Vitamin D, Calcium May Lower Risk of Melanoma for Some Women

Women who have a history of skin cancer and take supplements of calcium and vitamin D may lower their risk of developing melanoma, according to a new study published Monday in the Journal of Clinical Oncology.

Researchers at the Stanford University School of Medicine analyzed data collected from 36,000 women for the Women’s Health Initiative and found that women with a history of non-melanoma skin cancer who took a daily dose of 1,000 mg of calcium plus 400IU of vitamin D had a 57 percent lower risk of developing melanoma than women with the same cancer history who didn’t take the supplements.

However, the study’s authors found that the combination of supplements did not have this protective effect in women without a history of non-melanoma skin cancer.

The authors noted that although these results should be interpreted with caution, it may be that vitamin D and calcium could prevent melanoma in high-risk women.

Health researchers try to link up with more Hispanic women

Illinois’ number of Hispanic women reporting that they were in fair or poor health was the highest in the nation, according to a 2009 study, and efforts are growing to figure out why.

Researchers want specifics on why 34.3 percent of Latino women in Illinois said their health was not good, compared with about 8.5 percent of non-Hispanic white women, in the study by the Henry J. Kaiser Family Foundation. Hispanic women in the state also have higher rates than non-Hispanic white women of diabetes, cardiovascular disease and obesity, according to the study.

But enlisting people to be studied can be complicated by a distrust of medical research and an inability to overcome language barriers and other concerns.

Northwestern University’s Feinberg School of Medicine is taking a step toward finding answers through a recently launched Spanish-language version of its Illinois Women’s Health Registry. The idea is to boost the number of Hispanic women who participate in clinical trials and provide data to help researchers understand their health needs and access to care.

“It will really give us the statistical power we need for analysis of ethnic differences,” said Candace Tingen, director of research programs at Northwestern’s Institute of Women’s Health Research. “There’s a strong desire among Illinois women to join research trials, but we knew the language barrier might be a problem for Hispanic women.”

Almost 6,300 women have joined the registry since it began in 2008, but only 4 percent describe themselves as Hispanic. The registry’s Spanish-language website, whr.northwestern.edu/es, went live in May.

Tingen hopes to attract 1,000 Hispanic women to the registry in the next year. Building up the number of Hispanic women involved is crucial to gaining a better understanding of their health across the state, she said.

The disparities between ethnic groups are striking. Hispanic women in Illinois have a 9 percent rate of diabetes compared with the 3 percent rate among non-Hispanic white women, and about 4 percent of Hispanic women have cardiovascular disease while fewer than 2 percent of non-Hispanic white women do, the Kaiser Foundation study says.

In addition, about 30 percent of Hispanic women in Illinois are obese compared with about 21 percent of non-Hispanic white women, the study says.

Contributing factors are inadequate access to and use of health care, a lack of health insurance, lower socioeconomic status and lower levels of education.

“We need to have better planning and coordination,” said Esther Sciammarella, director of the Chicago Hispanic Health Coalition, “to make sure we help people reach the services they need.”

Sciammarella, who advocates for a “good state plan” to tackle health disparities in Illinois, said her coalition will promote Northwestern’s effort to reach Hispanic women. Involving them in clinical trials allows access to the latest treatments and quality care, she said.

Northwestern has matched women already in the registry with about 20 clinical trials, including studies related to hearing, fertility, postpartum depression, osteoarthritis, HIV, menopause and gestational diabetes.

In the past, women were excluded from clinical research, but the National Institutes of Health Revitalization Act of 1993 requires women and minorities to be included unless their involvement is inappropriate for the purpose of the research or the health of the subjects.

On its website, the registry poses these questions: “Why do some diseases affect women more than men? Why do women respond to some drugs and treatment therapies differently than men? What environmental factors and behaviors most influence women’s health? We don’t know. But we want to find out. And we need your help.”

“We make the connection between women and researcher, disallowing any excuse for researchers not to include women,” Tingen said. “We want to do the same for Spanish-speaking women. They’re hard to recruit because they’re often hard to reach.”

The registry intends to focus recruitment efforts on church groups and other small-group gatherings, but Northwestern’s Institute of Women’s Health Research does not have funding to hire a Spanish-speaking community liaison.

Northwestern professors Aida Giachello and Dr. Martha Daviglus plan to help with outreach and to use the data collected from the registry. The two recently submitted a National Institutes of Health grant application for $950,000 over five years to establish something that would be called the Center of Health Disparities for Cardiovascular Health. They are seeking funds for research, research training and community engagement.

