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					                                                                                           Health Resources and Services Administration
                                                                                           Maternal and Child Health Bureau
Health Resources and Services Administration




                                                                                        Women’s Health at HRSA
                                               Maternal and Child Health Bureau




                                                                                          DataSpeak • July 23, 2003

                                                                                        Deborah R. Maiese, M.P.A., Director
                                                                                  Reem M. Ghandour, M.P.A., Women’s Health Analyst
                                                                                           HRSA Office of Women’s Health




                                                                                                                                          1
                                                                                             HRSA Serves Women
                                                                                      Bureau of Primary Health Care serves 6.1 million
Health Resources and Services Administration




                                                                                  
                                                                                      women; 90 percent of recipients are at or below
                                                                                      200 percent of the poverty line. (Source: HRSA, Bureau of Primary Health
                                                                                      Care, Uniform Data System (UDS), 2001)



                                                                                     HIV/AIDS Bureau’s Ryan White Care Act clients
                                               Maternal and Child Health Bureau




                                                                                      total more than 157,500 women. (Source: HRSA HIV/AIDS Bureau )

                                                                                     In 2001, the Maternal and Child Health Block
                                                                                      Grant program served 4.5 million women, 2.2
                                                                                      million of whom are pregnant (54% of all pregnant
                                                                                      women in the U.S.). (Source: HRSA Maternal and Child Health Bureau www.mchb.hrsa.gov)

                                                                                     BHPr supports health professions training for
                                                                                      women and curriculum on women’s health
                                                                                      issues.

                                                                                                                                                                        2
                                                                                        HRSA Investments in
                                                                                        Women’s Health, FY 2002
Health Resources and Services Administration




                                                                                         Community Health Centers             Reproductive Health
                                                                                         HIV/AIDS                             Other
                                                                                                                5.6%   3.7%
                                               Maternal and Child Health Bureau




                                                                                                         39.9%                        50.8%




                                                                                                     Total HRSA FY 2002
                                                                                          Investments in Women’s Health : $1.5 Billion
                                                                                  Source: HRSA Submission to the
                                                                                  Congressional Moyer Report, 2003
                                                                                                                                                    3
                                                                                          HRSA OWH Mission
                                                                                          and Selected Projects
                                                                                  In support of HRSA’s        Selected Projects:
Health Resources and Services Administration




                                                                                                               U.S. – Mexico Border
                                                                                     mission to expand
                                                                                                                Health Initiative;
                                                                                     access to
                                                                                     comprehensive,
                                                                                                                 GIS Mapping of HRSA
                                               Maternal and Child Health Bureau




                                                                                     culturally competent,        Investments in
                                                                                     quality health care          Women’s Health;
                                                                                     for all, OWH provides
                                                                                     a cross-cutting and         Bright Futures for
                                                                                                                  Women’s Health and
                                                                                     unifying focus for           Wellness (BFWH&W);
                                                                                     reducing gender
                                                                                     disparities in support      Women’s Health USA
                                                                                     of women’s health            2003 Data Book.
                                                                                     and wellness.
                                                                                                                                   4
                                                                                               BFWH&W – Goals
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                                                                                     Increase the use of preventive services;

                                                                                     Empower women to share in health care decision-
                                                                                      making;
                                               Maternal and Child Health Bureau




                                                                                     Increase practitioner utilization of preventive
                                                                                      health guidelines;

                                                                                     Encourage women to practice prevention in their
                                                                                      daily lives; and

                                                                                     Support community-wide health promotion.

                                                                                                                                        5
                                                                                            BFWH&W – Initial Tools
                                                                                      Focus on Physical Activity and Nutrition across
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                                                                                  
                                                                                      the lifespan:

                                                                                         Consumer: Self-Assessment, Goal Setting and
                                                                                          Take Home Plan with Resources
                                               Maternal and Child Health Bureau




                                                                                         Healthcare Providers: Clinical Measurement
                                                                                          and Counseling Suggestions

                                                                                         Community: National Health Observance
                                                                                          Connections and Tools for Public Health
                                                                                          Promotion


                                                                                                                                        6
                                                                                           Women’s Health USA
                                                                                          First edition was released in May 2002
Health Resources and Services Administration




                                                                                  

                                                                                         Companion to Child Health USA
                                                                                         Developed by HRSA:
                                                                                           MCHB Office of Data and Information Management,
                                               Maternal and Child Health Bureau




                                                                                           MCHB Division of Perinatal Systems and Women’s
                                                                                            Health,
                                                                                           Office of Women’s Health
                                                                                         Developed with input from:
                                                                                           HRSA Coordinating Committee on Women’s Health
                                                                                           HHS Coordinating Committee on Women’s Health
                                                                                           Departmental Data and Women’s Health Experts
                                                                                           Public Comment


