Research has emerged about the link between pregnancy complications and a higher risk of stroke, and a Wisconsin health expert suggested it is a risk which might be flying under the radar amid positive trends for other populations.

May is American Stroke Awareness Month, and it is also National Women's Health Week.

A study out this year noted women with two or more complicated pregnancies had double the risk for stroke before age 45.

Cassie Nankee, vascular neurologist at the University of Wisconsin School of Medicine and Public Health, said it shows while there has been brighter news on this front for the public, pregnant women are isolated.

"Even more striking is that the prevalence of maternal stroke is higher in the U.S. than in any other developed nation," Nankee pointed out. "I think that's where we're seeing a lot of this data coming out and really demonstrating this huge problem."

Nankee acknowledged prevention efforts, such as limiting tobacco use, have helped to reduce stroke rates more broadly, but added there are unique and traditional risk factors for pregnant women, including higher blood pressure rates, which still need to be monitored. She encouraged providers to offer plenty of support and education to patients about these risks.

Nankee, who is also an American Heart Association board member, said when interacting with new or expectant mothers, doctors should offer a safe space, allowing the patients to open up about their health.

"It's the responsibility of the providers to take the time to listen to their patients," Nankee emphasized. "Even if it seems like a relatively small concern, we need to validate these patients."

Nankee added most strokes occur in the postpartum period and policymakers could cover a lot of ground by extending Medicaid coverage to postnatal mothers.

"A lot of women are not even cleared to go back to regular activity and are oftentimes not even back to work in that period, and they lose their insurance coverage," Nankee noted. "This can be a really big problem with a significant impact on these women."

A bipartisan bill in the Wisconsin Legislature would extend coverage for up to a year. At the moment, Medicaid coverage runs for 60 days after a birth. It is unclear if the plan will be adopted in final budget talks.

Breast cancer is the leading cause of cancer death in Utah women.

According to the Utah Women and Leadership Project at Utah State University, Utah is among the three lowest-ranked states in the country for mammography screening rates in women aged 40 or older. According to the group, The Utah Department of Health and Human Services was unable to meet its goal of 76% of Utah women, aged 40 years and older, to be screened for breast cancer in 2020.

Chloe Bhowmick, clinical psychologist and research fellow for the Utah Women and Leadership Project, said a lot of the challenges inhibiting mammography rates are "financial and systemic."

"Having lack of insurance, not having insurance coverage through their job, not being able to get time off," Bhowmick outlined. "Those are all, I think, pretty important factors that we found or at least we surmised in being pretty significant."

Bhowmick noted other factors which have negatively affected screening rates include lack of affordable child care, discrepancies between mammography guidelines as well as varying levels of health literacy. Only 62.7% of Utah women aged 40 years and older reported having a mammogram in the last two years. The national average for U.S. women in the same group was 69%.

Bhowmick emphasized it is also important to not forget because of the COVID-19 pandemic, medical centers are still catching up on the backlog of mammography appointments, which can further delay preventive services.

Bhowmick added while the Beehive State is currently sitting 6.3% below the national average, local and state systems can take steps to increase screening rates, including having insurance systems building patient advisories into electronic record systems, tracking how often providers remind individuals of preventive care and employers implementing initiatives such as wellness programs and policies.

"I think having systems that support women, women will be able to both realize that this should be a priority with certain age groups, but also they have the freedom to go," Bhowmick explained.

The Utah Department of Health and Human Services has a goal of 81% of age-eligible Utah women receiving a mammogram by 2030. Bhowmick stressed education and advocacy from community groups can help the state reach its goal.


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To wrap up Women's Health Week, doctors are urging women to take stock of their mental health.

Dr. Sharon Eloranta, medical director at the Washington Health Alliance, said COVID-19 was hard for everyone and led to a drop in health screenings.

She said with the worst of the pandemic over, some women may need to consider how to prioritize their health.

"Women experienced more anxiety and stress during the time of the pandemic," said Eloranta, "and I think that may have been reflective of the fact that they worry not only about their own health, but about health of the people in their families and others. And that can be a hill to climb if you're trying to get back into taking good care of yourself."

For Women's Health Week - which runs through Saturday - the Centers for Disease Control and Prevention is asking women to schedule regular checkups, exercise and eat a healthy and balanced diet.

CDC data show a disturbing trend in mental health, with the rate of young girls saying they attempted suicide twice that of young boys.

Dr. Donna O'Shea, an OB/GYN and chief medical officer of Population Health at UnitedHealthcare, said parents need to be on the lookout for symptoms of depression and anxiety in adolescent girls.

"Especially after COVID," said O'Shea. "We found that 57% of high school girls have experienced persistent feelings of sadness in the last year. Ten years ago, that number was only 36%."

Eloranta said it's important for people to pay attention when they aren't feeling normal.

"'I'm just down, and nothing that usually makes me happy tends to change it.' Then that's time to reach out and try and find some support," said Eloranta. "And again, it can be through your employer, it can be through your primary care. You can always call a friend and see if they have any referrals for you to go and get some assistance."

Two groups are working to create equal opportunities for Black and Latina women in the trucking industry.

The Truist Foundation has pledged $1.5 million to the Accion Opportunity Fund to support the Down Payment Assistance Program, which aims to empower minority women by helping them become first-time truck owners and entrepreneurs.

Luz Urrutia, CEO of the Accion Opportunity Fund, said the step is crucial in bridging the equity gap for underrepresented groups.

"America is in the midst of an entrepreneur boom with record numbers of small businesses, and they're led by women and people of color," Urrutia pointed out. "At the same time, there is a $130 million financing gap for small businesses who need less than $100,000 in this country."

Urrutia noted since 2010, Accion Opportunity Fund has invested $360 million in the trucking industry, providing crucial support to more than 6,000 first-time truck buyers through loans.

Nicole Ward, president of the African American Women Trucking Association and a trucking entrepreneur from Georgia, has firsthand experience with the challenges faced by women of color breaking into the trucking industry.

Despite encountering setbacks when trying to purchase her first truck, Ward persevered and now advocates for others in her community to do the same.

"I thought it would be as easy as purchasing a car, but I didn't realize that entering the industry you are looked at as a weaker link because it's a male-dominated industry," Ward explained. "Instead of jumping into the transportation industry I had to crawl in because I didn't have a certain financial support that was needed."

Ward hopes the Accion Opportunity Fund Program sets a precedent for other financial institutions in ensuring equitable access to funding for entrepreneurs of color.


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