News

US survey reveals deficits in women's health care

Janice Hopkins Tanne , New York

A study of women's health in the United States by the Commonwealth Fund, a philanthropic organisation, has indicated worsening health care for poorer women and revealed widespread violence and abuse.

The study, conducted by a national polling organisation, was based on telephone interviews with 2850 women and 1500 men between May and November 1998, who were chosen as a cross section of the population, with an additional over sample of African American, Hispanic, and Asian American women.

Interviewees were asked about access to care, health knowledge and behaviour, violence, depression, use of hormone replacement therapy, and caregiving roles.

Results published last week showed that the number of non-insured women of working age had increased from 14%to 18%since a comparable survey in 1993. In the lowest income categoryunder $16000 (£10000) a year35%of women had no health insurance. The main reason seemed to be a drop in health insurance provided through the woman's job or through her husband's employment.

Only one half to two thirds of the women interviewed had received preventive care in the past year, including a physical examination, clinical breast examination, cervical smear, or cholesterol test, even though 76%of women were in managed care. This was about the same number as five years ago. Women on low incomes and those who did not have a university education were less likely to receive regular preventive care or advice on hormone replacement therapy.

Regardless of insurance coverage, 20%of women under the age of 65 reported problems in getting medical care they thought they needed, having access to a specialist, or getting a prescription filled because of cost.

The Commonwealth Fund is working with the National Committee for Quality Assurance, an accrediting organisation, to identify the health plans that include the best practices in women's health. Senator Patty Murray, Washington state, has recently introduced a bill in the US Senate that would require managed care plans to cover contraception, mammography, and screening for colon cancer, and to provide information about treatments such as hormone replacement therapy.

Violence and abuse were identified as major problems by the survey. Thirty nine per cent of women reported that they had experienced domestic abuse or violence, childhood physical or sexual abuse, or rape.

Health Concerns Across a Woman's Lifespan: The Commonwealth Fund 1998 Survey of Women's Health is publication number 332 of the Commonwealth Fund Commission on Women's Health. It is available free from the Commonwealth Fund, 1 East 75th Street, New York, NY 10021, USA, and is also posted on the fund's website: www.cmwf.org.

(Credit: KATHY WILLENS/AP PHOTO) Many female workers may lose their health insurance if they lose their jobs

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