                                                                                                                                              7
                                                                                        WHUSA Table of Contents

                                                                                      Population Characteristics
Health Resources and Services Administration




                                                                                  

                                                                                     Health Status
                                                                                     Health Services Utilization
                                               Maternal and Child Health Bureau




                                                                                  Health Status includes:
                                                                                     Health Behaviors

                                                                                     Health Indicators

                                                                                     Maternal Health

                                                                                     Special Populations



                                                                                                                    8
                                                                                         WHUSA Table of Contents
                                                                                  New Topics
Health Resources and Services Administration




                                                                                  WHUSA 2003 presents the latest data available. Topics
                                                                                  without updated data were replaced with a new topic
                                                                                  of interest in women’s health, such as:
                                               Maternal and Child Health Bureau




                                                                                     Activity limitations      Medication use
                                                                                     Arthritis                 Special Populations
                                                                                     Bleeding disorders        Title V Abstinence
                                                                                     Breastfeeding              Education Programs
                                                                                     Home and hospice          Title X Family Planning
                                                                                      care                       Services
                                                                                     Maternal morbidity        Vitamin and mineral
                                                                                     Medicare/Medicaid          supplement use

                                                                                                                                           9
                                                                                             Population Characteristics
                                                                                      In, 2001 females represented 51.2% of the U.S.
Health Resources and Services Administration




                                                                                  
                                                                                      population

                                                                                     The proportion of females aged 25 years and
                                                                                      younger was higher in non-White racial and
                                               Maternal and Child Health Bureau




                                                                                      ethnic groups

                                                                                     In 1999, females received a greater proportion
                                                                                      of college degrees than men.

                                                                                     The 60.9 million women in the labor force lack
                                                                                      income parity. Women represent:
                                                                                          Less than 1/3 of those who earned $50,000-$99,000
                                                                                          Less than 1/5 of those who earned $100,000 or more

                                                                                  Source: U.S. Census Bureau and
                                                                                  U.S. Department of Labor                                  10
                                                                                                        Physical Activity
Health Resources and Services Administration




                                                                                                      Adults Engaging in Regular Physical
                                                                                                                Activity, 2001

                                                                                                 50
                                                                                                 45                                                  Females
                                               Maternal and Child Health Bureau




                                                                                                               48.5
                                                                                                 40
                                                                                                                                                     Males
                                                                                                 35
                                                                                       Percent




                                                                                                 30   35.3                    35.6
                                                                                                 25                    30.1                 30.0
                                                                                                 20                                  24.3
                                                                                                 15                                                       18.9
                                                                                                 10                                                13.1
                                                                                                  5
                                                                                                  0
                                                                                                      18-24 years     25-64 years    65-74 years 75 years and
                                                                                                                                                     older

                                                                                  Source: National Health Interview
                                                                                  Survey                                                                         11
                                                                                                       Activity Limitations
Health Resources and Services Administration




                                                                                       31.5% or women aged 75 years and older and
                                                                                        21.4% of women between the ages of 65-74
                                                                                        years reported activity limitations in 2001.
                                               Maternal and Child Health Bureau




                                                                                       The five conditions most frequently reported as
                                                                                        the cause of activity limitations, include:
                                                                                             Arthritis/Rheumatism – 25.5%
                                                                                             Back/Neck Problem – 20.4%
                                                                                             Heart Problem – 14.0%
                                                                                             Hypertension – 12.9%
                                                                                             Depression/Anxiety/Emotional Problem – 11.7%

                                                                                  Source: National Health Interview
                                                                                  Survey                                                     12
                                                                                                        Cancer & Diabetes
                                                                                  Cancer
Health Resources and Services Administration




                                                                                   In 2000, 267,009 women                 Women with Diabetes,
                                                                                    died of cancer in the U.S.                   2001

                                                                                       In 2002, it is estimated
                                               Maternal and Child Health Bureau




                                                                                        that cancer of the lung                                         120
                                                                                                                                 102.5
                                                                                        and bronchus cause 25%                                          100




                                                                                                                                                              Rate per 1,000
                                                                                        of cancer deaths, followed
                                                                                        by breast cancer (15%),                           68.9          80




                                                                                                                                                                 women
                                                                                                                          55.7                   53.9
                                                                                        and cancer of the colon                                         60
                                                                                        and rectum (11%).
                                                                                                                                                        40
                                                                                       Incidence rates of lung                                         20
                                                                                        cancer among women                                              0
                                                                                        varied by race and

                                                                                                                                     N




                                                                                                                                          N
                                                                                                                            N




                                                                                                                                          H
                                                                                        ethnicity.
                                                                                                                                      H




