Planned Parenthood aids women’s care needs continued funding

It’s hard to believe that not a single state measures up when it comes to providing for women’s health care needs. But that’s the state of the union, according to a study released recently by the National Women’s Law Center.

The 10-year study from the National Women’s Law Center and Oregon Health Services University is called “Making the Grade on Women’s Health.” It ranks the states based on 26 measures of good health for women, established by the U.S. Department of Health and Human Services. Only two states ranked as high as a “satisfactory-minus.” Thirty-seven states, including Michigan, earned an “unsatisfactory.” Twelve states flunked.

Among the alarming trends nationally are a rise in the rates of chlamydia infections among women and a decline in the number of women getting Pap tests. Pap tests are one of the most basic tools for early detection of cervical cancer, yet, since 2007, Michigan showed a 5% drop in the number of women getting tested.

While Michigan’s overall grade was “unsatisfactory,” it scored even lower on a number of women’s health measures, including rates of obesity, diabetes, high blood pressure and maternal mortality.

The study points out the direct connection between economics and women’s health. Compared to men, women are poorer (on average), spend a greater portion of their incomes on health care (mostly because of reproductive health needs), have more difficulty accessing care, and are more likely to struggle with medical debt.

Equally alarming was the increase in the number of Michigan women who no longer have health insurance. The percentage of uninsured women rose from 13% in 2007 to 16% in 2010. A quarter of Hispanic women are uninsured, and nearly 22% of African Americans.

The fact that fewer Michigan women have health insurance is compounded by the fact that state family planning funding has been reduced by over 75% over the past two years, leaving 32,000 Michigan residents without services.

Women’s health centre closes

Women who used to go downtown to use the Women’s Health Care Centre services, such as eating-disorder and sexual-assault programs, now must go to the hospital.

The centre relocated from 157 Charlotte St. to the Peterborough Regional Health Centre (PRHC) on Tuesday as part of the plan to balance the PRHC budget by 2012, said hospital spokes-woman Alicia Doris.

The new centre is on the hospital’s fourth floor, near the main entrance. All services and the phone number (743-4132) remain the same, Doris said.

The centre saw patients down-t ow n until Friday and will reopen for patient care Jan. 4 because it’s typically closed between Christmas and New Year’s, Doris said.

An open house is being planned for January, she said.

Healthy Lifestyle Boosts Eye Health

MADISON, Wis.—Women who exercise and consume a healthy diet are significantly less likely to develop age-related macular degeneration (AMD), one of the most common causes of vision loss in the elderly, according to a new study published in the Archives of Ophthalmology.

Researchers at the University of Wisconsin, Madison reviewed data from the Carotenoids in Age-Related Eye Disease Study, an ancillary study of the Women’s Health Initiative (WHI) Observational Study. Data was included for 1,313 participants, ages 55 to 74; the women provided information on physical activity and lifetime smoking history, and were assigned a score on a modified 2005 Healthy Eating Index (HEI) based on responses to a food frequency questionnaire administered at baseline of the WHI study. The HEI is a measure of diet quality that assesses the nutrient adequacy of the diet based on the five major food groups of the original Food Pyramid, aspects of the diet that should be limited, and a measure of variety in food choices.

Six years later, researchers took stereoscopic fundus photographs to assess the presence and severity of AMD. A total of 202 women had AMD, 94 percent of whom had early AMD, the primary outcome. In multivariate models, women whose diets were in the highest quintile compared to the lowest quintile on the HEI were 46 percent less likely to have early AMD. Further, women in the highest quintile compared to the lowest quintile for physical activity had 54 percent lower odds for early AMD. Finally, while smoking was not independently associated with AMD, having a combination of the three healthy behaviors—not smoking, consuming a healthy diet and getting physical activity—was associated with 71 percent lower odds for AMD compared to women with high-risk scores.

Hormone Replacement Therapy: Clearing Up the Facts About Women’s Health

As a gynecologist, practicing for over 25 years and having treated thousands of women of all ages and stages of their lives, I am certain of the following: Unless and until we have all our facts — regarding all aspects of our health and health care — we cannot make informed decisions. Many women live paralyzed by fear, hearing misinformation regarding medical studies. Misrepresentation of the absolute risk of various choices has created mass confusion and and in some cases, the reactive discontinuation of potentially helpful medications. These fear-induced reactions create a dangerous schism between women and their care providers. When I’m not engaged in individualized patient care I’m advocating for women to get the facts that may save them unnecessary misery, lower their quality of life and increase their risks for many diseases of aging. With a steady stream of intelligent, clear, organized and useful evidence-based good information, a sense of a working knowledge of their basic biology and body science, women can understand their options — something the sensationalized style of medical reporting and conventional medicine keeps us from having.

