As budget negotiations continue in earnest after the governor’s release of his revised budget proposal, it’s time to talk about an uncomfortable but important topic – sexually transmitted diseases.
This week, the California Department of Public Health released a new report showing STD rates have hit an all-time high in California, with 300,000 cases of chlamydia, gonorrhea and early syphilis reported – a 45 percent increase compared to five years ago.
According to the Center for Disease Control, California has the dubious distinction of ranking first among all states for the total number of cases for chlamydia, gonorrhea, syphilis and congenital syphilis. The prevalence of congenital syphilis has particularly skyrocketed, with an increase of more than 500 percent over years past.
In 2017, Sacramento had the 6th highest chlamydia rates of all 58 California counties. Since 2012, syphilis cases in Sacramento County rose by nearly 40 percent, with the highest STD rates found among young people, African-Americans, and gay and bisexual men.
Because most STDs don’t have obvious symptoms, they are often left undetected and untreated, leading to serious long-term health problems including infertility and cancer. Syphilis can progress into paralysis, blindness, internal organ damage, and even death. Congenital syphilis can cause stillbirths and lead to lifelong health complications in children born to mothers who pass the disease to their babies.
These outcomes are not only personally difficult and painful, they place a burden on our health system. Approximately $1 billion in state and federal resources are spent annually on health costs associated with STDs in California. Fortunately, all STDs are preventable and treatable, but we need an all-hands-on-deck approach to improve public health and save taxpayer dollars.
Sexually active individuals must have the resources, information and conversations needed to prevent STD transmission. Providers must be trained in clinical best practices for STD screening and care and outreach interventions must be more targeted and culturally and linguistically appropriate to help reduce the community health disparities that persist. Parents and educators need tools to talk about STDs in a medically accurate and inclusive manner. Youth need comprehensive prevention education and links to local health centers they trust to provide non-judgmental care at no cost.
We also must expand access to STD screening, testing, and treatment – and to condoms, the only method of protection against STD transmission besides abstinence. These evidence-based approaches are being implemented in Sacramento and in areas throughout the state, but a boost in funding is needed to bring them to scale and curb the continued growth in reported STD cases.
Until this crisis is under control, California must make a significant investment in STD prevention. Our state should also seek to expand access to testing and treatment through innovative public policy solutions. A new bill – SB 1023, introduced by Sen. Ed Hernandez this session – seeks to enhance the ability of Californians to receive STD and family planning services where they are, through their mobile phones.
For two decades, California has been a national leader in establishing programs to advance policies aimed at reducing unintended pregnancies. As a result, unintended pregnancy rates are at historic lows, including teen pregnancy rates which have dropped by more than 60 percent since 1992.
If we put the same level of energy and commitment toward reversing the tide of STD rates, we can reverse this public health crisis. With this year’s budget showing a projected surplus, it’s time for the governor and our elected lawmakers to make STD funding a priority in this year’s state budget, and provide the leadership and resources needed to get the job done.
Julie Rabinovitz, MPH, is the president and CEO of Essential Access Health, a nonprofit that promotes quality sexual and reproductive health care for all. Reach her at email@example.com.