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Volume 2: No. 2, April 2005
SPECIAL TOPICS
ORIGINAL RESEARCH: FEATURED
ABSTRACT FROM THE 19TH NATIONAL CONFERENCE ON CHRONIC DISEASE
PREVENTION AND CONTROL
Making the Grade on Women’s Health:
A National and
State-by-State Report Card 2004
Michelle Berlin, Judith Waxman
Suggested citation for this article: Berlin M, Waxman J. Making
the Grade on Women’s Health: A National and State-by-State
Report Card 2004 [abstract]. Prev Chronic Dis [serial online] 2005 Apr [date cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2005/
apr/04_0142t.htm.
PEER REVIEWED
Track: Methods and Surveillance
Making the Grade on Women’s Health: A National and
State-by-State Report Card is a comprehensive study of the status of women’s
health in the United States based on selected health status and policy
indicators. Health status indicators reflect conditions with a significant
impact on quality of life and well-being, affect large numbers of women
generally or disproportionately affect a specific population and/or age group,
are amenable to prevention or improvement, and are measurable through
consistent, reliable data. The 27 indicators fall within four categories:
women’s access to health care services, preventive health care activities, key
women’s health conditions, and whether women live in healthy communities.
The states and the nation received grades for each status indicator
based on whether the benchmark was met (Satisfactory) or not met (Satisfactory
Minus, Unsatisfactory, or Fail, based on scores’ distance from the benchmark).
In the 2004 Report Card, grades take into account that states and
the nation have several years to achieve those benchmarks based
upon Healthy People 2010. The Report Card also provides 67 policy
indicators to evaluate the performance of state and federal governments in
promoting women's health; these are based on state statutes, regulations, and
policies and programs that address problems identified by health status
indicators.
The nation met only two indicators (mammograms in women aged
>40 years and annual dental visits) and received an overall
grade of Unsatisfactory. All states and the District of Columbia
met one benchmark (annual dental visits) and missed eight
(including proportion of women with health insurance, rates of
high blood pressure and diabetes, infant mortality, poverty, and
wage gap). Twenty-five states improved at least five policies,
and the majority of states weakened in one to three policies. The
policy most consistently improved was preventing tobacco sales to
minors. Only one policy goal, Medicaid coverage for breast and
cervical cancer treatment, was met by all the states.
For most health status indicators, the nation and the states
fall short of meeting national goals. Despite interest in health
disparities, key differences (including race/ethnicity and age)
persist. A number of state governments improved policies in key
areas to meet women’s health needs, but many states have
fallen behind. The 2004 Report Card findings identify pressing
issues that must be tackled by policy makers, public health
administrators, and care providers. To improve and maintain the
health of U.S. women, these issues must be addressed swiftly and
accurately.
Corresponding Author: Michelle Berlin, MD, MPH, Director, OHSU
National Center of Excellence in Women's Health, and Associate Professor,
Departments of Obstetrics and Gynecology, Public Health and Preventive Medicine,
and Medical Informatics and Clinical Epidemiology, Oregon Health and Sciences
University, 3181 SW Sam
Jackson Park Rd, UHN 50, Portland, OR 97239-3098. Telephone: 503-494-4480. E-mail: berlinm@ohsu.edu.
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