Efforts to educate women about healthcare are achieving mixed results. Preventive care, access to care, domestic violence and caregiving are particularly problematic, according to new findings by The Commonwealth Fund 1998 Survey of Women's Health released last week.
These barriers must be addressed with more situation-specific health education and stronger physician communications. "Today's thriving economy provides an excellent opportunity to make long overdue progress toward improving women's health," says Karen Davis, president of the Commonwealth Fund.
The good news is that mammography and exercise rates are up, and more women are aware of how calcium supplements can help prevent osteoporosis. This progress, however, is greatest among upper-income and college-educated women. Those on the lower-income end of the spectrum lag far behind.
The survey of 2,850 women and 1,500 men nationwide, conducted by Louis Harris and Associates from May to November 1998, compares findings from the Fund's 1993 survey.
Women's Healthcare Voids
In spite of the strides being made to promote preventive healthcare, it still is critical to better educate physicians about the importance of counseling patients in key lifestyle areas.
Physicians are more likely to counsel women about exercise (49 percent) and diet or weight (46 percent) than the more difficult lifestyle issues of smoking (29 percent), alcohol/drug use (23 percent), sexually transmitted diseases (16 percent) and domestic violence (8 percent), according to the study.
Instances of domestic violence were disturbingly high, stressing an urgent need for hospitals and doctors to become more involved in prevention and support initiatives.
Nearly 31 percent of the women surveyed said they had been the victim of violence or domestic abuse by a spouse or partner; 21 percent had been raped or assaulted.
A few health plans and hospitals are tackling this issue. In the Oct. 15 issue of HPRMN, we profiled Victims Services, a New York-based advocacy organization that is working with managed care plans to teach physicians the early signs of domestic violence.
Despite the thriving U.S. economy, the proportion of uninsured working-age women is substantial:
- 26 percent of women age 18-64 were either uninsured or had spent time without insurance throughout the course of the year;
- Low-income women are at the highest risk of being uninsured
- 35 percent of women with incomes of $16,000 or less were uninsured, up from 29 percent in 1993;
- African American (23 percent) and Hispanic (42 percent) women were more likely to be uninsured than white women (13 percent).
(The Commonwealth Fund, Mary Mahon, 212/606-3853)