees enrolled in the company’s health care plan to a $200 monthly surcharge.

“I don’t think it’s a great road to go down,” Barro said.

Barro says that while he supports getting more people unvaccinated, such a move is a bad idea because healthcare laws in the nation are designed to delink pricing from health risks. He added that there are other things that can be identified besides coronavirus vaccines that can incurs the risks of filing health insurance claims.

“I think that there are a lot of things you can inquire into where people make choices that affect their health status,” Barro said. “And I think we have good reasons for not wanting that to flow through into the pricing.”

“And so… I think this is a step down a road that we don’t want to go down,” he continued.

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Mental health crisis calls increase during the COVID-19 pandemic

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SOUTH SALT LAKE, Utah (ABC4) – The Unified Police Department says it is dealing with more mental health-related calls during the COVID-19 pandemic.

Sgt. Melody Cutler said SWAT standoffs seem to be escalating quicker than before and happening more often.

She believes the rise in cases is due to mental health-related outbursts exacerbated by the pandemic.

Donated cadavers go unreceived at Idaho State University, police investigating funeral home

This weekend’s almost 24-hour SWAT standoff in Millcreek was a situation that affected more than 70 officers who responded to the scene and the mental health of those who survived.

As we reported on Saturday, three people died in that SWAT standoff. Salt Lake County Sheriff Rosie Rivera says these responses are getting out of control quicker than they used to.

Cutler says people’s behavior has noticeably changed nowadays and that’s why UPD goes through mental health training every year.

18-year-old killed in San Juan County crash

Cutler says there’s no way to tell whether an officer is in the midst of a mental health crisis until it’s actually happening, which is why they need to be experts who are ready and prepared to deescalate a situation.

“Jail is not the place for the mentally ill,” Cutler says. “You do not better them by putting them in jail, so we try to do other interventions other than incarceration.”

UPD employs social workers in case a mental health crisis needs to be resolved.

Utah may be due for major earthquake event, experts warn

They also will help provide mental health resources to those who need may need it.

UPD said they are looking to do more with its Metro Mental Health Unit.

If you are interested in learning more, click here.

You can also email communityrelations@updsl.org with any questions.

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Standing the test of time: Historic architecture in Taylorsville surveyed | Latest Headlines

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The project could benefit the town by supplying detailed records that can be referenced for projects including preservation or economic development.

“If there is any federal money being used for projects in town, that has to go through a review to make sure it’s not impacting any historic structures. This lays the groundwork of what’s here,” Thomas said. “It won’t necessarily lead to this, but if homeowners are interested in listing on the national register, something like this kind of lays the groundwork for that. Listing on the national register doesn’t put any regulations on the homeowner, but it does open them up to different tax credits and things like that.”

The last time Taylorsville was surveyed was in 1986. Architectural historian Vicky Mason recorded various historic houses, schools, churches and buildings for a two-county project that included Caldwell County. Many buildings in Taylorsville were too new at the time to be included on the 1986 survey. The survey Thomas is doing will include structures from that survey, as well as other buildings that have never been surveyed.

“There’s been interest at the local level. Alexander County put together a Historic Preservation Commission in 2019,” Thomas said. “They have been working with us, so that is one of the reasons we are here.”

Thomas uses photographs, written descriptions and oral and archival history to document her findings. As she walked around the town she took brief notes describing the conditions of the buildings, interesting details and any changes that have been made. Along with those documentations, she will identify properties that are potentially eligible for listing in the National Register of Historic Places, either individually or as districts, according to the release.

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China makes remarkable gains in maternal and child survival rates — ScienceDaily

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China has made remarkable gains in reducing the number of women who die during childbirth and boosting child survival rates over the past 70 years, according to new review.

The Lancet report brought together China’s health research institutions alongside its international colleagues from Australia, the UK and the US to review the country’s progress in maternal, newborn, child and adolescent health and nutrition since 1949.

Murdoch Children’s Research Institute (MCRI) Professor George Patton, one of the international researchers, said over the past 70 years China had made a remarkable transition from where the survival of women and children was the priority to one where children and adolescents now have similar health profiles to young Australians.

“This progress has been driven by rapid socioeconomic development and reducing poverty, the country’s capacity for top-down leadership such as the reorganisation of social health insurance and systematic public health planning,” he said.

