The states Zika is most likely to hit will be the worst at helping women deal with it

The mosquito-borne Zika virus causes severe birth defects, and it can be sexually transmitted — which means that helping women prevent pregnancy is a crucial part of Zika prevention efforts.

But as a new report from Population Institute indicates, the US states that are the most vulnerable to a Zika outbreak — namely, Southern and Gulf Coast states — are also the absolute worst at dealing with reproductive health issues.

The states where Zika is most likely to spread are also the states that rank lowest on the Population Institute’s “report card” for reproductive health, which grades states based on their rate of unintended and teen pregnancies, sex education requirements, access to emergency contraception, Medicaid eligibility rules, and abortion restrictions and access.

Bad sex education, bad Medicaid funding, and bad access to health services means that teens and low-income women are hit hardest.

Unintended pregnancy is the biggest worry when it comes to Zika, given the risk of birth defects. While more married women use modern contraceptives in the United States than the global average (68 percent in the US versus 56 percent globally), almost half of US pregnancies (45 percent) are unintended, higher than the global average of 40 percent. Research by the Guttmacher Institute highlighted this factor in particular:

Texas got an F- on the Population Institute’s report card and is “particularly vulnerable,” according to the report, because of recent massive cuts to family planning services and severe abortion restrictions. The abortion laws have been overturned by the Supreme Court, and much of the family planning funding has also been restored — but Planned Parenthood is still blocked from funding, dozens of family planning clinics in the state remain closed, and it may take years before capacity is restored.

And Florida, where more than 50 people have picked up the virus already, got an F for its high teen pregnancy rate, failure to require comprehensive sex education in schools, and abortion restrictions. The state has also tried to defund Planned Parenthood, but those efforts are currently blocked.

Planned Parenthood is a huge sticking point in the effort to fund Zika prevention efforts

In February, the Obama administration asked Congress for $1.9 billion in emergency funding to deal with Zika. But now it’s September, and Congress still hasn’t passed a spending bill — Republicans keep dramatically slashing the amount of money and trying to block Planned Parenthood from using it. Democrats won’t accept that.

Planned Parenthood is a major reproductive health provider, especially in rural areas that have no other family planning options, and failing to give them Zika prevention funding could mean failing to reach a significant number of vulnerable women.

Zika prevention money is needed for a lot of different reasons, according to the report: vector control (controlling mosquito populations by spraying or cleaning up roadside trash that can collect standing water); public education (telling people what the Zika virus does, how to avoid mosquito bites, how to avoid unintended pregnancy, and how to get tested for Zika); access to contraception and abortion services; and maternal and post-natal health services — namely, Zika testing for pregnant women and assistance for babies born with developmental disorders.

In general, Vox’s Julia Belluz has pointed out, we’re screwed when it comes to Zika and other public health threats as long as we have to depend on Congress to fund the response. But some of us are more screwed than others — and when it comes to Zika in the US it’s women who live in Southern and Gulf Coast states, especially younger and lower-income women.

“It’s a cruel irony that the women most at risk of Zika are often the ones with the least access to reproductive health services,” said Bob Walker, the president of the Population Institute, in a statement.

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