Women’s health fail

For every step forward the United States takes toward improving women's health, the country appears to be taking one back — or more.

The overall picture is so bad that the nation got a big, black "Unsatisfactory" grade on a report card issued recently by the National Women's Law Center, in conjunction with Oregon Health & Science University.Art deco woman

We are doing all right in some areas. Women are smoking less. The percentage of women getting regular mammograms, annual dental checkups and colorectal screenings has held steady since 2007. In only one area, cholesterol screenings, have we actually improved.

On the negative side, more women are binge drinking, and fewer are getting Pap screening tests for cervical cancer. More women are obese, diabetic and hypertensive, too. More are turning up with chlamydia, a sexually transmitted disease.

Not a single state got a "Satisfactory" mark this year; in 2007, three states made the grade. Massachusetts and Vermont have the best scores, a limp S (for satisfactory) -minus.

Many of the goals have to do with things people can conceivably control themselves, like quitting smoking, and drinking only moderately.

However, nearly 20 percent of women ages 18 to 64 have no health insurance. The disparities are troubling: 38 percent of Hispanic women, 32 percent of Native American women, 23 percent of African-American women — but only 14 percent of Caucasian women — lack health coverage.

And only seven states now require comprehensive maternity care — prenatal care, childbirth and postpartum care — be included in all individual and group health plans.

Most of the goals the report card addresses come from the Healthy People 2010 campaign of the U.S. Dept. of Health and Human Services. On its website, Healthy People is already hoping for better results in 2020, its new goal year.

"The Favorite" by Leon-Francois Comerre, courtesy of Wikimedia Commons

Clearing the first hurdle in breast-feeding

Fewer than 4 percent of births in the United States occur at facilities that are considered "baby friendly," according to the latest Breast-feeding Report Card, issued this week by the Centers for Disease Control and Prevention.Happy baby

That's interesting, in light of the fact that birth is the one point at which the nation's breast-feeding practices actually meet the goals set by Healthy People 2010.

And, it raises some questions: Are American women determined to breast-feed even in the teeth of an unsupportive environment? Or does strong support from the hospital not matter much in their decision? Do problems caused by settings where breast-feeding is not actively promoted only show up later?

Or are environments that come after the birth facility, including families, other medical advisers, child-care centers and workplaces, even less sympathetic to breast-feeding?

Only two hospitals in Illinois, my home state, are among the 99 "baby friendly" facilities recognized by the Baby-Friendly Hospital Initiative as providing "an optimal level of care for infant feeding." These are Pekin Hospital in Pekin and St. John's Hospital in Springfield.

Thirty of the hospitals on the list are in California.

"Although the hospital is not and should not be the only place a mother receives support for breastfeeding, hospitals provide a unique and critical link between the breastfeeding support provided prior to and after delivery," the BFHI's website states.

The BFHI is a joint global effort of the World Health Organization and the United Nations Children's Fund (UNICEF).

Mixed report on breast-feeding

Three-fourths of American babies start life on the breast, but moms are giving up on breast-feeding sooner than officials would like to see.

Healthy People 2010, a national statement of health goals, sets the bar for breast-feeding at birth at 74 percent. Fully 75 percent of American moms are breast-feeding at birth, so the country is (barely) meeting that objective.

However, the goals would have half of mothers breast-feeding at six months of life and a quarter continuing on at a year. In practice, 43 percent are breast-feeding at six months and 22 percent at one year.

"We need to direct even more effort toward making sure mothers have the support they need in hospitals, workplaces and communities to continue breastfeeding beyond the first few days of life, so they can make it to those six- and 12-month marks," said William Dietz, M.D., Ph.D., director of Nutrition, Physical Activity, and Obesity for the Centers for Disease Control and Prevention in Atlanta, Ga.

The CDC issues an annual report card of how "key community settings" like hospitals and child-care centers are supporting breast-feeding, which research has demonstrated can improve an individual's lifetime health outlook.

While the overall news is good for moms' getting a start on breast-feeding at birth, the swing among the various states ranges from 90 percent in Utah to to 53 percent in Mississipi.