“China population policy over the past seven decades, including its previously one-child policy, has profoundly affected its age structure. But its growing focus on the health of children and young people reflects a need to invest in its next generation. This is something that we will increasingly see in other countries across the region including Australia.”

The study found rapid reductions in the maternal death ratio from about 1500 cases per 100,000 births in 1949 to 17.8 cases per 100,000 births in 2019. The infant death rate has lowered from about 200 cases per 1000 births in 1949 to 5.6 cases per 1000 births in 2019.

Professor Patton said in some aspects China was a model for what other low- and middle-income countries could achieve.

“Some elements of China’s success such as good quality antenatal and postnatal care, scaling up of childhood vaccination and delivering a good health education in schools are relevant almost everywhere,” he said. “But it’s questionable how successful China’s strategies might be in countries with different cultural norms and political systems.”

However, the report also found a series of emerging or neglected conditions in China that now required a greater focus including infertility, advanced maternal age, stillbirth, child protection, mental health, and sexual and gender-based violence, as well as emerging infectious diseases such as COVID-19.

Professor Patton said several barriers remained in addressing maternal depression and child and adolescent mental health.

“Mental health problems are still poorly understood and stigmatised in China,” he said. “Pregnant women are reluctant to seek help and mental health problems among children and adolescents are neglected. There is also a shortage of health service providers including child psychiatrists and counsellors, especially in rural areas where the mental health problems of children left-behind by parents migrating to the cities for work are considerable.”

Professor Patton said maternal, newborn, child, and adolescent health would continue to be vital for the healthy development of the next generation in China.

“The next 10 years will be crucial for China’s goal of universal health coverage, particularly in addressing disparities and inequities in marginalised and disadvantaged communities,” he said.

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As Some COVID-Related Unemployment Benefits End In NC, Employers Watch To See If Workers Return | WFAE 90.7

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The latest numbers show the national unemployment rate fell slightly to 5.2% in August from 5.4% in July. The new numbers were released Friday, just before supplemental federal unemployment benefits ended.

Those benefits included providing payments to gig workers, extending how long jobless workers received benefits and paid an extra $300 a week.

South Carolina was one of 25 states that ended the $300 benefit early, while North Carolina kept it to the end. And Wells Fargo senior economist Mark Vitner says it’s difficult to tell what impact pulling the extra money early had on a state’s worker shortage. Employment growth during the last few months in states that left early were nearly even with those that continued to provide the benefit, he said.

“But the states that remained in the program were the states that locked down the hardest when the pandemic first hit,” Vitner said. “So employment fell nearly twice as much in those states as it did in the states that left early, so they had more ground to make up.”

Vintner says Georgia and Florida were some of the first states to end the extra benefit early, and they’re now seeing their strongest job growth since the first two months after their lockdowns ended.

The jobless numbers also gave a hint of how the delta variant slowed job growth last month. Sectors that require interacting with the public, such as restaurants, hotels and retailers, had the lowest hiring numbers.

Vitner is now keeping an eye on whether these workers will return. The jobs depend on employees returning to the office, he said, which may be delayed due to the surge in COVID-19 cases.

“I think that there’s some split, by major employers in Charlotte, Raleigh, as to whether they’re going to come back to the office in September or October or push it out to the start of next year,” Vitner said.

The Associated Press contributed to this story.

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Gabrielle Union-Wade’s ‘Don’t Skip’ PSA Promotes Well-Visits, Vaccines – SheKnows

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We’re coming off a year where, for many moms, just getting through the day was a goal. Keeping up with daily family to-dos that normally would go unremarked upon suddenly deserved a gold star — and if we didn’t keep up? Well, that called for giving ourselves some grace. And Gabrielle Union-Wade is proving to be #momgoals on both counts.

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The actress, author, activist, and mom knows that it was a hard year for parents in general — and moms in particular — to keep every plate spinning, which is why her family decided to participate in a public health campaign called Don’t Skip, which is encouraging families to get back on track with well-visits and recommended vaccines for kids.

The numbers are sobering: It’s estimated that 9 million doses of recommended childhood vaccines were missed in 2020, and according to one survey, 40 percent of parents admit their kids missed vaccines due to COVID-19.

Union-Wade spoke with SheKnows about the campaign, prioritizing her family’s health, and what she let slide during the pandemic. Speaking with her even inspired me to prioritize scheduling my own well visit with my GP — and one for my spouse, as well. We’d kept up with our kids’ visits — but not our own. So thank you, Gabrielle!

