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Nation gets failing grades in women's health report

WASHINGTON (CNN) -- America's policy makers and health care providers "have a lot more work to do" to promote women's health and well being, a new report says.

"Making the Grade on Women's Health: A National State-by-State Report Card" measures key indicators on women's health status and related public policy across the country. In the report, authors say that individual states and the nation as a whole are failing women at nearly every turn, and cite gaps in health care access, health promotion and education, funding for research and income.

"Women just do not have access to health care services," said Marcia Greenberger, Co-President of the Women's National Law Center, a report sponsor. "We as a country have to do better. Improving access is one of the highest priorities."

There also is great disparity between states. In percentage terms, for example, a woman is twice as likely to die of heart disease in Mississippi as she is in Minnesota. And Tennessee and Texas, the home states of each of the major presidential contenders, both rank in the bottom 10 for overall women's health.

But it's not just a matter of geography.

"There are significant health disparities based on race, ethnicity, income, disability and sexual orientation throughout the nation," said Dr. Michelle Berlin, co-director of a women's health consortium at the University of Pennsylvania School of Medicine.

"We're doing OK for those who can afford it," noted Dr. Safa Rifka, president of the medical staff at Columbia Hospital for Women in Washington, D.C. "To those who cannot afford it, we're doing terrible."

No single state received a satisfactory grade. And although Hawaii ranked first overall, it was still rated as unsatisfactory, according to the report.

"It's particularly alarming that, of the 25 indicators of women's health status for which we established benchmarks, no state met all of them, and all of the states missed 10," said Berlin. "The 50 states and the District of Columbia all met only one benchmark: the percentage of women age 50 and over who received mammograms. This is not good enough."

Success in achieving increased awareness about the importance of mammography for women over 50 shows that such success is possible in other areas, such as increasing the availability of mammograms to women at younger ages, said Greenberger.

"With concerted effort and attention, we can make progress, but we have to do it in a full-grown way," she said, noting a study which found significant differences in breast-cancer mortality rates in relation to whether the women had health-insurance coverage.

"Women will not reach the health status they really deserve without attention to all these issues," added Greenberger.

The report also found shortcomings regarding:

      • Wellness and prevention efforts. In addition to mammograms, women also often lack access to other critical screening tests such as Pap smears and exams for colorectal cancer.

      • Key health conditions, diseases and causes of death. While 30 states met the national goal for reducing heart-disease deaths, no state met the goal for reducing rates of high blood pressure.

      • Reproductive health. Nationally, almost half of all pregnancies are unintended, falling substantially short of a goal to reduce them to 30 percent of all pregnancies. In addition, the maternal mortality rate for African-American women is four times higher than it is for whites.

      • Violence against women. National data show that 55 percent of women face physical assault or rape in their lifetime.

"We looked very hard to try to get a better set of data for a lot of indicators," said Greenberger. "And on violence against women, the only data we felt confident about was national. We couldn't get it for state-by-state."

In fact, researchers found a considerable lack of state-level data on many factors, Greenberger said.

U.S. Secretary of Health and Human Services Donna Shalala praised the group's effort to take a snapshot of the status of women's health, calling the report an important work that "will inform public policy at the state and national levels."

The report "is thorough and incisive," Shalala said, and provides "a road map to programs and policies that will improve women's health in the future and identifies gaps that need to be filled."

In addition to the National Women's Law Center, report sponsors are the University of Pennsylvania School of Medicine and the Lewin Group, a health care consulting firm.

CNN.com Writer Michele Dula Baum and Correspondent Gary Nurenberg contributed to this report.



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RELATED SITES:
National Women's Law Center
"Making the Grade on Women's Health: A National and State-by-State Report Card"
The Lewin Group
FOCUS on Health & Leadership for Women


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