“In poor communities, people don’t understand what research is. There is distrust,” said Giachello, former director of the Midwest Latino Health, Research, Training and Policy Center at the University of Illinois at Chicago. “If we receive funding, we can do a comprehensive community campaign, outreach and a media effort to get the word out about research, clinical studies and the importance of studies to improve their own health.”

Giachello and Daviglus are working on a six-year study of Hispanic health by targeting 16,000 participants in Chicago, Miami, New York and San Diego. They have a $65 million National Institutes of Health grant funding the research.

The lack of data on Hispanic health is more apparent among recent immigrants and Hispanics with low income and low levels of education, Giachello said. In Illinois, advocates say they are fighting the perception that Hispanics are clustered in the Southeast, Northeast, Texas and California, and not the Midwest.

About 13 percent of the state’s population — 1.7 million people — is Hispanic, according to U.S. census figures, constituting the 10th-highest Hispanic population in the nation.

“Latinos are all over the place, but that’s something not a lot of policymakers are necessarily aware of,” Giachello said. “That lack of awareness has led to a lack of funding to do research in Illinois. We need the data for better programs, services and public policy.”

Kansas’ Stringent New Licensing Law Shuts Down Abortion Clinic, Others Fear ‘We’re Doomed’

Kansas is now down to just two abortion providers, after one clinic failed to meet the rigorous licensing requirements established by a new state law. Abortion advocates see the new regulations — which require abortion clinics to obtain a state license to continue operating past July 1 — as an effort by opponents to chase abortion providers out of the state. Kansas’ remaining clinics worry they could be next“:

A lawyer for the Aid for Women clinic in Kansas City, Kan., said Friday that it received a notice that its application for a license had been denied by the Kansas Department of Health and Environment without an inspection. Attorney Cheryl Pilate said the clinic was looking at its legal options but would have to close, at least temporarily.

The clinic received its notice on the same day the leader of a regional Planned Parenthood chapter said inspectors who spent two days at its Overland Park clinic found it will comply with all new regulations. An inspection of the third provider is scheduled for Wednesday. All three are in the Kansas City area.

“We’re doomed,” said Dr. Herbert Hodes, who performs abortions for the third provider, the Women’s Health Center, also in Overland Park.

The new requirements are far more specific than anything the state requires for hospitals and ambulatory surgical centers, and are much more detailed “than the rules for most clinics and offices in which doctors perform many surgical procedures.” The abortion providers were informed of the new standards earlier this month and given just weeks to comply with the new licensing requirements. For instance, the room where the abortions occur must maintain a temperate of between 68 and 73 degrees, have at least 150 square feet (excluding ‘fixed’ cabinets), and come with its own janitor’s closet with 50 or more square feet. Women also have to remain in recovery for at least two hours afterward.

No such requirements exist for hospitals or surgical centers and the state doesn’t mandate specific room sizes or temperature standards. Instead, “they’re tied to standards from the American Institute of Architects for medical facilities, which call for at least 360 square feet of unrestricted space for surgery rooms. But those standards apply to new construction.” The health department also doesn’t “set a minimum recovery time.”

If the licensing standards succeed in closing down the two remaining abortion clinics and discourage any new providers from entering the market, it will pose a direct challenge to Roe v. Wade. In Planned Parenthood v. Casey, the Supreme Court held that states may enact some abortion regulations, but they may not “strike at the right itself” to terminate a pregnancy.

New website aims to help inform aboriginal Canadians on sexual health issues

Experts behind a new website devoted to aboriginal sexual health hope it will be a culturally relevant tool for a population vulnerable to health issues such as high-risk pregnancies and sexually transmitted infections.

The launch of AboriginalSexualHealth.ca by the Society of Obstetricians and Gynaecologists of Canada coincided with the kickoff of the organization’s annual clinical meeting in Vancouver on Tuesday, which also marked National Aboriginal Day. The meeting began with a day-long International Indigenous Women’s Health Symposium.

Dr. Don Wilson, chair of the SOGC’s aboriginal health initiatives committee, said the website will target both aboriginal people and health professionals.

“All cultures have their own takes on reproductive health, having children, family life,” said co-chair Dr. Sandra de la Ronde.

“Each culture has its own sort of special importance and ceremony around it, and so this will provide a place where non-aboriginals but also aboriginals can learn more about cultural practices.”

Wilson said the site’s homepage, which features a medicine wheel, was selected as the centre image because it’s symbolic of the cycle of life and how everything in life is connected.

