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Unformatted text preview: Why Study Women's Health?
Chapter 1 Beth Hensleigh, M.A. Texas A&M University Why Study Women's Health ?
Larger part of the population differences in all dimensions of health influences the health of Unique Women's health strongly future generations Women's health is important about women is a keystone to progress Education U.S. Population
http://www.census.gov/cgi-bin/popclock US Population, 2004 293,857,444 One birth every.....................8 seconds One death every...................12 seconds One migrant every................24 seconds Net gain of one person every...11 seconds 2000 Census = 143,400,000 females 2000 Census = 138,100,000 males Emphasis on Health Promotion Health promotion making wise healthrelated choices in all dimensions of health Three types of health action: Proactive care: living a lifestyle that reduces illness and promotes positive health status Health care maintenance: continuation of lifestyle to maintain current health status Reactive care: treatment of illness after an unhealthy condition has developed Holistic Health Holistic health care considers the interaction of the mind, body, and spirit area affects the other area of health Each A proactive, holistic focus empowers women to have a strong voice in their own health care Women's Health: A Global Issue Concerns of women throughout the world include: Poverty, discrimination, violence Limited access to birth control Limited access to child care Diseases and disorders specific to women Low self-esteem and poor body image Serious gynecological health concerns Two Concepts Impacting Women's Health Issues Sexism attitude of bias or an act of discrimination Example: paying women less than men for the same job Misogyny Example: hatred of women treatment of women in Afghanistan resulting in serious depression, stress disorders, suicide Progress Toward the 21st Century Late 1700s to early 1800s:
Start of Women's Movement with a general concern for education for women. 1860's Women recruited as nurses during Civil War Women and children were basically considered the property of the man: controlled finances and jobs Prior to 1900s 1873 1st nurses training opened in New York Male docs were the authority figure; female nurses were the subordinates Women usually depended on their husbands for finances, homes, security, and safety Late 1800's - Progressive Era: advanced women's health, roles of women and women's rights 1920's Right to vote (suffrage) was granted to women with the passage of the 19th Amendment Enabled women to have a voice in most aspects of important decisions 1950's Period of redefining sexuality Kinsey Report in 1953, dispelled the concept that marriage was not a prerequisite for sex Lesbians organized groups to change public opinions and advocate equal rights. 1960's Women's Movement focused on: health care, job and wage discrimination, abortion, childbirth FDA approved birth control pill in 1960 Government added the category of sex discrimination to Title VII of the 1964 Civil Rights Act. Out of Title VII came the Equal Employment Opportunity Commission, delegated to protect women and other minorities from discrimination in the workforce. 1966 National Organization for Women was started Equal Rights Amendment- 1972 1972 92nd Congress voted overwhelmingly to approve a constitutional amendment know as the Equal Rights Amendment. (ERA) Which read as follows: Sec. 1. Equality of rights under the law shall not be denied or abridged by the United States or by any state on account of sex. Sec. 2. The Congress shall have the power to enforce by appropriate legislation the provisions of this article. Sec. 3. The Amendment shall take effect two years after the date of ratification. Congresswoman Martha Griffiths, principal sponsor of the Amendment said that the ERA seeks to say to the Supreme Court of the U.S. "WAKE UP! This is the 20th Century. Before it is over, judge women as individual human beings." The ERA was not incorporated into law. 1970's - 1980's 1970s Affirmative Action assisted women in battling discrimination and obtaining higher paying jobs, or at least an improvement in the amount women are paid for the same job done by men. 1980s Sexual harassment became illegal in the work place giving women the ability to fend off sexual innuendos and threats without repercussions that could lead to job demotion, loss of promotion or loss of job. Important Legislative Acts: Summarized 1920 19th Amendment gave women right to vote 1964 Title VII prohibits discrimination based on race, color, religion, sex or national origin 1991 Civil Rights Act amendments provides for discrimination damage award 1964; 1991 Sexual harassment recognized as sex discrimination 1967 Age Discrimination in Employment Act, protection for persons 40 years and older 1963 The Equal Pay Act requires equal pay for equal work 1990 American with Disabilities Act prohibits qualified disabled individuals from discrimination in workplace 1992 Family and Medical Leave Act required up to 12 weeks leave (unpaid) for family/medical reasons 1972 Title IX in Education Amendments prohibits sex discrimination in schools (sports) 21st Century There are still issues that require major attention in the 21st Century: Focus on women's health through the lifespan Promoting a healthy and realistic body image Countering the implied obligation to fulfill a sacrificial caretaker role Halting the expectation that women follow stereotypic traditional career choices requiring greater supervision and offering lower salaries Curbing violence against women Continuing the battle against gender-role socialization along with job and wage discrimination, and Establishing standards of emotional, physical, and spiritual wellbeing that are specific to women and not derived from comparisons with men. Women's Health Research
