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Tuesday, June 06, 2000
By Ellen Mazo, Post-Gazette Staff Writer
When it comes to women's health care, at least one local delegate to the Beijing conference five years ago feels that a national group's C-minus grade on progress on this issue is unfairly low -- especially for local women.
Irma Goertzen, president and chief executive officer of Magee-Womens Hospital, said not only have women become more enlightened about the need for preventive care over the past five years, but more and more money is going into research on women's health needs.
Women: A
Work in Progress
"The research has become a major driving force in our country, especially in the past three or four years," said Goertzen, who was a delegate for Magee at the Beijing conference.
The billions of dollars spent nationally translates into several million dollars in federal, state and private investments at major medical institutions in Western Pennsylvania, including UPMC Health System (with which Magee is affiliated), and Allegheny General and the Western Pennsylvania hospitals, which are in the process of working out a financial merger.
Preventive health research on heart disease, breast cancer, osteoporosis, obesity, diabetes and aging was just a part of an estimated $51.4 billion in federal money spent on women's health issues in fiscal 1999. As part of its effort, the U.S. Department of Health and Human Services set up 18 National Centers of Excellence in Women's Health as models for women's health care.
With the United States experiencing an aging population -- one in five women are 60 and older -- the Medicare program has become key in providing preventive care, including vaccinations, mammography, colorectal cancer screening, Pap smears and bone density measurement.
"There has been a heightened awareness of prevention in the past five years," said Dr. Peter Z. Cohen, an orthopedic surgeon who is director of the senior sports and fitness program at UPMC. "Not only are physicians more aware of the importance of helping patients, but the public has become more educated."
Goertzen said the Beijing conference helped advance women's health.
"I don't care where you were at the time, [the conference] had an impact in women's health," Goertzen said. "If nothing else, the political beings were made more cognizant of women's health."
Because of these efforts, Goertzen does not agree with the group U.S. Women Connect, which gave women's health efforts in this country a C-.
The group acknowledged the "impressive investments in research in prevention of breast and cervical cancer, HIV/AIDS and older women's health," but it criticized the lack of access to health care among low-income women and women of color, as well as the cutbacks in funding for family planning services.
But Goertzen countered: "Look at the international scene, and then look at ours. I don't believe that any woman in this community who needs health care would be turned away -- from any institution or center. There's a very positive attitude among all health care providers to take care of people."
Recent reviews of women and health in this region by the Jewish Healthcare Foundation and the Commonwealth Fund found a "mixed story" on the quality of women's health.
While this survey also noted the increase in women's health research, it pointed out that the number of working-age women without health insurance has risen nationally -- from 14 percent in 1993 to 18 percent in 1998.
As expected, poorer women were the most affected, with lower rates of preventive care and higher incidences of depression and disease.
"Do you know how difficult it is to get an MRI, even with insurance?" asked Judith L. Palkovitz of Squirrel Hill, vice president of the national Hadassah, the Zionist women's group that has put a major emphasis on health education. "What about for those with no access to health care? Clearly the progress has been uneven."
Nevertheless, Palkovitz, who also was a delegate to the Beijing conference, agreed with Goertzen's assessment of the favorable state of women's health.
One salient example of improved access to preventive care, Palkovitz said, is that no woman over 40 in this region has an excuse for forgoing an annual mammogram to detect breast cancer, thanks to the $4.6 million raised in the past seven years through Pittsburgh's Race for the Cure allowing neighborhood centers to be set up around the region.
At UPMC, Allegheny General Hospital and Mercy Hospital, more emphasis has been placed on treating women with heart disease -- the leading killer of women in the United States.
Only in the last decade have efforts been made to develop diagnostic tests for women rather than dismiss their symptoms.
"We are realizing that there are some differences in how we need to approach women," said Dr. Daniel Edmundowicz, director of UPMC's Preventive Heart Care Center, which grew out of the Women's Heart Center established by the Ladies Auxiliary at UPMC Montefiore.
The cardiologist said that more women are taking advantage of the center as they come to understand their risk factors for heart disease, such as high cholesterol, high blood pressure and a family history of the disease.
"It's really just starting -- this emphasis on gender-specific medicine," said Goertzen. "Imagine how far along we'll be in another five years."