                                                                                                                                           H
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                                                                                                                                                     c
                                                                                      Source: National Cancer Institute
                                                                                                                                                                13
             Heart Disease & Overweight and Obesity
                                                                                      More women die of heart
Health Resources and Services Administration




                                                                                                                          Overweight and Obesity in
                                                                                      disease than men.                    Women Aged 20 and Older,
                                                                                                                                  1999-2000
                                                                                     Risk factors: High blood                   Overweight Obese
                                                                                      pressure, obesity, and                         39.7
                                               Maternal and Child Health Bureau




                                                                                                                      Mexican
                                                                                      smoking.
                                                                                                                      American
                                                                                                                                                    71.9
                                                                                     Women under the age of
                                                                                      45 years experience a                                 49.7
                                                                                      higher rate of heart            NH Black
                                                                                                                                                     77.3
                                                                                      disease than men of the
                                                                                      same age.
                                                                                                                                     30.1
                                                                                                                      NH White
                                                                                     After age 65 years, men                                57.3
                                                                                      report higher rates than
                                                                                      women.                                     0              50               100
                                                                                  Source: National Health Interview                         Percent
                                                                                  Survey                                                                    14
                                                    Mental Health Treatment and Suicide
Health Resources and Services Administration




                                                                                      Non-Hispanic (NH) White and Native
                                                                                       American/Alaska Native women were most
                                                                                       likely to commit suicide
                                               Maternal and Child Health Bureau




                                                                                      More women than men receive mental health
                                                                                       treatment or counseling (not including
                                                                                       drug/alcohol treatment)
                                                                                      5.7 million women and 2.7 million men report
                                                                                       unmet need for mental health
                                                                                       treatment/counseling.
                                                                                  Source: National Vital Statistics
                                                                                  System and National Household
                                                                                  Survey on Drug Abuse
                                                                                                                                15
                                               Prenatal Care & Maternal Morbidity
                                                                                      In 2001, 83.4% of the             The three most frequently
Health Resources and Services Administration




                                                                                       women who gave birth               recorded medical risk
                                                                                       began prenatal care in the         factors: Hypertension,
                                                                                       first trimester.                   Diabetes, and Anemia.

                                                                                      88.5% of non-Hispanic             In 1999, 31.4% of women
                                               Maternal and Child Health Bureau




                                                                                       White and 84.0% Asian              discharged from hospitals
                                                                                       Pacific Islander women             experienced a maternal
                                                                                       received early prenatal            illness or pregnancy-
                                                                                       care compared to 74.5% of          complication during labor
                                                                                       non-Hispanic Black, 75.7%          and delivery.
                                                                                       of Hispanic, and 69.3% of
                                                                                       American Indian/Alaska            Females aged 15 years
                                                                                       Native women.                      and younger had the
                                                                                                                          highest percentage of
                                                                                      Of the 4,025,933 births,           deliveries with
                                                                                       42,000 women received no           complications (49.4%)
                                                                                       prenatal care.

                                                                                  Source: National Vital Statistics
                                                                                  System                                                          16
                                                                                      U.S.-Mexico Border Health
Health Resources and Services Administration




                                                                                      The U.S.-Mexico Border                                    Live Births By Females
                                                                                       Region is 2,000 miles                                        Aged 15-19, 1999
                                                                                       long and extends 62                                       70




                                                                                                                    Rate Per 1,000 Live Births
                                                                                       miles north and south of                                                             67.8
                                                                                                                                                 60
                                                                                       the border.
                                               Maternal and Child Health Bureau




                                                                                                                                                 50
                                                                                                                                                             49.6
                                                                                                                                                 40
                                                                                      The teen birth rate in the                                                    41.2
                                                                                                                                                 30
                                                                                       border region is                                               28.7
                                                                                                                                                 20
                                                                                       significantly higher than
                                                                                                                                                 10
                                                                                       national averages,
                                                                                       particularly in Texas                                     0
                                                                                                                                                        U.S.          Border
                                                                                       (82.1 per 1,000 females                                                        Region
                                                                                       aged 15-19).
                                                                                                                                                 15-17 years        15-19 years
                                                                                  Source: Health Resources and
                                                                                  Services Administration                                                                      17
                                                                                       Rural and Urban Health
                                                                                                                      Health Conditions in Women
Health Resources and Services Administration




                                                                                      In 2000, 21 percent of
                                                                                                                         by MSA-Status, 2001
                                                                                       the population lived in a
                                                                                       rural area.                          MSA        Non-MSA
                                               Maternal and Child Health Bureau




                                                                                      Older population,         Cancer
                                                                                       limited supply of health
                                                                                       care providers, and
                                                                                       distance from health Hypertension
                                                                                       care resources
                                                                                       contribute to special      Heart
                                                                                       health care needs        Disease
                                                                                       among rural women.
                                                                                                                             0           100        200         300
                                                                                                                              Rate Per 1,000 Women
                                                                                  Source: National Health Interview              Note: MSA = Metropolitan
                                                                                  Survey                                         Statistical Area or Urban Area 18
                                                                                  Preventive Care & HIV Testing
                                                                                     In 2000, women made 488
Health Resources and Services Administration