We live in a paradoxical time with regard to women’s health care consciousness. How the generation of Baby Boomer feminists, the burners of the bra, the women who took control of their fertility with the pill, who fought for equality in their professions, could retreat so far into submission in fear is certainly puzzling. Case in point: the debate about hormone replacement therapy. It is clear that misrepresentation of the facts by journalists is frightening women from something that may benefit their health and certainly enhance their quality of life.

The single largest barrier to women taking estrogen/hormone therapy and allowing themselves to feel better after menopause is the fear of breast cancer. A powerful recent example is the New York Times, October 20th headline which read “Prempro Hormone Therapy Amplifies Breast Cancer Risks, Study Finds.”

The study released on October 20th regarding hormone replacement therapy (HRT) and breast cancer (from Women’s Health Initiative group Chlebowski et., al JAMA,) was met with fearful reactions by the news media, but aside from getting terrified by the reports, what can we actually learn from this study? For one thing, this study has absolutely no impact on women who are not taking Prempro, and for those who are, the absolute risk is exactly what we already knew. There is a .008 percent increase risk for a breast cancer diagnosis with an increase risk of death from breast cancer of .012 percent. These are very tiny individual risks of an increase of 8 cases per 10,000 women years of use. The reader was led to believe that there was a 29 percent increase in deaths from Prempro, with an absolute difference of 1.2 women in 10,000 years of use! Placing such data in perspective is a great service to aid women in placing risk in a meaningful context. Why are we not told this? What is to be gained from frightening us? Why can’t we know the truth? Women are competent to know these facts and figures as adults making long term self care choices.

The new information from the study published on October 20th in JAMA actually is in the details of breast cancer cell types associated with the particular progestin found in Prempro, and the incidence of higher death rates. The increase in the risk of death from breast cancer while taking Prempro compared to a placebo, in the new report, was one woman per 10,000 woman-years of use — a level described by the FDA as “extremely rare” — while the estrogen alone trial of the WHI study showed a 23 percent decreased risk of being diagnosed with breast cancer.

The detail of which hormones a woman takes is very important. We must help make women aware of news about different products that do not relate to their risk status. For example, we even have very reassuring data about estradiol and natural progesterone not statistically increasing risk for breast cancer (Breast Cancer Res Treat. 2008 Jan;107(1):103-11. Epub 2007 Feb 27) and also showing much better survival if one does get a breast cancer diagnosis if the woman is on estradiol at the time of diagnosis. Improved breast cancer survival among hormone replacement therapy users is durable after 5 years of additional followup, Christante D). (These are identical hormones to naturally produced estrogen and progesterone, also called Bioidentical hormones by some with FDA approved products available all across the U.S.)

The bottom line is there are many better options than Premarin or PremPro. Simply look at the estrogens delivered through the skin, all biologically identical to that which we naturally make in our bodies and for which nature selected over millions of “randomized blinded trial years” (the process of natural selection at its finest in my opinion). In all sorts of research, at cellular levels, as well as gene regulation and gene suppression/expression studies, estradiol is very positive in its effects on cell differentiation; in essence, keeping healthy breast cells healthy. That is the goal of ideal hormone support for every tissue we study: The enhancement of balanced, regulated cell growth and positive antioxidant effects of estradiol.

The truth is that after all the hullabaloo over the past nine years since the initial termination of the HT arm of the WHI, estrogen turns out to be quite safe, the MPA has a cloud of suspicion, and the future recommendation is for careful assessment on an individual basis for every women transiting menopause to determine health status, future risk for disease, and a decision based on a clear indication whether hormones are truly needed and recommended in her situation. If a woman chooses hormone support then current knowledge should be used to determine what dose, type and route of administration is best for her.

The WHI has succeeded in adding valuable information showing that postmenopausal hormone therapy has clear rewards and very small risks when started in newly menopausal women. It remains a woman’s right to choose, not just a legal abortion, but to engage in a process of education and transparent explanation of the facts. Each of us can check these facts in a clear and unbiased way at the North American Menopause Society’s website.

