Mar 21 2024KFF Health News
"This is a disease we thought we were going to eradicate not that long ago, because we have a treatment that works really well," said Meghan Curry O'Connell, a member of the Cherokee Nation and chief public health officer at the Great Plains Tribal Leaders' Health Board, who is based in South Dakota.
In 2022, New Mexico reported the highest rate of congenital syphilis among states. Primary and secondary syphilis infections, which are not passed to infants, were highest in South Dakota, which had the second-highest rate of congenital syphilis in 2022. In 2021, the most recent year for which demographic data is available, South Dakota had the second-worst rate nationwide — and numbers were highest among the state's large Native population.
Native Americans are more likely to live in rural areas, far from hospital obstetric units, than any other racial or ethnic group. As a result, many do not receive prenatal care until later in pregnancy, if at all. That often means providers cannot test and treat patients for syphilis before delivery.
She said that's due not only to a lack of services but also to a mistrust of health care providers who don't understand Native culture. Some also worry that providers might report patients who use illicit substances during their pregnancies to the police or child welfare. But it's also because of a shrinking network of facilities: Two of the Navajo area's labor and delivery wards have closed in the past decade. According to a recent report, more than half of U.S.