Nation, States Fail To Provide Adequate Care for Women’s Health, Survey Finds

The United States is failing to meet the health care needs of women as a nation, as well as on a state-by-state basis, according to a report card issued Thursday by the National Women's Law Center and Oregon Health & Science University, the AP/Dallas Morning News reports (AP/Dallas Morning News, 5/6). The 2004 edition of "Making the Grade on Women's Health: A National and State-by-State Report Card," is the third report card to grade and rank each state based on 27 health status benchmarks developed using HHS goals (NWLC release, 5/6). The report used data from the National Center for Health Statistics (Smith, Arkansas Democrat-Gazette, 5/7). According to the report, the United States as a whole is meeting only two of the 27 measures: percentage of women who had annual mammograms and the percentage who had dental check-ups. According to the report, more than 25% of U.S. women have high blood pressure and nearly 20% lack health insurance. The report also found that African-American and Hispanic women "fared far worse" than white women, the AP/Dallas Morning News reports. States were considered inadequate in the areas of disease screening and treatment, smoking cessation programs and prenatal care in the first trimester of pregnancy (AP/Dallas Morning News, 5/6). No state received a "satisfactory" grade for women's health status, although eight states -- Colorado, Connecticut, Hawaii, Maine, Massachusetts, Minnesota, New Hampshire, Utah, Vermont and Washington -- received grades of "satisfactory minus" (NWLC release, 5/6). Minnesota received the highest grade, and Mississippi received the lowest. Five other states also received a failing grade (Saxton, Associated Press, 5/6). Quality and access to care vary widely by state, according to the report. For example, 7.9% of women in Minnesota are uninsured, compared with nearly 29% in Texas. In addition, 84.5 women per 100,000 die from coronary heart disease in Hawaii, compared with 210.6 women per 100,000 in the District of Columbia. In New Hampshire, 91.5% of pregnant women receive prenatal care in the first trimester, compared with 69% of women in New Mexico AP/Dallas Morning News, 5/6).

The report also examined how states fared in adopting 67 key health policies, noting that 43 states met the national goal for mammograms for women ages 40 and older, while only three states met the national goal for pap smears and 19 states met the goal for colorectal cancer screening. In addition, 17 states provide public funding for safe abortion procedures; three states have adequate laws to improve access to emergency contraception; and 20 states require private insurers to cover contraceptives, the report found (NWLC release, 5/6). New York, California and Rhode Island met more than 35 policy goals, according to the report (Associated Press, 5/6). The report also examined improvements since the last report card in 2001. It found that while many states have expanded Medicaid eligibility for pregnant women and working parents, some have decreased coverage for low-income childless adults. Further, 16 states improved their Medicaid enrollment process by adding mail-in applications, and 15 states imposed copayments for prescription drug coverage. In addition, since the 2001 report card, only one state required private insurers to cover annual mammograms for women over age 40; three states began requiring coverage of colorectal cancer; and no states added coverage for annual Pap smears (NWLC release, 5/6).

"The outlook for women's health is not good. Both the nation as a whole and individual states fall short," Judy Waxman, vice president for health at the NWLC, said. She said state budget crises and federal policies are partly to blame for the situation (AP/Dallas Morning News, 5/6). However, she added, "State policy makers' piecemeal approach to our health care crisis has resulted in a complex and ineffective system that fails to meet the health care needs of women. Lawmakers need to take a comprehensive, long-term approach to meeting women's health needs and tackle this serious problem that plagues so many families" (Associated Press, 5/6). Dr. Michelle Berlin, an associate professor at OHSU, said, "There is a great distance to go with the nation meeting only two out of 27 benchmarks graded in this report. Failing to meet these goals undermines not only the health and well-being of women, but the well-being of our country as well" (NWLC release, 5/6). Samantha Stamper, women's health coordinator with the West Virginia Office of Maternal, Child and Family Health, said, "Women need to take personal responsibility and accountability for participating in their health outcomes. We want to do preventive health instead of treatment" (Saxton, Associated Press, 5/6). MPR's "Marketplace Morning Report" on Thursday reported on the study. The segment includes comments from Waxman (McCray, "Marketplace Morning Report," MPR, 5/6). The complete segment is available online in RealPlayer.

KPBS' "KPBS News" on Thursday reported on California's ranking on several benchmarks in the NWLC study. The segment includes comments from Elizabeth Patchias, a policy fellow with NWLC (Goldberg, "KPBS News," KPBS, 5/6). The complete transcript of the segment is available online. The complete segment is available online in RealPlayer.