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Women's Health Finally Getting Federal Attention

Women's health has become a federal priority backed by more than $2 billion in program spending on research, health care service delivery, and educational initiatives, according to Susan Blumenthal, M.D., deputy assistant secretary for health and women's health and an assistant surgeon general in the Public Health Service (PHS).

To ensure a comprehensive women's health agenda, every PHS agency now has women's health coordinators, and women and minorities must be included in all clinical research supported by the National Institutes of Health (NIH), said Blumenthal at the American Psychological Association Conference on Women's Health last month in Washington, D.C. The conference was cosponsored by APA, PHS agencies, and other organizations.

Blumenthal outlined several PHS interagency initiatives sponsored by her office with implications for women's mental health.

  • Conferences on mental and addictive disorders as part of the "Healthy Women 2000" education campaign.

  • The creation of "national centers of excellence" on women's health integrating research, clinical practice, and public and professional health care education. Academic medical centers will be linked with community services.

  • A national women's health information clearinghouse accessible via a toll-free number and the Internet.

  • A national advisory council on domestic violence chaired by HHS secretary Donna Shalala and Attorney General Janet Reno. An additional $570 million will fund a new research initiative and prevention and intervention programs.

  • A national domestic violence hotline, which logged more than 13,000 calls during the first two months of operation this year. The number is (800) 799-CARE.

  • An educational campaign on eating disorders aimed at public and health care professionals and cosponsored with the McKnight Foundation.

  • A women's health curriculum for medical students, residents, fellows, and CME cosponsored with the Association of American Medical Colleges, the American Medical Women's Association, the NIH, and several medical specialty societies.

    Blumenthal commented that her position was created in 1994 by President Clinton to address inequities in women's health care. For example, biomedical research was conducted on men and the findings were extrapolated to guide treatment and interventions for women. "This neglect has resulted in glaring health care problems for women," said Blumenthal.

    AIDS, often presumed to be a "man's disease," is now the number one cause of death in women of reproductive age in several of the nation's major cities, noted Blumenthal.

    Mental illness affects women disproportionately, yet only one-quarter are diagnosed appropriately, and only one-quarter of those women are adequately treated, commented Blumenthal.

    More than three billion assaults on women occur annually in the United States, one-third by someone the woman knows. Yet, only 3 percent of domestic violence cases are detected by physicians, noted Blumenthal.

    Behavioral and psychosocial factors are a major factor in causing diseases affecting women including heart, cancer, and lung disorders and diabetes, yet they too have been neglected, said Blumenthal.

    "More than any miracle drug or vaccine discovery, strategies to change high-risk behaviors such as smoking, substance abuse, poor diet, and lack of exercise could reduce premature mortality in our nation by one-half, chronic disability by two-thirds, and acute disability by one-third. Health care costs would also be reduced."

    Blumenthal introduced PHS panelists who described their agency's efforts to improve women's health. For example:

  • The National Institute of Mental Health invested about one-sixth ($101 million) of its budget on research on or related to mental disorders in women in Fiscal 1995. A research program announcement may be obtained by dialing NIMH FAX4U, or (301) 443-5158, using the fax handset or visiting the NIMH Web site at .

  • The Office for Women's Services within the Substance Abuse and Mental Health Services Administration (SAMHSA) is focusing on women with mental and addictive disorders, women with HIV or AIDS, women in the criminal justice system, and the impact of managed care and service financing on state, county, and community-based organizations serving women and children.

  • SAMHSA has a new national clearinghouse to disseminate research on the prevention and treatment of alcohol, tobacco, and other drug abuse and mental illness in women. More information is available by calling (800) 354-8824 or visiting the Web site .

  • The recently created Office of Behavioral and Social Science Research at NIH is encouraging research on violence against women and families in response to the Violence Against Women Act signed into law by President Clinton two years ago. Another targeted research area is sexual abuse.

    (Psychiatric News, October 18, 1996)