The evolving landscape of health care in the United States is at best confusing and at worst confounding. While Americans theoretically benefit from the finest care in the world, health care issues persist. Among these are access for all women to the latest preventative and curative care, and lifestyle and personal care choices.
A Perspective from Local Health Care Leaders
By Mike Haskew
Today, women are becoming acutely aware of the necessity to maintain good health while managing the obligations and time constraints related to family and career. Living, working, and coping with the needs of each day challenge women to seize the initiative and take charge of their own good health.
“Women and men share many similar health problems,” noted Debra Moore, of Memorial Health Care System, “but women have their own health issues including fertility, pregnancy, childbirth, motherhood, and menopause. Diseases more common in women than men include gallstones, urinary tract infections, kidney disease, autoimmune diseases like multiple sclerosis and rheumatoid arthritis, and osteoporosis. Certain cancers are specific to women too, of course – cancers of the breast, cervix, womb, and ovaries.”
Heart disease is the leading killer of both women and men, and because the symptoms are different in women, such problems may not be diagnosed as rapidly, she added.
“Women must take an active role in their health issues,” asserted Charlsetta Woodard-Thompson, Executive Vice President and Chief Operating Officer of Erlanger Health System. “We often take care of so many people – husband, children, parents, siblings, and put ourselves last – neglecting our own health issues until they are presented at a time when they are more serious. Because we are the major care providers, this delay in personal care can cause a chain reaction on the family’s health care since we will not be available to monitor the care for the family.”
According to Woodard-Thompson, women taking charge of their own health care includes seeking a provider who understands women’s health, since women are not microcosms of men. Their bodies exhibit different symptoms and react differently to some courses of treatment. Women should also be willing to challenge their providers, asking questions and being cognizant of their own health issues.
“We need to have regular check-ups and follow up on suggestions given to us by care givers,” she commented. “Women need to listen to their bodies and make sure we have care givers who listen to us. If you have a physician who insists that there is nothing wrong with you and you feel otherwise, get a second or third opinion if necessary. Don’t let others minimize your health concerns.”
Prevention is indeed the cornerstone of good health for women. The Centers For Disease Control Women’s Health Databank reports that since 2004 the leading causes of death among American women are heart disease at 27.2 percent, cancer 22 percent, and stroke 7.5 percent. True enough, major efforts are underway to educate the public on the need for preventive care and recognizing warning signs, as well as researching cures for such high profile diseases as breast cancer. However, the responsibility for good health resides with the individual.
“The biggest opportunity for women in health care today is to decide that their lives are important and that they may need to make changes and take care of themselves better,” reasoned Debbie Reeves, Chief Nursing Officer and Vice President of Patient Care at Hutcheson Medical Center. “Obesity is at an all-time high in the United States, and those who are overweight have higher risks in the top three causes of death for females.
“Women need to eat healthy, including five or more servings of fruits and vegetables a day and less saturated fat. Be active. More than fifty percent of women do not get enough physical activity to provide healthy benefits. At least 30 minutes of moderate physical activity every day of the week is recommended. It does not take a lot of money or time to walk. Start slowly, working up to a satisfactory level and routine. Enjoy the outdoors, and you will immediately notice a difference in your mental and physical condition. Other ways to get in shape, lose unwanted pounds, and feel good about your life include doing something you enjoy such as gardening, dancing or swimming.”
Health care professionals agree on several other key points to good health for women. They include:
• Stop smoking. Smoking triples the risk of heart disease in middle-aged women and increases the likelihood of cancer, lung disease, and early menopause.
• Get vaccinated. Vaccines are not just for children.
• Balance stress. Easier said than done, but for women, stress contributes to a variety of emotional and physical conditions.
• Know your family history. Take precautions against health conditions identified in previous generations.
• Protect yourself. Wear seatbelts, sunglasses, and sunscreen. Wash your hands. Be aware of your surroundings and personal safety.
• Drink plenty of water. Mild dehydration can affect thinking, energy, and the immune system.
• Get an Annual Physical. Primary care physicians help patients stay current with screenings for early detection of any problems.
• Get Sufficient Sleep. We tend to take sleep for granted, and a good night’s sleep can work wonders.
• Laugh a Lot. A great stress reliever, humor helps maintain a positive perspective on life.
Certainly, these are among the basics of prevention. Still, the hustle and bustle of daily life can be the greatest obstacle to good health. Paying attention to lifestyle, during a period when 30 percent or more of American adults are overweight, is particularly important, both physically and mentally. Managing stress generated by external factors is also critical.
