I decided to try a little experiment on facebook, a sort of an AMA (“ask me anything”) but not so much in real time. The questions were so good that I had to close it down to give them the time they deserved. I liked all of the questions, and I’ll see how many I can get to this week.
Women’s Health
A reader asked, “What’s the best way to advocate for laws and implement changes to health care? Particularly for research that is geared towards women’s health. What are the best tests to determine things like heart health, bone health etc. besides the standard bloodwork labs.”
There are two very important questions here. First, the way to advocate for changes in health care is to write to your state and federal representatives and vote for the ones you feel represent your needs. This actually does make a difference, and the difference has never been starker.
Note: this is not meant to be anything like a comprehensive look at women’s health. Please consult your own doctor!
For many decades the Republican Party advocated for a free market system in nearly all things. Whether or not you subscribe to this ideology, the current iteration of the Party is very different—they have inserted themselves and their belief systems at every level of science and medicine, regardless of evidence. The “marketplace of ideas” and cold reliance on facts and truth has been replaced by the pet beliefs of the current leaders. One of the first things the administration did was do away with support for studying health care disparities.
It turns out that people are different from one another, as are groups of people. For example, the health problems of Filipina American women are different from those of Appalachian American men. Almost immediately on taking office, the Trump administration withdrew all support for studying health care disparities, which includes women’s health. Simply withdrawing support wasn’t enough, however, so they have actively worked to punish people who study these things, destroy data, and have actively promoted disinformation about the health of women and minorities. It turns out elections matter.
As to the second part of the question, thankfully we do have a great deal of science to help us out here. Even though it may have become harder to study and teach these concepts, professional societies are working to fill in the gaps left by the draconian cuts and by disinformation being spread on official government websites.
Women’s health is complex. It includes the prevention and treatment of diseases in cis- and trans-gendered women, and their needs differ. LGBTQ+ women have unique needs as well. There are also two distinct levels here: public health, and individual health.
At the level of public health, for example, at least 1 in 4 women will experience intimate partner violence at some point in their lives. This sort of violence has huge effects on physical and mental health. Women are also likely to be paid less than men for the same work, which can make access to healthcare and nutrition more challenging, especially as healthcare in the US is directly tied to employment. This of course is just the tip of the iceberg.
On the level of individual health, girls, pre-menopausal women, post-menopausal women, and trans women all have particular health needs, but some things are more universal.
Cancer screening: age-appropriate screening for breast, colon, and cervical cancer saves lives. Older women who are or have been smokers can also be screened for lung cancer.
Heart disease: it’s critical to screen for risk factors for heart disease. These include family history, diabetes, high blood pressure, high cholesterol, age, and smoking. Depending on your risk, a coronary calcium CT scan can help women further refine their own individual heart risk. Symptoms of heart disease in men and women often differ, and due to various disparities in how we view people, women’s heart symptoms are more often attributed to other (incorrect) causes, delaying care. One of the best tools for calculating heart risk can be found here.
Exercise and healthy eating help literally everything. Regular exercise even helps prevent dementia.
Post-menopausal women are a high-risk group for osteoporosis and fractures. Screening is simple and depending on risks, usually begins around 65 years of age. But prevention of osteoporosis starts much earlier. A diet with sufficient calcium and vitamin D and regular exercise including weight-bearing exercise and resistance training are important at every age, and the earlier you start, the better. Smoking and alcohol use also increase risk.
The idea here wasn’t to get political, as I really want to reach people regardless of their individual politics. But the current administration has crippled our public health and research infrastructure, and there is no “private sector” that can fill those gaps. Write your reps and vote your beliefs.
-pal