The online component is key, as one of the significant barriers to accessing health care is geography, said Wilson, a member of the Heiltsuk Nation from the north-central coast of British Columbia.

“There are many rural and remote aboriginal communities that don’t have ready access to health-care personnel that are there in their communities, but they’ll still be able to access this information via the Internet, because it’s becoming a more important tool to reach the rural and remote populations.”

Wilson said the information is also intended for urban aboriginal populations to help them understand what resources are available for them to access.

A section aimed at health-care professionals is focused on supporting the delivery of culturally safe care. Another section is designed specifically for aboriginal women and youth. It includes public health materials and information related to contraception, sexually transmitted infections and women’s rights.

Among the contributors is actor Adam Beach, who grew up on the Dog Creek First Nations reserve at Lake Manitoba. The film and TV star addresses subjects such as healthy and safe sexual relationships and sex education in videos produced with the SOGC’s sexualityandu.ca website.

“I think it’s very important for aboriginal people to hear from some people within their own communities about these topics and to bring education and information and advocacy forward in a way they feel comfortable and in a way they can relate to when they see it,” said Wilson.

The project was challenging “because the aboriginal world is not homogeneous,” he noted. Within Canada’s three main aboriginal groups — Inuit, Metis and First Nations — and even from community to community, there can be significant cultural variations.

“We’ve tried to take some representative examples from some communities and from some well-known aboriginal people to convey the necessary information in these domains.”

The SOGC recently released a new joint policy statement approved by more than a dozen organizations including the Assembly of First Nations and the Canadian Medical Association reaffirming sexual and reproductive health rights of aboriginal women and youth.

According to the statement, First Nations, Inuit and Metis women experience a disproportionately high rate of STIs, high-risk pregnancies, complicated and pre-term deliveries, teenage pregnancies and sexual violence. They are also more likely than the general population to have both low and high-birthweight babies, and infants born with fetal alcohol spectrum disorder and other developmental disorders.

First Nations, Inuit and Metis women also experience higher than average rates of obesity, diabetes, postpartum depression and cervical cancer, the statement said.

Wilson said when considering the social determinants of health, most outcomes are ultimately driven by factors like poverty, education or access to health services.

The doctor, who practises general obstetrics and gynecology in Comox, B.C., on Vancouver Island, said one of the biggest issues he sees affecting Canada’s aboriginal women is that some have to be evacuated from their home communities to give birth.

What should be a straightforward event can result in a “tremendous amount of emotional and economic upheaval,” Wilson said. Some women have to leave their communities up to four weeks before they give birth. This could lead to obstetrical interventions such as inducing a woman’s labour so that she can return sooner to her family, he noted.

“From a medical perspective, social inductions should be considered a no-no, but on occasion, we have to do them because there’s other mitigating factors that make it very important for a woman to rejoin her family.”

De la Ronde has been seeing patients since February at the Wabano Centre for Aboriginal Health in Ottawa. She hopes to develop a maternal-child program similar to one she helped establish at the Calgary Urban Project Society. Around 60 per cent of the population she saw at CUPS were aboriginal — primarily First Nations — many of whom were homeless or prostitutes.

“I saw a lot of families that had been broken up, people that I had met had been products of foster care themselves, a lot of addiction, I saw HIV, but it all went together,” she recalled. “The thing that I noted the most was the strength in those women that had been on the street, some of them from early teens, with their strength to survive.”

The SOGC is in the process of updating its guidelines for providing care to aboriginal people. De la Ronde said they’re hoping to get more information about cultural practices related to family life and childbirth across the country.

Wilson said there has been a steady decline in both maternity and obstetrical care providers over the past few decades as well as in the number of family physicians willing to do obstetrics. What’s more, there hasn’t been a dramatic increase in the number of other health-care providers who could possibly offer such care, such as registered midwives or nurse-practitioners.

“It requires a commitment on the part of the government, on the part of the training institutions and of individuals who go into these fields to be willing to go out into the smaller sites,” he said.

“If we had a magic wand and could create more health-care providers, it would certainly help the situation — no doubt at all.”

At the Heart of the Matter

Cardiovascular disease (CVD) is the number one killer of women in the United States. Although scientists have discovered demonstrable sex differences, treatment options remain the same. In response to this important issue, the Society for Women’s Health Research (SWHR) and WomenHeart: The National Coalition for Women with Heart Disease released the long awaited 2011 10Q Report: Advancing Women’s Heart Health through Improved Research, Diagnosis and Treatment on June 21 to a captivated audience on Capitol Hill.

