Research published in the journal Cancer found that the cervical cancer mortality rate for black women between 2000 and 2012 was 10.1 per 100,000 – sharply higher than other studies which had pegged the rate at nearly half that. White women’s mortality rates were about one and a half times as much as originally thought at 4.7 per 100,000.

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So what changed? For the most part, the researchers nixed a large pool of women in their analysis who they said weren’t at risk of dying from cervical cancer: those who had hysterectomies, which generally remove the cervix and therefore the possibility of developing and dying from the disease.

The new findings raise a number of red flags. For one, it suggests that an insufficient number of women are getting the HPV vaccine, which protects against the virus associated with cervical cancer, and the recommended screenings. Those preventive measures are largely successful in preventing cervical cancer in the first place.

But the racial chasm in death rates underscores a sobering reality in American health care: that poorer people and minorities are far less likely to get (or be able to afford) quality medical services, including preventive procedures.

And on that front, some medical professionals are concerned that impending changes to U.S. health policy may make the situation even worse. “We have screenings that are great, but many women in America are not getting them. And now I have even more concerns going forward, with the [likely] repeal of the Affordable Care Act, which covers screening, and the closing of family planning clinics, which do much of that screening,” said Dr. Kathleen Schmeler, an associate professor of gynecologic oncology at the University of Texas M. D. Anderson Cancer Center, in an interview with the New York Times.