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http://www.nytimes.com/2010/12/09/health/research/09women.html?_r=1&ref=health

 

USA - STUDY FINDS SETBACKS IN WOMEN'S HEALTH

 

By Roni Caryn Rabin - December 9, 2010

USA - More women are binge drinking, saying they downed five or more drinks at a single occasion in the past month, and fewer are being screened for cervical cancer. Over all, more women are obese, diabetic and hypertensive than just a few years ago, and more are testing positive for chlamydia, a sexually transmitted disease linked to infertility.

The latest health report card for women, issued on Thursday by the National Women’s Law Center and Oregon Health and Science University, paints a dismal picture, giving the United States an overall general grade of Unsatisfactory, with many F’s on specific goals set by the government’s Healthy People 2010 initiative.

“The takeaway message is that we’re really not where we should be,” said Dr. Michelle Berlin, an 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. “We’ve had 10 years of doing this report card, and you would hope the needle would have moved more than it has.”

While screening rates for colorectal cancer and high cholesterol have improved since the last report card was issued in 2007, and fewer women are smoking and dying of stroke or coronary heart disease, obesity continues to be a growing problem, with 26.4 percent of women considered obese, up from 24 percent in 2007. The objective of Healthy People 2010 is to reduce that rate to 15 percent.

“It’s boring but it’s true,” Dr. Berlin said, noting that one-quarter of women are sedentary and get no leisure-time physical activity at all, and that the vast majority do not eat five fruits and vegetables a day.

The report card is the fifth issued since 2000, and it grades and ranks states and the District of Columbia on 26 health-status indicators, depending on how close they came to achieving goals set by the United States Department of Health and Human Services, with more general assessments on dozens of policy indicators, like whether state laws require insurance coverage of mammography or whether their Medicaid program covers smoking cessation.

Vermont and Massachusetts ranked highest on health status and were the only states to get the grade of Satisfactory Minus; Louisiana and Mississippi were 50th and 51st, respectively. New York ranked 22nd, and was among 37 states that drew an Unsatisfactory grade.

California and New Jersey ranked highest on state health policies; Idaho and South Dakota were at the bottom of the list.

Judy Waxman, vice president of health and reproductive rights at the National Women’s Law Center, said the new health care overhaul law had the potential to sharply improve women’s health through its myriad provisions, which expand Medicaid eligibility and bar gender rating on health insurance policies. The sharp increase in binge drinking, a behavior not commonly associated with women, was one of the report’s surprises: More than one in 10 women reported having had five or more drinks on at least one occasion in the last month, up from 6.7 percent in the 2007 report.

“This is very concerning especially when we think about what other things can happen when people engage in binge drinking: there are more sexual-assault problems, they’re more likely to acquire an S.T.D., and more likely to have accidents while driving,” Dr. Berlin said, suggesting the increase might reflect poor mental health and depression resulting from economic insecurity or unemployment.

She was at a loss to explain the drop in cervical cancer screening: 78 percent of women ages 18 to 64 had a pap smear in the last three years, down from 84.8 percent in 2007. The Healthy People 2010 goal is 90 percent.

While the increase in chlamydia infections might simply reflect more women being tested, Dr. Berlin said the drop in cervical cancer screening was disconcerting and might reflect either loss of health coverage or confusion over changing guidelines and the new vaccine (women who have been vaccinated must continue to have pap tests).