The 2011 10Q Report is an update to the 2006 10Q Report that identified the top 10 unanswered research questions concerning the prevention, diagnosis and treatment of heart disease in women. Because these and other questions still lack answers, SWHR and WomenHeart are issuing an updated 2011 report.

Over 8.6 million women die annually of CVD and more women than men die each year of heart disease. Experts also estimate that one in two women will die of heart disease or stroke per year. There are known sex differences in symptoms and treatment of CVD, yet medical treatment of women has not changed substantially nor has it resulted in appropriate research into these distinct sex differences. The 10Q Report is a call to action to members of Congress, administration officials, researchers, health care providers, and women.

“The 10Q Report shows the major need to focus research funding appropriately for CVD to understand the important sex differences in heart health,” said Phyllis Greenberger, MSW, President and CEO of SWHR. “SWHR and WomenHeart consulted with cardiovascular experts to identify these top 10 unanswered questions to aid researchers in the study of prevention and treatment of this number one killer of women.”

The lack of understanding of sex differences in CVD can be attributed to insufficient recruitment of women and minorities for clinical trials. Improved participation rates would result in more accurate data and understanding of how CVD affects women differently than men. This in turn would produce more appropriate prevention and early detection plans, accurate diagnosis and proper treatment of all women with heart disease.

“The 10Q Report reveals a startling lack of research into how women and men are genetically differently in CVD symptoms, diagnosis and treatment,” said Lisa M. Tate, CEO, WomenHeart. “To better care for women, these 10 crucial questions must finally be addressed.”

Society for Women’s Health Research

The Society for Women’s Health Research (SWHR), a national non-profit organization based in Washington D.C., is widely recognized as the thought leader in women’s health research, particularly how sex differences influence health. SWHR’s mission is to improve the health of all women through advocacy, education and research. Visit SWHR’s website at swhr.org for more information.

WomenHeart: The National Coalition for Women with Heart Disease

WomenHeart: The National Coalition for Women with Heart Disease is the only national organization dedicated to promoting women’s heart health through advocacy, and patient support. As the leading voice for the 42 million American women living with or at risk of heart disease, WomenHeart advocates for equal access to quality care and champions prevention and early detection, accurate diagnosis and proper treatment of women’s heart disease.

Migraines – A Serious Women’s Health Issue

We have all known someone who has been devastated by migraines that may come on unexpectedly and bring symptoms like throbbing pain, sensitivity to light, nausea, and vomiting and lasts for hours or days. Chances are that someone was female. Migraine is not only a debilitating illness, it is an important women’s health issue. Of the over 36 million Americans afflicted with migraine, 27 million are women. Women suffer from migraines three times as often as men, in the U.S that is 18% vs 3% respectively, making it one of the leading serious health problems affecting women, according to the Migraine Research Foundation. In fact, of the women who suffer from migraines, 25% have four or more severe attacks per month, which can cause a serious interruption in their personal and professional lives.

Migraine is not just a bad headache. It is an extremely debilitating collection of neurological symptoms that usually includes a severe recurring intense throbbing pain on one or both sides of the head that lasts from four hours to three days, often accompanied by one or more of the following: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. These symptoms, which can last 20-60 minutes, are referred to as the aura phase of the headache. Of course, everyone is different, and symptoms vary by person and sometimes by attack. The challenge for neurologists is that migraine is difficult to treat because the symptoms are hard to evaluate and can change from one attack to the next. Since symptoms vary widely, migraine is often misdiagnosed and many sufferers are never diagnosed.
Prescription drugs from Mexico
So many women suffer from this incapacitating condition, yet the causes remain unknown and there is no cure. Women report pain that lasts longer and occurs more frequently than among men. There is much evidence connecting hormones to migraine, but not all migraines are hormonal. Curiously, during childhood, migraine is more prevalent in boys than in girls, but once puberty kicks in and estrogen acts up, girls are more susceptible. In fact, girls are more likely to have their first migraine during the year of their first period than at any other time in their lives, according to Cathy Glaser, President of the Migraine Research Foundation. After puberty, migraine in women increases until about age 45, when it begins to taper off. Many women find their migraine symptoms are affected for better or worse by menstruation, hormonal contraception, pregnancy, and menopause. Hormonal fluctuations, especially estrogen withdrawal, are thought to trigger migraines. During perimenopause, which can start in the mid 30s with hormonal fluctuations, migraines often get worse. Fortunately, migraine incidence decreases during menopause and drops to 5% in women after age 60.

