1980s: CDC/ATSDR Contributions to Women’s Health
Below is a sample of contributions CDC and ATSDR have made in women’s health during the 1980s.
Published findings from the CDC-Emory University Osteoporosis Study, which showed that bone loss is dependent on testosterone levels as well as estrogen levels and that bone loss begins before menopause.
Revised the U.S. Standard Certificate of Live BirthCdc-pdf to replace the 1978 version. This revision provided a wide variety of new information on maternal and infant health characteristics, representing a significant departure from previous versions in both content and format. The most significant format change was the use of check boxes to obtain detailed medical and health information about the mother and child. It has been demonstrated that this format produces higher quality and more complete information than do open-ended items.
Published the Surgeon General Report: Reducing the Health Consequences of SmokingCdc-pdfExternal, which described the health consequences of smoking in women, including an association between cigarette smoking and cervical cancer; an association between maternal smoking and complications of pregnancy; and a doubling of risk of low birthweight infants born to women who smoke during pregnancy.
Collected the first nationally representative data on bone mineral densityCdc-pdf of the hip in the third National Health and Nutrition Examination Survey (NHANES III). In 1988–94, 56 percent of women 50 years of age and older had a reduced level of bone density; 16 percent of these had osteoporosis, the more severe reduction. The NHANES III femur bone density data are currently used as the reference data when diagnosing osteoporosis and low bone density at the hip by physicians and health-care workers worldwide.
Established the Pregnancy Risk Assessment Monitoring System (PRAMS) to monitor maternal risk behaviors, such as smoking and drug use, and to identify gaps in the health care delivery for pregnant women and infants.
Began surveillance of maternal mortality. Maternal mortality is defined as the death of a woman during pregnancy, during childbirth, or within 42 days of termination of the pregnancy.
Established the Maternal and Child Health Epidemiology Program (MCHEP) to support state efforts to assess and protect the health of mothers and infants.
Identified disorders of reproduction as one of ten leading work-related diseases and injuries. Evidence from laboratory studies and clinical investigations indicated that a wide range of microbiologic, physical, and chemical agents (i.e. ionizing and nonionizing radiation, heat and vibration, tobacco, alcohol, and certain drugs) can adversely affect reproductive outcomes.
Participated in the Surgeon General’s Workshop on Violence and Public Health to provide national leadership and discuss the public health implications of violence. Recommendations for action were developed that addressed spouse abuse, sexual violence, and other aspects of violence against women.
Reported that women using the Dalkon Shield have a 5-fold increased risk for pelvic inflammatory disease (PID) as compared to users of other types of IUDs and non-IUD users. In the same year the CDC and FDA recommended that women still using Dalkon Shield IUDs have them removed.
Determined that an increase in Toxic Shock Syndrome in menstruating women was due to the use of tampons. Also studied a means to detect all cases and to define what characteristics of tampons determine the risk for Toxic Shock Syndrome.
Established a Violence Epidemiology Branch to apply public health prevention strategies to the problems of child abuse, homicide and suicide. Now the Division of Violence Prevention, it includes intimate partner violence and sexual violence as priority areas.
Conducted the 1982 and 1988 cycles of the National Survey of Family Growth (NSFG) for the first time with never married women. These surveys yielded new national data on trends in teenage sexual activity, use of family planning servicesCdc-pdf, contraceptive useCdc-pdf , the first reliable national estimates of infertility and fecundity impairments, and other issuesCdc-pdf.
Conducted the Hispanic Health and Nutrition Examination Survey to target the health of three special subgroups: Mexican-, Cuban-, and Puerto Rican-origin populations living in the continental United States.
Reported initial analysis of data from the Cancer and Steroid Hormones (CASH) study. The data showed that women who have used oral contraceptives are approximately half as likely to develop ovarian and endometrial cancer as women who have never used them and that, despite previous concerns, contraceptive use does not increase a woman’s risk of breast cancer.
Published the Health Consequences of Smoking for Women: A Report of the Surgeon GeneralExternal. This report was the first Surgeon General’s Report on smoking and health to focus on women. This landmark report examined the major issues relating to tobacco use and women’s health, including trends in consumption, health effects of cigarette usage by women, and determinants of smoking initiation, maintenance, and cessation.
Reported on cases of a newly recognized illness known as Toxic-Shock Syndrome.