While more than 50 percent of the US population is female, only three decades ago, women's health has been neglected in the corridors o...
While more than 50 percent of the US population is female, only three decades ago, women's health has been neglected in the corridors of public policy, laboratory research and clinical practice. The women were as subjects in studies and medical research data no distinction of sex and gender were analyzed, largely excluded. In the past, national campaigns tobacco avoid diets or cholesterol-lowering not healthy women targeted support. In addition, women often pay more for the same insurance plans as men and medical education will have a focus on gender differences. There was no public health departments, conferences, scholarships, women reported. In addition, there was a shortage of women in science and health officials in medical institutions in our country. These failures of public health put women's health at risk - with increased undetected rates of heart disease, lung cancer, autoimmune diseases, mental disorders and addiction, and HIV / AIDS.
The convergence of the month women with the commemoration of the 25th anniversary of the founding of the Women Bureau of Health, Department of Health and Human Services (HHS OWH) of the United States provides a good opportunity to reflect on the progress that has and the fact that much remains to be done to improve women's health in the 21st century, I am proud to have played a leading role in the exposure of large differences in the health of women in 1980 and as first Deputy Secretary of state for the Health of Women and the Director of the Office of women's health at HHS, after which women's health issues and professional development of women working to move, in science and medicine at the top of the agenda of health care in our country, they said belonged.
However, despite significant progress in this time made to improve women's health, attention shifted to other issues in recent years. In addition, lifestyle and environmental factors with increasing rates of obesity and smoking, lack of physical activity, lack of access dramatically in the last 25 years for women changed EzineArticles and increased stress in women's lives. The maternal mortality with the United States increases experienced the highest maternal mortality of all high-income countries. In terms of life expectancy, 25 years ago, the American women were in the middle compared to other peer countries, but now it has fallen to the ground. If a more detailed analysis, there is a geographic component to 42 percent of US counties with the highest death rate of white women in 1980 less education life expectancy was significantly lower than white women with more education. Minority women have higher death rates from certain diseases such as cardiovascular disease, diabetes, AIDS and stroke. Result: Today, the health of women in the US is much worse than the health of women in many other countries of income, so there are still a lot of work to do.
However, despite significant progress in this time made to improve women's health, attention shifted to other issues in recent years. In addition, lifestyle and environmental factors with increasing rates of obesity and smoking, lack of physical activity, lack of access dramatically in the last 25 years for women changed EzineArticles and increased stress in women's lives. The maternal mortality with the United States increases experienced the highest maternal mortality of all high-income countries. In terms of life expectancy, 25 years ago, the American women were in the middle compared to other peer countries, but now it has fallen to the ground. If a more detailed analysis, there is a geographic component to 42 percent of US counties with the highest death rate of white women in 1980 less education life expectancy was significantly lower than white women with more education. Minority women have higher death rates from certain diseases such as cardiovascular disease, diabetes, AIDS and stroke. Result: Today, the health of women in the US is much worse than the health of women in many other countries of income, so there are still a lot of work to do.
From childhood, health of the woman. When he was 10, my mother developed cancer of the thyroid. I will never in the hospital and feel powerless against this disease forget his visit. That was when I decided to be a doctor. I spent the summer in the research labs at my school and college years engaged in the acquisition of knowledge and skills, such as research. In addition, he was to learn Medical at Stanford Medical Center News Bureau on the importance to the public advances of science communication. I decided to keep an eye on my college program with medicine. developed in my first year of college, my mother breast cancer. In my last year of medical school, metastases in the spine, so he could not walk. She fought the disease with great courage and dignity, and lived long enough to see her daughter to a doctor. There are 35 years old when my mother died of metastatic breast cancer, who promised that no woman should be the way he did have to suffer. So it was not just a job but a vocation and honor to dedicate my career to improve the health of women.
I have at the National Institutes of Health, where I work with other lawyers and researchers inequalities in women's health to expose it for the first time as a researcher and head office in the 1980s. Just as women have fought for equality in the educational and career opportunities, have those in the field of women's health had to break a variety of obstacles and prejudices in clinical practice and research to bring healthy women in the foreground. Then, in 1993 I had the honor of the first secretary of state deputy appointed for women's health at HHS. The new high-level position was created to combat health inequalities of the past and a new national recipe write women's health to improve in our country. As director of the HHS Office of Women's Health (OWH HHS), my goal was to build women's health approach into the fabric of all agencies of the Ministry offices and regions, and cooperation with other public organizations and the private sector Girl and health improve women throughout life and eliminate health disparities. We are working to answer these questions in the world with health officials around the world.
