U.S. doctors call for health policies that support women

(Reuters Health) - Making it easier and more affordable for women to access care, and supporting research that includes how treatments work in both sexes, can improve the health of all Americans, not just women, U.S. doctors argue.

A woman shades herself from the sun with an umbrella as she walks down 34th Street in New York July 22, 2011. REUTERS/Shannon Stapleton

“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.

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 Annals of Internal Medicine, online May 28, 2018.