Let’s think about why these studies are misinterpreted, over-inflated and misreported, an important question and one I will address in future posts.

Hospital Will Continue To Provide Life-Saving Care And Protect Women’s Health Despite Withdrawal Of Support From Catholic Diocese

NEW YORK–(ENEWSPF)–December 21, 2010. A religiously affiliated hospital announced today that it will continue to provide life-saving abortion care to its patients, despite being stripped of its affiliation with the Roman Catholic Diocese in Phoenix. In a statement today, St. Joseph’s Hospital in Phoenix said, “Morally, ethically, and legally we simply cannot stand by and let someone die whose life we might be able to save.”

“St. Joseph’s made the right decision to stand up for the rights and health of women in need of life-saving care,” said Alexa Kolbi-Molinas, staff attorney with the American Civil Liberties Union Reproductive Freedom Project. “A hospital’s first responsibility must be the needs of its patients. Any hospital that fails to provide emergency abortion care violates federal law. No woman should be afraid that she will be denied the care she needs when she goes to a hospital.”

St. Joseph’s Hospital provided a life-saving abortion to a young mother of four in November 2009, prompting the Bishop of Phoenix to remove his endorsement of the hospital today after hospital officials refused to “acknowledge in writing that the medical procedure that resulted in the abortion at St. Joseph’s Hospital was a violation” of the policy that governs all Catholic hospitals and “will never occur again at St. Joseph’s Hospital.”

The ACLU, citing the Arizona incident and other refusals of emergency care across the country, wrote to the Centers for Medicare and Medicaid Services in July alerting them to the potential violations of federal law by religiously affiliated hospitals that refuse to provide emergency abortions and requesting an investigation.

Women’s Health is Getting a Failing Grade

A new report from the Oregon Health and Science University gives the United States a failing grade in women’s health. This is the fifth in a series of reports that began in 2000, and it’s a look back at the progress and setbacks we are seeing in women’s health today. The only areas that saw improvement were an increase in screening for colorectal cancer and a drop in the number of women smoking cigarettes.

The bad news is that more women are suffering from obesity, diabetes, hypertension and sexually transmitted diseases linked to infertility. And the findings that are getting the most attention are an increase in the dangerous behavior of binge drinking (having 5 or more drinks at one time), and a considerable decline in the percentage of women getting pap smears (the primary test for detecting cervical cancer).

From the Oregon Health and Science University, U.S. Fails to Meet Women’s Health Goals (which were set by the government’s Healthy People 2010 Initiative)

Overall, the nation is so far from meeting the Healthy People and related goals that it receives a general grade of “Unsatisfactory.” Of the 26 health indicators that were graded, the country received a “Satisfactory” grade in only three and received a failing grade in half.

Do you want to know the specifics of the state you live in? Here is a link to the state-by-state interactive map for this report card.

A large part of the problem is directly related to the growing numbers of women without health insurance.
One in 5 women aged 18 to 64 is uninsured, representing a considerable increase since 2007, the highest rate since the Census Bureau began reporting such data.
No state meets the Healthy People 2010 goal of 100 percent of women having health insurance; Massachusetts comes the closest with 95 percent of women insured.
The disparities in insurance coverage between White women and women of color are alarming. Nationwide, 37.6 percent of Hispanic women, 32 percent of American Indian/Alaska Native women, and 23.4 percent of Black women do not have health insurance coverage, compared with 13.9 percent of White women.

More from the report on State Policies and Goals for the future:

In addition to health status indicators, the report also assesses 68 health and health-related policies. Of these, only two policy goals were met by all the states: Medicaid coverage for breast and cervical cancer treatment and participation in the Food Stamp Nutrition and Education Program.

Though most states have made only piecemeal progress in adopting policies to improve women’s health, many of the policy goals examined in the Report Card will be realized with the implementation of the new federal health care law, the Patient Protection and Affordable Care Act.

But can these goals be met with the Affordable Care Act in jeopardy from the new Congress? This is from MPR News:

The report expresses hope that the national Patient Protection and Affordable Care Act, signed into law in March, will slowly improve these grades.

There are, however, forces at work that appear determined to block any progress whatsoever on women’s health. Note, for example, the cries to repeal national health care reform. And note the cries to “defund” Planned Parenthood being issued by U.S. Reps. Mike Pence, R-Ind., and Michele Bachmann, R-Minn. Their bill, which is waiting in the wings for the new Congress, would deny federal funding for family planning services to any organization that offers abortion care.