OWH HHS has organized conferences and consultations, published reports, the developed models and programs and innovation support in the field of women's health and working consumers, researchers and health experts on a wide range of topics to educate. As a result of this new national approach to women's health today is a top priority, the funding has increased dramatically, is a broad spectrum of research in progress, and addresses prevention programs and services delivery to the specific needs of women. In a State Department ambassador of women was appointed, women and girls a major concern for the development of programs and international health, including PEPFAR and gender equality is a priority of foreign policy.
Write to improve a new national order of women's health
It has been said that "it is better to light a candle than to curse the darkness." In the past 25 years a new national prescription women's health has been written to improve, to save both the federal government and the private sector on the dividends paid, life. I am proud that the prescription to have helped write, all women is the guiding principle that the programs have to offer research, prevention and services in our country from the hit nation, contribute all races, ages, socio-economic and ethnic groups and meet the health needs of all women - in body and mind.
OWH at HHS we define women's health than to promote good health throughout the life cycle, while the conditions addressed that women are unique; They are more common or more severe in women; women have different causes or events; or treatments have different results in women; or has a high morbidity and mortality in women. We focus on the issues of youth, women with an average age and older.
the development of a coordinated approach and structure of the national infrastructure in the United States have reached some milestones during my first term as a deputy secretary of the country, women's health to improve the health of women. Health care for women were called into the fabric of all HHS agencies including NIH, CDC, FDA, HRSA and many new initiatives into life, woven into a variety of health problems. Public awareness and scientific increased significantly since they all guidelines were used, the cooperation between the authorities and the private health sector. I appointed regional coordinators of women's health at work at the country level and also the health of women are National centers of competence developed and implemented. These centers serve as national models to improve research, services, public and professional education and community involvement and offer a network best practices in women's health to share. They also promote the recruitment, retention and advancement of women in medicine and science academic career. Women curriculum health was health care and research address developed and distributed in professional schools of health important gender differences in the disease. National Community competence centers have been established to strengthen links between community organizations to improve health care for women.
Because knowledge is power in the areas of health, I believe that women have access to state of the art required, complete information on the use and easy individual health has been the first in the government to use the power of the Internet for health education by the National Women's Health Information Center (NWHIC) up. The center, accessible via a toll free number (800-944-wife) and online at www.womenshealth.gov provides consumers, physicians and researchers with a connection to the united state of the art information in a variety of health problems of women by thousands of expanded resources in the federal government and the private sector. The site offers a reliable and comprehensive information on a wide range of topics and information requirements. Since the first proposal of this center and the site in 1994, it is amazing to think how much in the course of the revolution in information technology has changed. At this time, the Internet has not been widely used in many fields. In fact, some representatives of the NIH, CDC and other federal agencies concerned were reluctant to provide their brochures and other documents for inclusion in the new location that the budgets of public companies that could be affected by this new portal "one-stop" for information on women's health. This led me to the US Department of Defense to work - the Agency, where the Internet was created for the first time - to build the portal. if the group as a powerful communication tool, ran to the site again in the coming years, the Ministry of Health and Social Services of the United States has emerged for the start.
A key for me was the first Assistant Secretary for Health priority of women that our national prevention campaigns to ensure either quit smoking, to promote a healthy diet, participating in physical activity and prevent HIV / AIDS, to the special needs of Women to concentrate. In fact, today, the main causes of death of American women chronic diseases, such as heart disease, chronic lung disease, cancer, stroke, diabetes and injuries - the conditions for a maximum of 50 percent attributed the cause of behavior and lifestyle factors such as smoking, obesity, lack of physical activity, alcohol , opiates and other substances, unsafe sex, and injury. For example I have with the Girl Scouts to establish the first partnership between the Government and the Organization. It was the merit of preventing smoking flagship initiative, which was launched with First Lady Hillary Rodham Clinton launched the White House. We also work with federal agencies and the private sector and the media worked disorders and osteoporosis to develop prevention campaigns and set up a Working Group on Women and AIDS to eat. We focus on heart disease in women, such as cardiovascular educate the public and health care providers disease, for too long the illness of a person considered, in fact, the main cause of death among American women, but the symptoms can appear very different.
Following the new national recipe that was written in the last 25 years, a wide range of research currently supported on the conditions and diseases that affect women throughout their lives. Several large studies have in the seasons of life founded by women, children's health study, adolescent health, the SWAN study of women in mid-life and Health Initiative of Women NIH including - the largest clinical research study on health was carried out by post-menopausal women in men or women, concentrated. The results of this study recommendations for the treatment and prevention of disease in older women significantly altered.