“By helping research scientists discover the root causes of migraine and determine how to treat them, the Migraine Research Foundation hopes that everyone who suffers from migraine will eventually have an effective treatment that they can count on to allow them to live a healthy, happy and productive life, says Stephen Semlitz, co-founder and Chairman of the Board of Migraine Research Foundation.

Study finds people in Appalachia, Deep South live the shortest lives

Living to the ripe old age of…60? Where you live could factor into how long you live.

A new study published in the online journal Population Health Metrics showed life expectancy is falling in many US counties, hitting women especially hard.

Appalachia and the deep South have the lowest life expectancy numbers (mid-60′s for men, early 70′s for women).

In our area:

Highest life expectancy for men (age 72): Montgomery, Bedford and Botetout Counties.

Lowest life expectancy for men (age 67): Roanoke City, Martinsville, Danville.

Highest life expectancy for women (age 80): Bedford and Salem.

Lowest life expectancy for women (age 77): Halifax, Danville, Martinsville, and Smyth and Grayson Counties.

One of the biggest trends in this study has to do with women.

Women have, historically, always lived longer than men, but this study found that the age a women is expected to live to, is declining in many counties.

A women’s life expectancy has remained the same, or even dropped, in more than 850 counties, over a 20 year period. That’s compared to just 84 counties where mens life expectancy declined, according to the study.

Southwestern Virginia doctors say higher poverty rates, less health education and culture could contribute to the life expectancy discrepancies in different areas, specifically for how long women are living.

“This study tells us there are issues in the rural areas that are particularly hard hit socioeconomically,” said Mary Arnold, a women’s health navigator at Carilion’s New River Valley Medical Center. “Women take care of everybody but themselves; their kids, family, home, and if given the choice, they are going to focus on those things.”

“But there are also stress factors that come with having less money to deal with or a loss of jobs, which may lead to the choice of poor life style habits,” Arnold said.

Carilion has a outreach programs to help combat some of the factors leading to shorter lives, like smoking, obesity, chronic illness, said Arnold, but taking advantage of those services is up to the individual.

Affordable contraception vital to women’s health care

In 1965, the U.S. Supreme Court struck down a Connecticut law making it illegal for married couples to use birth control. The case of Griswold v. Connecticut, initially brought against one law in one small state, ensured that women can make personal decisions about if and when to have children — monumentally improving their health and the health of their families.

Forty-six years ago, women had few choices in planning their lives and their families. Thus, they were more likely to experience poor health outcomes, and their children were, too. They faced enormous barriers in pursuing educational and professional goals. And communities suffered.

The Griswold case set women, and our country, on a new, healthier path. Today, family planning is widely recognized by the medical community as integral to improving women’s health and the health of their children. For many women, access to contraception has allowed them to go to college, to pursue a career and to have a healthy pregnancy. Thirty-eight million women — more than 60 percent of those between 15 and 44 — use some contraceptive method at any given time. Not surprisingly, communities are healthier than they were in 1965.

When women plan their pregnancies, they are more likely to seek prenatal care, improving their own health and the health of their children. Access to family planning is directly linked to declines in maternal and infant mortality rates. In 2005, pregnancy-related deaths were down 52 percent from 1965. At the same time, the number of women in the U.S. labor force more than doubled.

Yet still, for millions of American women, birth control is beyond their reach. For uninsured women, out-of-pocket costs are prohibitive; even for women with health insurance, related co-payments are often unaffordable. More than a third of women have struggled with the cost of prescription birth control at some point and have thus failed to use it consistently.

A woman with insurance faces co-pays of $15 to $50 a month ($180 to $600 annually) for birth control pills and hundreds of dollars in out-of-pocket costs for longer-acting methods. Studies show that when cost barriers are removed, women switch quickly to more effective methods, and experience fewer unintended pregnancies — a critical outcome in a nation where nearly half of all pregnancies are unintended. Ultimately, removing cost barriers to birth control could mean as much today as removing legal barriers did a half-century ago.

The Affordable Care Act holds enormous promise for expanding access to birth control. Under the new law, millions of women will become insured for the first time, and health care — including birth control — that they have gone without will finally be attainable. Moreover, the law offers an unprecedented opportunity to make birth control more affordable. Efforts by some states to oppose the law is shortsighted.

The Griswold anniversary is a time to celebrate and also an occasion to recommit ourselves to improving our nation’s health.