WOMEN’S HEALTH: More Get Preventive Care, Fewer Insured
Although women today are more knowledgeable about healthy behaviors than they were five years ago, many still lack the health insurance to follow through on prevention, according to a survey released yesterday. The 1998 Commonwealth Fund Survey of Women's Health -- which compares findings with the Fund's 1993 Survey of Women's Health -- found that more women over age 50 and more minority women are receiving mammograms, and women are more aware of osteoporosis and how to prevent it. However, no difference was found in the use of lifesaving preventive services such as Pap tests and clinical breast exams. Upper-income and college-educated women appear more likely than their low-income or less-educated counterparts to receive regular preventive care services and counseling on hormone replacement therapy.
All About Money?
"The extent of the problem of uninsured women is understated," said Cathy Schoen, vice president for research and evaluation at The Commonwealth Fund (Commonwealth release, 5/5). "We are in a booming economy, and one striking finding of our survey is that it hasn't stopped the steady erosion of health insurance among adult women," she said. "This is particularly concentrated in the lower half of the income distribution, but uninsured rates are across the board for all groups of women" ( AP/Baltimore Sun, 5/6).
The Numbers, Please
Among the findings of the Louis Harris and Associates, Inc.-conducted survey, based on interviews with 2,850 women from May to November 1998 :
- Mammograms: The number of women over age 50 receiving mammograms increased from 55% in 1993 to 61% in 1998. While 83% of respondents over age 50 with incomes above $50,000 received a mammogram in the past year, only 49% of those with incomes less than $16,000 had. The number of minority women receiving mammograms increased substantially over the five-year period, climbing from 37% of African-American respondents in 1993 to 66% in 1998, and from 54% to 64% for Hispanic women.
- Pap Tests: The number of women receiving Pap tests (64%) and the number receiving breast exams (66%) held steady over the five-year period. Women in managed care plans reported higher rates of Pap tests, with 74% receiving the screening the past year, compared to 67% of those women in fee-for-service plans.
- Hormone Replacement Therapy: The proportion of women over 50 using hormone replacement therapy rose from 23% in 1993 to 34% in 1998. Use of HRT, like the other services reviewed, corresponds to education and income: 49% of women with a college degree used HRT, compared to 22% with less than a high school degree. Further, only 25% of low-income women reported receiving counseling about HRT, compared to 61% of women with high incomes.
- Uninsured Women: The proportion of working-age women without health insurance increased in 1998, with 18% of women ages 18 to 64 uninsured, compared to 14% in 1993. African-American and Hispanic women were more likely than their white counterparts to be uninsured: 13% of white women underage 65 lacked insurance, compared to 23% of African-American women and 42% of Hispanic women without insurance.
- Osteoporosis: Education messages were slow to reach the minority community, the survey found, noting that 25% of black women, 19% of Hispanic women and 17% of Asian American women said they were not "very familiar" with osteoporosis. By contrast, 41% of white respondents said they were "very familiar" with the disease (Commonwealth release, 5/5).