“We, as health care providers, can educate women about the importance of making their own health care a priority,” related Jerri Underwood, Chief Nursing Executive at Parkridge Medical Center. “With the global financial crisis, there will be increased concerns for women who are faced with managing finances and the increased cost of everyday living. This can lead to elevated stress hormones and potential cardiovascular events and strokes. The other thing about the financial crisis is that if you are not working you may become isolated. That can cause depression. Losing a job can lead to using drugs and alcohol or smoking, and people tend to eat less expensive comfort food. This can contribute to obesity.”
Underwood also sees financial stress as a contributor to a delay in seeking medical care and even in filling needed prescriptions.
Perhaps chief among the modern stressors for women is the fundamental and precious commodity of time. Rae Bond, Executive Director of the Chattanooga-Hamilton County Medical Society and the Medical Foundation of Chattanooga, asserts,
“We want our kids to have dance lessons, to play soccer, and to participate in cultural activities, but the simple fact is that the Lord gave us 24 hours a day and some of those are required for sleeping. I overschedule myself, wanting to do everything and help people, but one thing we can do for ourselves is to be better at saying ‘No.’ Everybody I know is so stressed now, seriously worried about the economy and financial concerns. Going into the new year it is extremely important that women do more to take care of themselves.”
Bond recognizes Project Access, a local community health partnership which provides health care for uninsured Hamilton County residents, as a key initiative for the improvement of women’s health and that of entire families. Since 2004, more than $30 million in free health care services have been provided through Project Access.
Reinforcing Bond’s perspective is the startling fact that nearly 1,000 Hamilton County residents were enrolled in 2007 alone and more than 68% of these were female. Linking those in need with quality health care is critical. Otherwise, the barriers for some, primarily women, could prove tragically insurmountable.
Compounding the issue of access, even for those who have health insurance coverage, is a difficulty understanding the complexities of coverage itself. “Having worked in post-acute settings with an aging population, a major issue is the lack of education for health care access,” said Julia Smith, Chief Financial Officer for Kindred Hospital in Chattanooga. “This includes the knowledge of access to home health care and benefits coverage. Most folks don’t really know what coverage they have or how to use it. This is more difficult for them when they are challenged with a long-term illness.”
Considering the challenges and issues which exist in women’s health care today, tremendous advances in quality care are providing benefits well beyond those of a generation ago. Research and advancing technology are increasing longevity and improving the quality of life at the same time.
“We have had many advances which make the diagnoses of health issues easier,” Woodard-Thompson evaluated. “We have digital mammography which provides clearer images for the diagnosis of breast problems, virtual colonoscopy for people who fear the regular testing procedures, the merci catheter for eliminating blood clots which had previously been fatal, and much more.”
Reeves added, “In June 2006, the Advisory Committee on Immunization Practices recommended the use of a quadrivalent human papilloma virus vaccine for the prevention of these viruses for all women ages 9-26 years in the United States. This revelation for genital HPV, the most common sexually transmitted infection in the U.S., may prevent women from getting cervical cancer. It is estimated that 6.2 million women are affected each year by HPV.”
For Underwood, some of the most significant advances in women’s health include the widespread use of new surgical techniques and more effective treatments for cancer.
“Minimally invasive laparoscopic and robotic surgery mean less time away from work,” she explained, “along with fewer complications and blood loss. Other improvements are better imaging for breast cancer detection, the HPV vaccine to hopefully prevent cervical cancer, and the potential for procedures and treatments for cancer that are being developed every day. Some of these therapies may be able to cut off the blood supply to tumors or require only one radiation treatment to be effective.”
In addition to these advances, Memorial’s Moore sees progress in genetic testing which can enhance the prevention of breast cancer and other diseases. “Genetic testing and studies have only scratched the surface,” she said. “There is much potential here for early diagnosis and treatment. Research into women and heart disease will help clarify the difference in the symptoms for women and provide earlier detection. Brain studies and other studies to find the causes and cures for diseases like Alzheimer’s, Parkinson’s, and stroke will continue.”
As we look to the future, advances in research and medical care will offer improved medical care for women. The demands on time will most likely challenge lifestyle and personal health care choices. As the American health care system continues to evolve, the hope is that the best medical care can be available to all.
Mike Haskew is a graduate of the University of Tennessee at Chattanooga and holds a degree in history. He is a native Chattanoogan and is currently Executive Vice President and Chattanooga City President for Cohutta Banking Company.