2011 won’t go down in medical history as a banner year for women’s health.
Matters were hardly helped by this year’s American Medical Association meeting in Chicago. As this correspondent noted at the time, the conference passed up important 2011 women’s health developments in favor of revisiting (yet again) the Affordable Care Act.
Almost half of American women passed on medical care in 2011 because they couldn’t afford it, up from a third 10 years ago. And women in the U.S. are dying younger than they were a decade ago, wiping out nearly a century of progress in public health. This kind of thing doesn’t usually happen in developed countries.
While aiding health by putting a million plus men back to work in the U.S., the slow economic “he-covery” has meant more unemployment for women, contributing to family woes.
Good news about cancer
Generally, health care reform has made cancer more treatable. Lung cancer screening has been revolutionized in the past year, helping the growing numbers of women with the life-threatening disease. Also, targeted drug therapy has improved treatments for many cancers, including melanoma.
In breast cancer news, follow-up studies have continued to associate combined hormone therapy with breast cancer risk, with the rate increasing the longer therapy is used. Also, the BRCA gene has been linked to early hereditary breast cancer risk. And a new environmental health risk has been identified for 350,000 nail salon employees–exposure to dozens of potentially carcinogenic chemicals, including acrylates and solvents.
Reproductive health strangled by politics
Family planning, including contraception, seems mired in American politics. Efforts to de-fund Planned Parenthood rose to a fever pitch several times in 2011, even threatening a government shutdown. Contrary to public opinion, Planned Parenthood provides vital health care, including basic health and cancer screenings, for many underserved women. Abortion care makes up less than 5% of the agency’s medical services.
U.S. Health and Human Services Secretary Kathleen Sebelius overruled the Food and Drug Administration on the “morning after pill” restrictions for girls under 17, making access to Plan B One-Step harder for girls under 17.
Mental health: depression of unwanted pregnancy same regardless of outcome
Unwanted pregnancy has been found to double women’s risk of mental health problems. One third of women with an unwanted pregnancy suffer depression or anxiety. This rate remains the same for women whether they opt for abortion or continue with the pregnancy.
Substance abuse setback from the tobacco industry
Strong graphic product warnings developed by the Food and Drug Administration have been put on indefinite hold by a federal court ruling this fall pending legal action from Big Tobacco. Meanwhile, maternal cigarette smoking in the first trimester has been associated with a 20-70% greater likelihood of congenital heart defects.
Natural disaster toll in lives and public health
As well as the earthquake and tsunami in Japan, Australia’s massive flooding, and a drought in Africa, 2011’s natural disasters played havoc with health care and insurance in the United States. These included seismic activity in places that normally seem stable (Colorado, East Coast), deadly tornadoes (the worst, in Joplin, Missouri), tsunamis in Hawaii and California, Hurricane Irene, a million-dollar blizzard, major river floods in the Upper Midwest and on the Mississippi River, and a horrific wildfire season, especially in the Southwest.
Other 2011 developments
- the first new lupus drug in 50 years
- several breakthroughs in HIV/AIDS
- a simpler “My Plate” design to replace the food pyramid
- recommendations limiting salt intake to about a teaspoon per day
- a lowered threshold for lap-band surgery
- increased interest in maternal surrogacy and uterine transplants
- investigation of cell phone health risks
The Affordable Care Act (“Obamacare”) and other legislation
A ray of hope for women’s health in 2011–new guidelines under the ACA, which is the biggest U.S. health care overhaul in the last 50 years, require new insurance coverage of women’s preventive services (breastfeeding support, domestic violence screening, contraception, etc.) without charge.
However, a raft of political objections has sent the Affordable Care Act to the Supreme Court. The court will rule on aspects of the law’s legality in the coming year. Oral arguments will begin in March, with a decision expected before June.
A study in the American Journal of Public Health indicates that new same-sex marriage laws have actually reduced health care costs.
More public health moves in the right direction:
- the Healthy, Hunger-Free Kids Act
- smoking bans now in more than half of the states
- health warnings about bath salts, vitamins, dietary supplements, and Yasmin birth control
- the first-ever crackdown on prescription drug abuse (especially targeting narcotic painkillers).
And so far, Medicare and Medicaid appear to remain on track.
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