There is a lot of information in this latest women’s health report card, and sadly, even the few areas that we are seeing some improvement, we are still far below goals. It’s not good news for women.

I have my own thoughts on one of the findings. I’ve been thinking about the possible reason for a drop in women getting Pap smears.

In the last few years there has been a huge push towards encouraging women (and even young girls) to get the HPV vaccine. Although it’s simply a vaccine to prevent the human papilloma virus, it has been touted as a “cancer” vaccine (but it’s NOT). Let’s face it, getting a pap test isn’t all sunshine and puppy dogs, they are actually something most of us women dread. So is it really that surprising that when we give a woman a vaccine and tell her it will prevent the same cancer that is detected by a pap smear, she is less likely to follow-up with continued cervical screening? [Yes, I know, women are being told to continue with pap tests, but it's not realistic to assume they will, and I think the findings in this report are just the first signs of the problem.]

It seems like a no-brainer and I’ve said as much in previous posts on Gardasil and the HPV vaccine. Anyway, what worries me even more than the decline in women getting routine pap screening, is the inevitable outcome of a rise in the incidence of cervical cancer (and cervical cancer deaths). At some point, once the pharmaceutical companies have made their billions scaring women into getting the HPV vaccine, someone is going to put two and two together and realize that since this vaccine hit the market, fewer women are getting pap tests and more women are developing cervical cancer.

What do you think? Are you surprised by the continued decline in women’s health in our country? Are you worried it may get even worse with the new congress? Do you think there is a correlation between fewer women getting pap smears and the push towards getting the HPV vaccine? Let us know your thoughts in comments.

Phoebe Sumter to open Womens health facility

AMERICUS, GA — On Monday Phoebe Sumter will open up a brand new women’s health facility. It’s the hospital’s first new building since the old campus was destroyed by a tornado two and a half years ago.

“This is just another step in the rebuilding process of our hospital that was completely devastated by the tornado,” said Americus Mayor Barry Blount.

While it was sad day for many who live in Sumter County, on Sunday they had something new to smile about.

Hundreds of came out to see Phoebe Sumter unveil a new medical facility, their Women’s and Family Health Center.

There was special ribbon cutting plus a tour of the halls of the building which still have the brand new smell.

“It’s kind of built for the sense of having convenience for women. They can get their appointments as well as bringing their kids in for immunizations and other tests. Kind of a one stop shopping for everybody,” said Marcus Johnson of Phoebe Sumter.

The new facility will house 24 exam rooms shared by three OB/GYNs and three family medicine physicians.

“It affords this region and our community access to medical services that we probably didn’t have before,” said Blount.

”When that tornado came and just blew us away we were lost and so was the community, and all our babies and we had to go down to Albany for deliveries and everything,” said Dorothy McCray, who lives in Sumter County.

Phoebe Sumter plans to open up another two health care facilities which will be satellites of this main hospital which is still under construction. They say they plan to have that open for patients around this time next year.

W.Va. flunks women’s health study

CHARLESTON, W.Va. — West Virginia ranks near the bottom nationally in obesity, smoking and diabetes, and has made limited strides to improve health-care policies, according to a national report that grades each state on various women’s health issues.

West Virginia ranked 47 out of 50 states and Washington, D.C., and was among 12 states given a failing grade in the report titled “Making the Grade on Women’s Health: a National and State-by-State Report Card.” The report comes from the Office of Women’s Health, part of the U.S. Department of Health and Human Services. It was updated by the National Women’s Law Center.

The state ranked last nationally in the percentage of women who are not physically active, a ranking that has gotten worse over the past three years.

In 2010, 36.8 percent of women had no leisure time and were not physically active, an increase from 31.3 percent in 2007.

“The magic bullet is being physically active,” said Jessica Wright, director of the state Division of Health Promotion and Chronic Disease.

Exercise and a healthy diet are simple and effect ways to reduce the rate of chronic disease and improve a person’s general health, Wright said.

“When it come to eating fruits and vegetables, West Virginia ranks so low that it’s embarrassing,” Wright said.

The number of women eating five servings of fruits and vegetables a day decreased from 22.9 percent in 2007 to 18.8 percent in 2010, ranking the state 48th in the nation.

