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 "Women and their families are adversely affected by policies that do
not support women's health," said Dr. Ana Maria Lopez, president of
the American College of Physicians (ACP).
Such policies "hurt the health of our population," Lopez, a
professor at the University of Utah School of Medicine in Salt Lake
City, said by email.
In a position paper published in Annals of Internal Medicine, the
ACP lays out many areas where health policy decisions may result in
discrimination or inequitable barriers to care for women.
Among other things, the paper touches on paid family and medical
leave, domestic violence, sexual abuse and harassment, and
participation in clinical trials. The paper also addresses access to
coverage for reproductive health services.
Access to affordable, comprehensive public or private health
insurance that includes coverage for all evidence-based care women
need throughout their lives helps not only women but also their
families, doctors argue in the paper. To support this level of
access and affordability, insurers should not be allowed to impose
higher premiums or cost sharing on women because of their sex or
gender.
In addition, universal access to family and medical leave with a
minimum of six weeks of paid leave can help support women and
families when a new baby arrives, a parent gets sick or someone else
in the family needs help, doctors note.
Clinicians also need better and more widely available screening
tools to identify women who have been victims of sexual violence or
intimate partner abuse and treat these patients effectively.
Adding more women to clinical trials may help identify better ways
to treat women in a wide variety of circumstances when they might
require a different treatment approach than men - for example, with
a different dose of a drug or a different symptom checklist for
diagnoses.
In research and treatment, clinicians also need to understand that
the unique medical needs for women of color, who have an increased
risk of certain diseases relative to white women.
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Health care providers in all specialties, including internal
medicine, should also receive training in health issues that are
specific to women and understand leading causes of chronic illness,
disability and fatalities in women that aren't always the same as
what's seen in men.
"Based on comparisons of overall health and survival in countries
that surpass Americans' longevity, the biggest risks to women's and
society's health are suppression of reproductive health care leading
to increased unintended pregnancies, failure to provide paid
maternal leave, and lack of universal mental and physical health
care insurance," said Carol Rowland Hogue, author of an accompanying
editorial and a researcher at the Rollins School of Public Health at
Emory University in Atlanta.
"The 'canary in the mine' is maternal mortality, which has risen
dramatically over the last four decades - but only here in the U.S.
compared with other resource-rich nations," Hogue said by email.
"This paper highlights approaches that can reverse this trend,
including needed research into preventing unintended pregnancy,
improving the health of women before they become pregnant, and
reducing the causes and consequences of depression through screening
at all opportunities and access to effective treatment," Hogue
added.
Providing women with comprehensive reproductive healthcare
throughout their lives can help the health of entire families, Hogue
said.
"Women are the primary caregivers for both children and the elderly,
and women comprise almost half of the U.S. employed workforce,"
Hogue added. "When women suffer, families and businesses suffer."
SOURCE http://bit.ly/2wYH0qu Annals of Internal Medicine, online May
28, 2018.
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