There was also a significant change in the search for the path will be realized in the United States, but still problems. Driven advocacy and activism of women, was a Congress report in 1990 that only 13 percent of the National Institutes of Health was the budget for research on women's health and that the data is not well analyzed gender and equality. This led to the adoption of the law in 1993, requires that women and minorities should be included in clinical trials, if any. As a result, now account for 57 percent of women of all participants in clinical trials by the NIH supports. Last year, however, the Government Accountability Office (GAO) released a report of the current status of women's participation in the NIH clinical trials supports the adoption of the 1993 Act, although the GAO report assesses the most participants in clinical trials are women - - good news found also found that some problems remain. The NIH has provided information on the percentages of men and women are available in the study not of specific diseases (eg, AIDS, heart disease, cancer and depression) or institutions involved. Moreover, the agency do not provide information to the public, whether the research data that had suffered possible gender differences, as required by the 1993 Act therefore, were after the GAO report "analyzes NIH is limited in its ability to detect whether women are underrepresented in the studies in certain areas - such as cardiovascular disease -. Or if data challenges do throughout the agency accidentally masked registration not examine detailed information about the enrollment of under the global level can not NIH know if you women in all research understand it, supported in line with its policy of inclusion. "additional measures to break down now data in this way. In addition, more attention should be paid to the reporting of racial / ethnic differences in the health of women.
In addition, a report by the Institute of Medicine points out that gender issues in the system of molecular, cellular and organ of the most basic scientific NIH studies included only men and cells that are suited to the understanding of the influences of critical gender in health obscure and disease. It was a question that I was working to address health of women during my tenure as deputy secretary. At this time, the NIH was estimated, however, that the participation of women in clinical trials to ensure his first priority, and it would be for the studies on the basis of animals of both sexes include too complex and expensive to be. Twenty years later, the NIH has taken steps to remedy this omission in the conduct of intelligence gathering. In January 2016 new NIH guidelines were issued, according to which all basic study science research assisted by the Agency include both animals and male and female cells, unless there is a compelling reason is that use of one sex, such as research on disease-specific sex as ovarian cancer or prostate cancer. This new policy is to identify, in the form of hypothesis before human clinical trials certain gender differences. In addition, in August 2014, the FDA has the collection of data for demographic subgroups, such as pharmaceuticals and medical devices affect subpopulations improve an action plan to improve the participation of minorities and women in research studies and results are available on the product labels.
While these problems in the NIH, the FDA addressed and other authorities, he said that these rules and recommendations by the private sector is not necessarily studies and other organizations, the research means not receive federal. Pharmaceutical companies, for example, are the main supporters of the Phase 3 clinical studies. In medical journals, gender differences in the literature are rarely reported unless the purpose of the study indicated. That needs to change.
Moreover, understanding differences affect only sex (biological) between men and women, health and disease is not enough. Impact on women's health should always pay more attention to social and environmental factors - gender - as well as the quality of life. Socioeconomic status is one of the strongest predictors of health in the United States and the world. In the US, 56 percent of the 46 million people are living in poverty, women and girls. Women still earn 77 cents for every dollar men earn. Women with low income and / or education have a higher prevalence and mortality from diseases such as AIDS, diabetes and cancer in the US and worldwide. Lifestyle changes, including lack of physical activity, obesity, smoking and increased burden faced by women issues that have had a negative impact on the health of women in the 25 recent years. Therefore, attention to the socio-cultural, environmental and racial / ethnic is essential for the promotion of women's health.
Another key challenge, the health of women develop to accelerate innovative strategies to improve the time for the scientific discovery of the application of new knowledge in the communities. Currently, there are about 15 years from the time of serving, removed, a new scientific discovery of its wide use in the scientific community. This should be addressed. should help the application of mobile technology and social networks, to fill this gap, improve service delivery and the empowerment of women to health information to be a priority
The war against breast cancer has also an important concern for my work and the HHS Office on Women's Health. The Office conducted a presidential initiative on breast cancer a private / public sector partnership. Meanwhile, the government and the private sector financing grew to find the causes in order to improve early detection and improved treatment strategies and prevention. And in the last two decades there have been some very good news: our national investment pays off to save lives. Death in breast cancer rates dropped 1990-2014.
