Rural hospital closures and the cervical cancer crisis

(Southern Rural Black Women’s Initiative) – As a researcher for the Southern Rural Black Women’s Initiative and a Washington County Supervisor, I have seen firsthand the systemic failures that leave Black women in the Mississippi Delta without access to lifesaving health care. The upcoming SRBWI No Excuse report, created in collaboration with Human Rights Watch, reveals an urgent crisis: Black women in the Delta face disproportionate barriers to cervical cancer prevention and treatment – barriers that are exacerbated by the ongoing closure of rural hospitals across Mississippi.

Cervical cancer is one of the most preventable and treatable cancers, yet Mississippi has one of the highest cervical cancer mortality rates in the nation. Black women in the state are nearly 1.5 times more likely to die from this disease compared to White women, a disparity that worsens with age. The No Excuse report, based on nearly 160 interviews conducted by community-based researchers like myself, documents the lived experiences of women navigating a health care system that fails to provide them with equitable access to screenings, treatment and preventive care.

A glaring barrier identified in the report is the shrinking availability of gynecological care in the Delta. Mississippi’s refusal to expand Medicaid has contributed to a worsening health care crisis, leading to hospital closures that have left entire communities without essential services. A December 2024 report from the Center for Healthcare Quality and Payment Reform found that more than half of rural inpatient hospitals in Mississippi are at risk of closing, with 25 facing immediate threat – placing the state among the top five most at risk for hospital closures.

Greenwood Leflore Hospital, one of the few remaining facilities in the Delta offering comprehensive cancer and gynecological care, is now in jeopardy. If it closes, women across multiple counties will have nowhere nearby to receive cervical cancer screenings, HPV vaccinations, or treatment. Already, many women must travel long distances – sometimes hours – to access basic gynecological care. Without robust public transportation system, this journey is impossible for many, forcing them to forgo preventive care altogether.

The No Excuse report makes clear that the cervical cancer crisis in Mississippi is not just a public health issue; it is a human rights failure. Many women interviewed for the report had never even heard of the HPV vaccine, a critical tool for preventing cervical cancer. Limited access to affordable health care, transportation barriers, and discrimination within the medical system have all compounded this crisis. Rural hospital closures are not just numbers on a page – they are the loss of lifesaving care for Black women in the Delta.

The state must take immediate action to address this crisis. The findings of No Excuse call for policy changes that could save lives, including:

• Expanding Medicaid to stabilize rural hospitals and increase access to affordable health care.
• Investing in transportation infrastructure to connect rural communities to medical services.
• Funding cervical cancer screenings and treatment programs.
• Enhancing public education about cervical cancer prevention, including increasing awareness of the HPV vaccine.

We cannot afford more hospital closures. The women in our communities deserve access to basic, preventive and lifesaving health care. There is no excuse for inaction.

Mala Brooks is a Washington County Supervisor and Community-Based Researcher with the Southern Rural Black Women’s Initiative

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