                                                                                                                                                  Women Ever Tested for
                                                                                      million visits to a health care
                                                                                      provider; more than 21%                                          HIV, 2001
                                                                                      were for preventive, prenatal,
                                                                                      or other non-illness care.                                                            31.2




                                                                                                                                                               te
                                                                                                                                                             hi
                                               Maternal and Child Health Bureau




                                                                                                                                                           W
                                                                                     Common types of                                                                                51.3




                                                                                                                                                         H
                                                                                                                                                       ck
                                                                                                                                                        N
                                                                                      counseling provided:




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                                                                                        Diet – 15.4%




                                                                                                                                                  B
                                                                                                                                                                               40.6




                                                                                                                                                H
                                                                                        Exercise – 9.8%




                                                                                                                                              N

                                                                                                                                              c
                                                                                                                                           ni
                                                                                                                                         pa
                                                                                        Prenatal Instruction – 3.8%




                                                                                                                                       is
                                                                                                                                                                              36.0



                                                                                                                                     H

                                                                                                                                    er
                                                                                                                                 th
                                                                                                                               O
                                                                                      The majority of women                                                                  34.8
                                                                                                                          H
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                                                                                                                         N

                                                                                                                             l
                                                                                                                          ta
                                                                                      reported receiving a Pap
                                                                                      smear within last three           To                                          0   20    40      60
                                                                                      years.                                                                             Percent


                                                                                                                                                                                     19
                                                                                                Vitamin and Mineral
                                                                                                Supplement Use
Health Resources and Services Administration




                                                                                      In 2000, 56.9% of women took at least one vitamin
                                                                                       or mineral supplement

                                                                                      Non-Hispanic White women reported the highest
                                               Maternal and Child Health Bureau




                                                                                       proportion of supplement use (61.7%), compared
                                                                                       to non-Hispanic Blacks (42.3%), and Hispanics
                                                                                       (43.3%).

                                                                                      64.6% of women between the ages of 65-84 years
                                                                                       reported supplement use – the highest proportion
                                                                                       of supplement use among women.


                                                                                  Source: National Ambulatory
                                                                                  Medical Care Survey                                20
                                                                                                      Medication Use
                                                                                      In 2000, medications were prescribed or given at
Health Resources and Services Administration




                                                                                  
                                                                                      2/3 of all doctor’s visits.

                                                                                     Higher rates of medication use were reported for
                                                                                      females (156.4 drugs per 100 visits) than males
                                               Maternal and Child Health Bureau




                                                                                      (149.1 drugs per 100 visits)
                                                                                     Most frequently used by         Nearly 20% of women
                                                                                                                       

                                                                                      females :                       aged 45-64 reported
                                                                                     Premarin (hormone therapy)      using central nervous
                                                                                     Synthroid (for Thyroid disease) system drugs including:
                                                                                     Claritin (for allergies)        sedatives, anti-
                                                                                     Celebrex (for arthritis pain)
                                                                                                                      depressants, and
                                                                                                                      antianxiety agents.
                                                                                     Lipitor (to lower cholesterol)
                                                                                  Source: National Ambulatory
                                                                                  Medical Care Survey                                   21
                                                                                             Get Your Copy
Health Resources and Services Administration




                                                                                  To order copies of
                                                                                  Women’s Health USA 2003
                                               Maternal and Child Health Bureau




                                                                                  or Women’s Health USA 2002:
                                                                                     Call 1-888-ASK-HRSA


                                                                                  To view online:
                                                                                     http:///www.hrsa.gov/womenshealth/

                                                                                                                           22
                                                                                         Contact Information
Health Resources and Services Administration




                                                                                  Deborah R. Maiese, M.P.A.   Reem M. Ghandour, M.P.A.
                                                                                          Director             Women’s Health Analyst
                                                                                  HRSA Office of Women’s       HRSA Office of Women’s
                                                                                            Health                       Health
                                               Maternal and Child Health Bureau




                                                                                     5600 Fishers Lane,           5600 Fishers Lane,
                                                                                       Room 10C-09                  Room 10C-09
                                                                                    Rockville, MD 20857          Rockville, MD 20857
                                                                                    301-443-8695 phone           301-443-3786 phone
                                                                                      301-443-8587 fax             301-443-8587 fax
                                                                                     Dmaiese@hrsa.gov           RGhandour@hrsa.gov


                                                                                      http://www.hrsa.gov/womenshealth/
                                                                                                                                   23

				
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