Although the ultimate goal is to have breast cancer to prevent never happen to find the beginning of the disease and a cure, early detection is important to find today, if it is not the best chance for successful treatment. 20 years ago, and today there was a controversy about the age at which women should get her first mammogram. What caught my attention in this debate is that mammography, the "gold standard" for the current detection, is a 60-year technology and three are in four benign lesions lead to many unnecessary biopsies. Moreover mammograms lose about 15 percent of breast cancers. I thought that if scientists could see the surface of Mars with the Hubble telescope, maybe it was possible precisely to small tumors in the breast of women to realize here on earth. Therefore, in 1995, I brought the director of the CIA director in contact NASA and the General of the Department of Defense Research Medical Command whether imaging investigate technologies to these organizations for missile detection for the study of intelligence and the space could be used to breast cancer detection improve.
In 1996 organized the HHS Office on Women's Health, a conference at which I presided intelligence, aerospace and defense of scientific communities and radiologists with the best in our country. The recommendations of this meeting led to an initiative called "rocket mammograms." This program has to find camouflaged by a dense breast tissue transfer the imaging technology used concealed only by the CIA satellites for cars behind the trees small tumors. The initiative promoted advances in computer-aided diagnosis and images in 3-D. While much has been done, because my mother had breast cancer, it remains clear to be done to eliminate the suffering and death caused by this global enemy of women. The new initiative of contributing "precision medicine", new knowledge, and the study of epigenetics and behavior, lifestyle and environmental risk and protective factors that lead to a new generation of therapeutic products breast cancer and other cancers.
Mental health is also very important for women. In the US, 1 in 5 Americans each year will experience a mental illness. Some of these diseases affect women, such as depression and anxiety disorders disproportionately. Depression is the leading cause of disability for women in America. Women are 70 percent more likely to be diagnosed with depression, but 30 to 50 percent of women are not diagnosed. Women with substance use disorders have a much earlier age of death of women in the general population five times the risk of death. However, it is 30 years ago, when I began my career in the National Institute of Mental Health, it was surrounded by a strong social stigma of this disease. At that time, were considered by many character flaws or personal weaknesses mental disorders, rather than real, disabling heart disease or diabetes, the causes and effective treatments have established diseases. Fortunately, in the last 25 years there have been many changes in our understanding of mental illness. In 1999, emphasized the first report of the Surgeon General on Mental Health, that mental health for general health is essential, and encourages Americans to get help when they occur emotional problems. Throughout my career I have tried to raise the attention of the public and the scientific insanity, especially gender differences in these disorders and their effects. The challenges include before increasing knowledge about prevention of mental illness and direct interventions to the specific needs of women. In addition, we are faced with the epidemic of opiates in America to increase at rates of addiction and overdose in women. Women have higher rates of comorbidity of mental illness and addiction compared to men who have more complex processing. The approval of the Affordable Care Act now provides parity for coverage of mental illness and substance use disorders, which is a big step forward. Other brain diseases such as Alzheimer's disease is a priority, as women age and are often the caregivers of relatives with the disease.
Violence against women has also an important priority during my tenure as the first Assistant Secretary for women's health. It is estimated that up to 30 percent of American women are victims of physical or sexual violence. The experience of violence is the strongest correlation of chronic disease in women. The violence is linked to higher rates of heart disease, obesity, depression, addiction and pain. A multifaceted initiative took place during my mandate, including the creation of a National Advisory Council, a domestic violence Federal Coordination Committee a telephone line (800-799-SAFE) leads -Co-Chair, an increase of resources for intervention and prevention programs and the implementation of training programs for health professionals and law enforcement.
Moreover, the use of a health in all policies approach, which all government agencies mobilized critical health issues must be referred to that found several other federal coordinating committees on breast cancer to identify new technologies and the image of women's health and the environment and to eliminate environmental hazards prices could contribute to certain diseases to increased impact on women in recent decades.
Health reform
Just as women were excluded from the survey and preventive measures that had been discriminated against in the health system. Women were more likely than men have no health insurance because workers as a result of divorce or death of a spouse a day or insurance were lost unemployed or half. In addition, pay women were often more than men for health insurance premiums. As a result of the adoption of the Affordable Care Act of 2010, the missing piece of national legislation to improve women's health, he was finally taken into account. ACA redesign and modernize the health care system for the 21st century by increasing the efficiency, effectiveness and equity. The law eliminated discriminatory insurance practices. Women can no longer be provided for insurance than men invoiced. It provides parity in health insurance for mental illness and also covers the deductible without preventive services or cost sharing. Following the ACA, currently 90 percent of Americans are insured. The uninsured rate for women in the 19 percent before the promulgation of the Law of 11 percent in 2014. The accelerated legislation and the prevention revolution and incentives for individuals, companies, schools reduced US and municipalities to adopt prevention program.