SheKnows: Given the fear and uncertainty so many of us have lived with over this past year, what was the conversation like in your family about making sure you kept up with normal things like well visits and vaccine schedules?

Gabrielle Union-Wade: Well, during the last year-plus, unfortunately, we had a couple of medical emergencies, so we had to get over our fear of going to the doctor and what that meant. And if we can go in a time of crisis, we can for sure go in to stay on schedule. So we got comfortable by talking to our doctors, making sure that they were comfortable — that their staff and their offices were ready and prepared — and we got that level of confidence to stay on track throughout the pandemic.

With this series of PSAs, we’re really just talking to parents and families and reminding them to get back in the schedule of talking to your doctor, your children’s doctor, scheduling those well-visits if you missed them, and scheduling your doctor-recommended vaccinations. That’s how we’re making every decision in our house. Like, I’m not listening to whoever has the most followers; I’m talking to my doctor about what makes the most sense for me and my family.

SK: Is there a message you want to share with people who did skip visits or vaccines, who may be feeling guilty now that their child is behind? Or maybe they’re just feeling vaccine-hesitant, in general?

GUW: I would just say, it’s okay to be afraid. It’s okay to feel guilty. It’s okay to feel literally everything that you’re feeling. Today’s a new day. Just take that first step, which is just to reach out to your doctor and start opening up those lines of communication. And the more you talk, the more you build trust and the more you build trust, the more you build confidence with everything healthcare-related.

Coming out of a time of so much misinformation, sometimes it’s hard to know which way is up, but centering healthcare professionals and your doctors and letting them lead, that is what has worked for our family.

SK: What are some of the best sources of education you’ve used to help yourself feel informed about the vaccines your kids need?

GUW: Literally, I just talked to my doctor. We took a lot of time in finding our healthcare providers, especially, Dahveon and Zaya’s doctors. So I felt confident texting them throughout this pandemic [and saying], ‘What do you think? I know you know my health history, my children’s health history, what do you think is best for us at this time?’ And that’s what we went with.

It’s weird to say, ‘Lean into facts.’ But in this day and age, two plus two totally equals five for some folks, and I don’t know what to do about those particular people. But folks who believe in science, facts, figures, I would say, listen to your healthcare provider that is familiar with your health history and your children’s health history. The internet can be confusing and media can be confusing, but hopefully, your doctor can declutter a lot of that and put it in plain language to help it make sense to you.

SK: How do you and Dwyane have conversations about vaccines and preventative health with your family? Obviously, you have kids of varying ages who require varying levels of information…

GUW: We both come from families and [have] loved ones who rarely prioritized their health and ended up dying from things that are totally preventable. Ended up really suffering just because of a fear of going to the doctor, really suffering because they were afraid of a diagnosis. I watched my girlfriend die because she had deprioritized for her own health. I didn’t need anything to have to happen to me because I’ve watched it around me. So, from the time that we got together as a family, we have always centered our health and our wellness because we always looked at information as our power.

I can’t do anything without the information, and we can’t get the information without going to the doctor, taking full blood panels, not skipping out on our annual physicals and our mammograms, and everything else that’s recommended for our different ages. And we’ve just taken that through with the rest of our family. We don’t play around with anything. We are those people that are quick to text Kaav’s doctor, quick to text Zaya’s doctor, quick to text our own doctors to get that reassurance and that information. Because we’ve seen what can happen when you don’t.

SK: So it’s just a daily part of your family life?

GUW: Yeah. You have to completely normalize it. If something doesn’t feel right in your body, in your mind, let’s talk about it, let’s address it now. Whether it’s feelings bottling up or symptoms bottling up, let’s address them when they first arrive. So we want to make sure that our kids feel comfortable, whether something has gone wrong with their friends or with their heart or if any part of their body doesn’t feel right, let’s address it quickly.

SK: You joke in the PSA about letting Zaya skip making her bed. But seriously — what’s something you skipped this year that you really do feel good about?

GUW: We all had to skip some things to make life work during the pandemic. I skipped setting my alarm clock in the morning, doing some of my daily workouts, and putting on makeup, among other things. The problem is, a lot of families have also been skipping visits to their doctor, which has caused a big drop in recommended vaccinations, especially for children and preteens. Sadly, the long-term public health problems that come out of this drop could be major because so many children, preteens, and adults remain unvaccinated against a range of preventable diseases.