The state and individual communities have done better at teaching residents how to eat well and encouraging residents to become more active, but they still has a long way to go, Wright said.

“When trying to address chronic disease as a whole, I don’t know if we will ever get enough programs out there that will really help improve our health,” Wright said. “West Virginia gets a lot of funding, but not enough to show incredible gains in the health across the state.”

West Virginia also has the nation’s highest rate of women with diabetes at about 13 percent, an increase from about 11 percent in 2007.

About 33 percent of West Virginia women are obese, an increase from 30.2 percent in 2007. The number of women with high blood pressure increased from 31.6 percent in 2007 to 36.3 percent in 2010.

U.S. Women Lag in Achieving Health Goals

December 15, 2010 – A new report finds that although fewer American women are dying of heart disease, stroke, and breast and lung cancer, and fewer are smoking, women as a group are not meeting most of the health goals set for them by the federal government. Obesity, high blood pressure, and diabetes are on the rise among women and fewer are being screened regularly for cervical cancer, for example, according the report by the National Women’s Law Center and Oregon Health Sciences University.

Several of the report’s findings echo a recent Institute of Medicine study that provided a progress report on women’s health research. Researchers’ efforts to boost study of women’s health over the last two decades has lessened the burden of disease and reduced deaths among women due to cardiovascular disease, breast cancer, and cervical cancer, the IOM study said. Less progress, although still significant, has been made in reducing the effects of depression, HIV/AIDS, and osteoporosis on women. However, several health issues important to women have seen little progress, including unintended pregnancy, autoimmune diseases, alcohol and drug addiction, lung cancer, and dementia. Overall, fewer gains have been made on chronic and debilitating conditions that have lower death rates but cause significant suffering, pointing to the need for researchers to give similar consideration to quality of life as to mortality.

Women’s Health in the U.S. Fails to Make the Grade

Women’s health initiatives in America are largely failing, according to the latest report card released by the National Women’s Law Center and Oregon Health and Science University.
Overall, the nation received a grade of Unsatisfactory, with 23 of the 26 goals outlined in the government’s Healthy People 2010 initiative — a decade-long effort to monitor the progress of the nation’s health objectives — remaining unmet.

This is the fifth and final report card for the decade, and its findings uncovered some troubling trends about the state of women’s health. Most notably, more women report binge drinking and fewer report being screened for cervical cancer than in 2007. On these two important indicators, the nation’s grade dropped to an F: the percentage of women who reported consuming five or more drinks at a time in the past month jumped more than 3% since 2007, to 10.6%, while the percentage of women who received annual pap smears dropped nearly 10% to 78% over the same time period. (More on Time.com: Health Check-Up: Women & Health)

Additionally, more women reported obesity, hypertension and diabetes than in 2007. And more have tested positive for chlamydia, a sexually transmitted infection that can cause infertility.

State-by-state findings reveal similar trends. Massachusetts and Vermont received the highest grades with an S- (Satisfactory minus), while 37 states scored a U (Unsatisfactory) and 12 states failed. Louisiana and Mississippi came in 50th and 51st, respectively. No states received the highest possible score of S, or satisfactory.

Dr. Michelle Berlin, associate professor of obstetrics and gynecology at the Oregon Health and Science University School of Medicine and associate director of the university’s Center for Women’s Health, told the New York Times that the findings were disappointing, given the length and comprehensiveness of the study. “The takeaway message is that we’re really not where we should be,” she said. (More on Time.com: Photos: A Brief History of Women in Power)

But despite this dismal picture, progress has been made in a few areas. One indicator — cholesterol screening — received a higher grade than in the previous report, moving from a U to an S-. Three benchmarks of the Healthy People 2010 initiative were met, including the percentage of women receiving regular mammograms, visiting the dentist and screening for colorectal cancer. Also notable is that the rate of smoking among women declined in 42 states, making that one of the most improved health status indicators.

The hope is that the passage of President Barack Obama’s health care legislation, the Patient Protection and Affordable Care Act, will help raise these grades over the next decade and help the country meet goals set by Healthy People 2020. The health-care act includes a significant focus on women’s health, including an expansion in Medicaid eligibility, that could prompt improvements on issues that have so far failed to be addressed. However, many of the services won’t go into effect until 2014, leaving women’s health in a state of uncertainty for at least a few more years.