In 1990, the NIH was investigated for failing to include female subjects, which was investigating diagnostic and prescriptive guidelines for both men and women. Many aspects of women's health are uniquely different from that of men, such as our hormonal system, reproductive system, aging process, biochemical responses, diseases! NIH Definition of Women's Health
A health problem is a woman's issue if: Unique to women or subgroup of women More prevalent in women More serious in women Conditions for which risk factors are different in women Intervention care is different Low Income as a Risk Factor Nearly 1 out of every 8 Americans lives in a family with an income below the poverty level. For all the chronic diseases that lead the Nation's list of killers, low income is a special risk factor. Former View of Health Research Andocentric view of health Research dedicated to men's health Male dominated health care system Women treated as a special interest group Focus on women as reproductive, rather than productive beings! Biases in Health Research Gender bias some medications, treatments and diagnostic procedures prescribed for women have not actually been tested on women. Ethnic bias studies which do have women as subjects, usually have a subject pool of Caucasian, middle-class, and young to middle-aged females. Ethnic minorities remain significantly underrepresented in health research. Biases in Health Research Socioeconomic bias continuous, high quality health care is often limited to the middle and upper class who have insurance. Geographical Inner-city concerns families may not afford or be aware of health care access Rural families may not have quick access to care or to specialists; distance to health care is a concern Urban & suburban families most fortunate regarding availability and affordability of quality health care Types of Research Observational Studies attempt to reveal possible associations between physical characteristics or health habits and disease. Usually include large numbers of people who are followed and questioned for several years. Interventional Studies try to determine the effects of specific treatments, diets, health practices on one's health. Participants are randomly assigned to groups and each group follows a different protocol with at least one group receiving no treatment or a placebo (like a non-effective medication). Results of each group are compared at the end of the research study and conclusions made and recommendations are made. Nurses Health Study The Nurses Health Study (NHS) was the first comprehensive effort to clinically study health issues for women. NHS I began in 1976, enrolling about 121,000 nurses between the ages of 30 and 55. This continuing research has women fill extensive questionnaires about health and lifestyles and find the relationship between lifestyle and various diseases and disorders. NHS II began in 1989, enrolling 116,000 nurses; research via biennial questionnaire the relationship between lifestyle and health problems. Office of Women's Health
Actions to Address Inequities Increased funding and national projects for research, services & education Include women in clinical trials Assess gender differences in cause, treatment, & prevention of disease Focus on lifespan health Address special access needs of women for health care services Help women access senior positions in health and science careers Women's Health Initiative Women's Launched Long-term Health Initiative
in 1991 national study focusing on preventing heart disease, breast & colorectal cancer & osteoporosis in women Institute of Health (NIH), National Heart, Lung, and Blood Institute (NHLBI), and National Cancer (NCI) & National Institute of Arthritis and Musculoskeletal & Skin Diseases act as a consortium to conduct multiple research studies. National WHI Research National Institute of Health is funding the largest study so far (n=162,000). Enrollment began in 1993 and ended in 1998 Other Research Studies
The Women's Health & Aging Study Disorders Study on Health Issues Affecting National Institute of Aging Women's Health Interactive & Valleylab, Inc. Menstrual Research Women National Institute of Allergy & Infectious Disease, NIH SWAN Study of Women's Health Across the Nation (SWAN) This is a study underway at 7 medical centers in the US using 3,200 women between the ages of 42-52 who will be followed for 5 years. The physical and psychological differences will be determined between African-American, Hispanic, Asian-American, and Caucasian women during menopause. Other Research In Women's Health 1995 National Action Plan on Breast Cancer (means to stop breast cancer) Initiating New Frontiers in Breast Cancer Imaging (improved breast cancer detection) Federal Breast Imaging Technology Inventory (helps to connect research partners interested in breast cancer) Sources of Research Funding Private Foundations: Kellogg, Johnson & Johnson Government Initiatives: FDA, NIH, DOE, CDC, NIAID Private Sources: family trusts, benevolent funding Health-related Agencies: AHA, ACS, ALA For-profit Companies: genetic labs, pharmaceutical companies Conclusion Women have health concerns that unique to our gender culture of women has evolved The Positive and negative events throughout history affected health-related issues specific to women of women's health issues within the context of social, political and medical arenas will be address throughout this course Importance ...
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- Fall '05