SK: We at SheKnows have been hugely inspired by your family’s acceptance and advocacy. What’s your advice for parents looking to be allies/accomplices and truly affirming to their LGBTQ+ kids?

GUW: We’ve learned a lot, but understand that there’s still so much we don’t know. Most parents think they need to have it all figured out, and the truth is, it’s okay if you don’t. The most important thing a parent can do is to be there for their child and support them in every aspect of life.

SK: Finally, congrats on Shady Baby! What’s it been like bringing that project into the world?

GUW: It’s been amazing. Inspired by our daughter, Kaavia, we wanted to create a children’s book that not only had a little Black girl as the main character but to also give the word “shady” a more positive association, using it as her superpower, moral compass, and inner strength. As a family, we also understand the platform that we have and the importance of doing right for our community. That’s why we get involved in various initiatives to help give back to our community, whether it’s LGBTQ+ rights, advocating for diversity and inclusion in the workplace, or our Don’t Skip public health campaign.

This interview has been edited and condensed for length and clarity.

Before you go, check out our gallery on Cute & Stylish Kids Face Masks.

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As Texans fill up abortion clinics in other states, low-income people get left behind

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“As Texans fill up abortion clinics in other states, low-income people get left behind” was first published by The Texas Tribune, a nonprofit, nonpartisan media organization that informs Texans — and engages with them — about public policy, politics, government and statewide issues.

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Two days after Texas’ new abortion restrictions went into effect, women’s health clinics in surrounding states were already juggling clogged phone lines and an increasing load of appointment requests from Texans.

At a clinic in Albuquerque, New Mexico, an abortion provider said that on Tuesday, the day before the law’s enactment, every patient who had made an appointment online was from its neighbor state to the east. By Thursday, all of New Mexico’s abortion clinics were reportedly booked up for weeks, and a Dallas center had dispatched dozens of employees to help the much less populated state’s overtaxed system.

But for every Texan who is able to leave town to elude the new law, there are more who can’t.

“That’s the people that have a working car, that can get time off, who have somebody who can take care of their kids,” said Vicki Cowart, president and CEO of Planned Parenthood of the Rocky Mountains, which covers New Mexico, Colorado and Las Vegas, Nevada. “There are going to be thousands of individuals who don’t have that wherewithal, and it’s really particularly going to impact women of color, young women, rural women.”

The Texas law prohibits abortions after doctors detect a “fetal heartbeat,” which can be as early as six weeks along, when many people still don’t know they are pregnant. Experts call the term misleading because embryos haven’t developed a heart by this stage, but do exhibit cardiac activity. The law does not exempt cases where someone was impregnated as a result of rape or incest.

But the state does not enforce the law. Instead, private citizens can sue those they suspect are violating it, ranging from abortion providers to abortion funds and even other civilians, like Uber drivers who drive women to abortion clinics. And under the law, anyone in the country is able to file lawsuits against Texans they suspect of aiding in a now-illegal abortions.

For Republican lawmakers and abortion opponents, the Texas law was a long-fought victory, one of the strictest abortion laws to go into effect since the landmark Roe v. Wade ruling in 1973. When signing the legislation in May, Gov. Greg Abbott said the measure “​ensures that the life of every unborn child who has a heartbeat will be saved from the ravages of abortion.”​

But abortion providers, as well as advocates for the rights of immigrants and Black women, say that the new restrictions won’t establish a de facto ban on abortion for all Texans. Instead, they argue, state lawmakers have created a system that will most heavily affect teenagers and Texans with disabilities as well as further disadvantage poor women of color.

Half of all women in the U.S. who got an abortion in 2014 lived in poverty, double the percentage in 1994, according to a 2016 study by the Guttmacher Institute, a reproductive health research group. Texas health data shows that Black patients accounted for about 30% of Texas abortions in 2020, though 12% of the state’s population is Black. In Texas and the nation, Black women are much more likely to die in pregnancy-related deaths than white or Hispanic women.

“For Black women, we know that our young girls are at risk of losing their futures because they’ll be forced to parent before they’re prepared,” said Michelle Anderson with the Afiya Center, an advocacy group for Black Texans’ reproductive rights. “It will further perpetuate the rate of generational poverty in Black communities … . It also perpetuates the rate of maternal mortality.”

