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Chief Health Officers, Women, Are In Pain

Taking an inventory on several health risks for American women in 2013 paints a picture of pain: of overdosing, caregiver burnout, health disparities, financial stress and over-drinking.
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Women are the chief health officers of their families and in their communities. But stress is on the rise for women. Taking an inventory on several health risks for American women in 2013 paints a picture of pain: of overdosing, caregiver burnout, health disparities, financial stress and over-drinking.

Overdosing on opioids. Opioids are strong drugs prescribed for pain management such as hydrocodone, morphine and oxycodone. The number of opioid prescriptions grew in the U.S. by more than 300 percent between 1999 and 2010. Deaths from prescription painkiller overdoses among women have increased more than 400 percent since 1999, compared to 265 percent among men. "Mothers, wives, sisters and daughters are dying at rates that we have never seen before," said Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC), which compiled the data." These findings on women and opioid overdosing are getting a lot of play in local media outlets, from Cherry Hill, New Jersey, to Lexington, Kentucky, and San Francisco, where the article in the city's major newspaper was "More Women Dying From Prescription Drug Overdoses Than Cancer."

Children and others first. One of the most stressed-out demographics in America is the middle-age woman taking care of everyone -- her parents, her mate and her kids. Two-thirds of family caregivers are female, and 34 percent take care of two or more people. The average age of a female caregiver is 48. While the proportion of men as caregivers is growing, the caregiver has typically been the "nearby daughter" where there might be one, discussed in recent research conducted at Cornell University. Sometimes called "the parent trap," the overwhelming challenge (physical, emotional, financial) of caring for aging parents while being in the middle of the sandwich generation is at a crisis point. Even though some adult children are moving home with parents (a phenomenon that the Pew Research Center calls the "boomerang generation)," caregiving is in crisis on the supply side, which Forbes coined as "The Disappearing Family Caregiver." Furthermore, becoming the caregiver for an aging parent can erode a woman's financial health.

Money and work stress. Women are twice as likely as men to experience financial stress. An August 2013 Gallup poll found that women are equally likely as men to be satisfied with many aspects of their jobs -- with the exception of their pay gap. The most likely people in the U.S. to be money-stressed in 2013 are women ages 30 to 44 years with minor children and annual incomes less than $60,000: 53 percent of people in this demographic are likely to have "high or overwhelming financial stress." Two studies came out of Indiana University School of Public Health-Bloomington this summer pinpointing the direct relationship between financial stress and health, especially for women. IU researchers learned, for example, that these stressors lead to greater levels of smoking, one of the most important avoidable health risks.

Higher health costs. Women bear greater health insurance costs than men, as calculated by the National Women's Law Center in 2012. This is one of the key rationales underneath the Affordable Care Act: to ensure that women aren't discriminated by health insurance pricing practices that have been common in the industry. TIME magazine put this in the category of a "woman tax," where females have paid more for many consumer goods, including but not limited to deodorant, haircuts and sneakers. Marie Claire magazine covered this in their story, "Why Women Pay More."

Less access to evidence-based health care. Women often receive different health care services than men when it comes to the most current, evidence-based protocols. There are especially dramatic health disparities for women of color (and people of color overall), compared with Caucasian women, especially notable for cancer and heart disease.

Women and wine. Gabrielle Glaser published the book, Her Best-Kept Secret: Why Women Drink -- And How They Can Regain Control, in July 2013. Glaser noted the latest trends in women's drinking, such as a 2011 CDC study published in January 2013 showing that women over age 65 binge-drink twice as often each month compared with women in their 20s, and binge drinking rising as a risk factor for women and girls dealing with unintended and alcohol-exposed pregnancy, sexually transmitted diseases and breast cancer.

These various issues fall into a bucket we health policy wonks term the social determinants of health (SDOH). These are the impacts on health that are largely outside of the doctor's office: where people live, work, play and pray, as Surgeon General Regina Benjamin has said. The World Health Organization calls out SDOHs as "the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies and politics."

It is indeed economics, social policies and politics that directly shape the state of American women's health: the lagging economy and wage gaps for women; social policies that don't sufficiently support caregiving (especially as the sandwich generation gets increasingly squeezed) and early-childhood education; politics that muddy the definition of "women's health" and the essential benefits included in the Affordable Care Act.

In fact, The Affordable Care Act (the ACA) addresses some (albeit, not all) of the underlying roots of women's health disparities, discussed in a recent blog post from the White House. Among the ACA's programs that can help women achieve greater health equity are expanding preventive health care services and coverage, covering pre-existing conditions, and, preventing insurers from charging women more for premiums than men in the health insurance marketplaces.

Beyond direct health care benefits, access to health services -- while not a panacea alone -- can help women bolster their personal economic development and ease the chief health officer's world of pain.

For more by Jane Sarasohn-Kahn, click here.

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