U.S. Women's Health Care Still Falls Short: Report

11 states as well as District of Columbia receive failing grades

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HealthDay Reporter

WEDNESDAY, Oct. 17, 2007 (HealthDay News) -- The United States isn't making the grade when it comes to women's health, a new report contends.

The report gives the country an overall grade of "unsatisfactory" because it meets only three of 27 benchmarks for women's health. Those benchmarks are the percentage of women aged 40 and over who get regular mammograms; the percentage of women who visit their dentist annually; and the percentage of women aged 50 and over who are screened for colorectal cancer.

Not one state received an overall "satisfactory" grade in the area of women's health. Three states -- Massachusetts, Minnesota and Vermont -- received "satisfactory minus" grades, down from eight states in 2004.

Eleven states, as well as the District of Columbia, received failing grades -- Alabama, Arkansas, Indiana, Kentucky, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee, Texas, West Virginia -- double the number that failed in 2004.

All other states received a rating of "unsatisfactory," according to the report, released Wednesday by the National Women's Law Center and Oregon Health and Science University.

"As the years pass, states are further behind in the quest to meet national goals for women's health," Judy Waxman, vice president for health and reproductive rights at the National Women's Law Center (NWLC), said during a teleconference. "States have made some progress in adopting policies that could advance women's health as opposed to past report cards, but we still have a long way to go because once policies are in place, it takes a while to make an impact on health status."

Dr. Suzanne Steinbaum, director of Women and Heart Disease at Lenox Hill Hospital in New York City, said she was "absolutely appalled by this study. We're running around the U.S. talking about women and heart disease, and here we have in all states an increase in obesity, and 46 states got worse in diabetes. This should be on the mind of every single presidential candidate."

The report, Making the Grade for Women's Health: A National and State-by-State Report Card, is the fourth in a series of triennial report cards analyzing benchmarks of women's health in all 50 states and the District of Columbia. The 27 benchmarks were based on goals set by the U.S. Department of Health and Human Services Healthy People 2010 agenda.

Obesity was the only indicator that worsened in every state since 2004.

"The implications for that are enormous," Dr. Michelle Berlin, associate professor of obstetrics and gynecology at Oregon Health and Science University, said at the teleconference. "Rates of diabetes and other cardiovascular diseases are on the rise across the U.S. and obesity is a clear link to that."

The report also looked at whether states have adopted 63 policies considered important for women's health. Only two policy goals were met by all states.

"Those were Medicaid coverage for breast and cervical cancer treatment and participation in the Food Stamp Nutrition and Education program," Waxman said.

Nine states met a majority (32 or more) of the policy goals, up from three in 2004. California, New York and Rhode Island were at the top of the list, while Idaho, North Dakota and South Dakota were at the bottom.

There was some progress in adopting policies for screenings for sickness. Twenty states (up from 17 in 2004) now require insurers to cover colorectal cancer screenings. And 11 states (up from eight in 2004) require coverage for osteoporosis screening. On the other hand, only 20 states (down from 21 in 2004) require insurers to cover annual mammograms for women over 40.

"There's been minimal progress on implementing some of these policies and, unfortunately, it is piecemeal and inconsistent," Waxman said.

The new report also spotlighted the issue of women's health insurance, and in this area the nation and states are still lacking.

No state met the goal for access to health insurance. Nationwide, 18 percent of women aged 18 to 64 were uninsured. In 2007, five states decreased Medicaid eligibility levels for working parents, making it more difficult for low-income people to get insurance.

The report also found great regional differences in the health status of women. Hawaii had the lowest percentage of obese women (16.7) percent, while Mississippi had the highest percentage (31.5 percent). Utah had the lowest number of women with high blood pressure (17.7 percent), while Mississippi, again, had the worst (34.4 percent). Minnesota had the lowest proportion of women with diabetes (4.3 percent), while West Virginia had the highest (11.1 percent) and Mississippi the second highest (10.6 percent).

"Health disparities are still an enormous problem in the U.S.," Berlin said. "We have made few gains in the time that we have had these report cards. There's not much time remaining before the year 2010 arrives."

More information

View the report at the National Women's Law Center.

SOURCES: Suzanne Steinbaum, D.O., director, Women and Heart Disease, Lenox Hill Hospital, New York City; Oct. 17, 2007, teleconference with Judy Waxman, vice president for health and reproductive rights, National Women's Law Center, Washington, D.C., and Michelle Berlin, M.D., associate professor of obstetrics and gynecology, Oregon Health and Science University, Portland; Making the Grade for Women's Health: A National and State-by-State Report Card, Oct. 17, 2007

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