For access to a legal abortion provider after about six weeks, Texas residents now have to be able to spend the time and money to travel out of state. That could take days: State laws in Louisiana and Oklahoma currently require, respectively, 24- and 72-hour waiting periods after an initial appointment before a patient can get an abortion. On the west, New Mexico has no major abortion restrictions, like waiting periods or required parental notification, but most of Texas’ population is closer to the more restrictive states.

Where the average distance to an abortion clinic in Texas had been about 12 miles, according to a report by the Guttmacher Institute, that has now grown to about 248 miles. Beyond driving time and cost of gas, abortions may now require the cost of lodging, child care and lost wages, the institute reported.

Although the new limits on abortion — which providers estimate will ban about 85% of abortions in the state — just went into effect Wednesday, Texas women and neighboring providers had a glimpse last year of what was to come. In 2020, an executive order from Gov. Greg Abbott effectively banned abortion for more than a month during the pandemic, labelling the procedure elective as hospital space became limited. During that time, Cowart said, clinics in Colorado and New Mexico saw a 12-fold increase in patients.

“The folks that went out of state [for abortions] and came back to have follow-up care tended to be higher-income, tended to be white folks,” said Bhavik Kumar, a doctor at Planned Parenthood Center for Choice in Houston, recalling patients he saw after Abbott’s executive order ended.

The patients who simply had to wait for weeks, until the order ended, to have their procedures in Texas “were the folks that were low-income, folks of color, especially Black women,” Kumar added.

Throughout 2020, the number of abortions performed on Texas residents out-of-state nearly doubled, from 654 the year before to 1,226, according to data from the Texas Health and Human Services Commission. The state did not split data by month for out-of-state abortions. Still, the number was relatively small compared with the nearly 54,000 performed in Texas.

About 3% of abortions for white and Black Texans were performed out of state, the health department reported. But while Hispanic women living in Texas had more abortions in 2020 than any other racial or ethnic group — nearly 20,000 — only two left the state for the procedure, the state reported. The health department could not clarify Thursday how other states reported on data about Hispanic people.

Immigrant rights advocates said Hispanic women have lower numbers of out-of-state abortions partly because many immigrants from Central and South America are unable to leave border cities, much less the state, due to federal immigration checkpoints. For others, any health care inquiry, any health care spending can be a burden.

“Outside of the existing barriers for the immigrant population to health care access … there’s already an existing fear to just call [a doctor] and find out [if they’re pregnant],” said Miriam Camero, vice president of social programs at RAICES, an immigrants’ rights group.

The flood of Texans reaching out to clinics in other states began well before the law took effect Wednesday. A Planned Parenthood spokesperson said Thursday that New Mexico clinics were already booked up three weeks out, after performing abortions for a significant number of Texans on Tuesday at the Albuquerque clinic. And one Dallas abortion provider, Southwestern Women’s Surgery Center, sent a dozen members of its staff to a sister clinic in New Mexico to help treat the increase in patients there.

Staffers left Dallas at 5 a.m. Wednesday so they could reach Albuquerque in time to “see as many patients as as possible, who are going to need abortion care that aren’t going to be able to access it here in Texas,” said Allison Gilbert, a doctor at the Dallas clinic.

The staffers plan to stay there for at least three to four weeks, Gilbert said.

Some organizations have started abortion funds to help women with the costs of traveling out of state. The law notes that providers and those assisting women in getting abortions can be sued for violating Texas’ ban; advocates and some providers fear that could include helping women leave the state. RAICES, as well as abortion fundraising groups like the Lilith Fund and Texas Equal Access Fund, are hoping to get women access to abortion who would otherwise not be able to afford it.

Even some private companies like Match Group in Dallas and Bumble in Austin, which are both headed by women, have set up similar funds.

But for many, even if they can get access to funds for a paid trip, the costs will still be insurmountable, said Anderson, with the Afiya Center.

“There are a lot of barriers, especially when you’re talking about Black women,” she said, referring to child care and job instability. “It also may be like, am I going to be able to pay my rent? Am I going to be able to put food on the table?”

Disclosure: Bumble, Planned Parenthood and Afiya Center have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.

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This article originally appeared in The Texas Tribune at https://www.texastribune.org/2021/09/02/texas-abortion-out-of-state-people-of-color/.

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