I missed this earlier in the summer, but wanted to let you know about a government report, Older Americans 2010: Key Indicators of Well-Being, which provides information on the health status of Americans aged 65 years and older, including life expectancy, chronic health conditions, symptoms of depression, prescription drug costs, obesity, physical activity, mammograms, and more. Several of the topics are split into male and female data, such as the percentage of women and men who have heart disease, hypertension, and other conditions, so this could be a good quick reference source for understanding some aspects of the health status of women older than 65.
Random Aside: does the generic descriptor “older Americans” bother anyone else? It always makes me ask, “Older than what/who?”
A new study in the journal Contraception reveals the power of a simple conversation: When trained counselors at family planning clinics ask young women if they have experienced reproductive coercion, it reduces the odds of their male partners forcing them to become pregnant.
A brief intervention was associated with a 70 percent reduction in the odds of male partner pregnancy coercion among women who recently had experienced intimate partner violence. Study participants who were asked about reproductive coercion and then counseled about harm-reduction strategies — including switching to longer-acting contraceptives and contacting domestic and sexual-assault resources — were also 60 percent more likely to report ending a relationship because it felt unsafe or unhealthy.
“There is a strong, indisputable link between domestic and dating violence and unintended pregnancy. This study is extremely important because it identifies an effective solution that can be implemented relatively easily,” said Family Violence Prevention Fund President and Founder Esta Soler. “We need to build on these results by making this intervention the norm in health care settings throughout the nation as quickly as possible.”
The study was funded by the National Institute of Child Health and Human Development; the intervention was designed by reproductive health experts, UC Davis School of Medicine, the Harvard School of Public Health, and the FVPF.
An earlier study this year, also published in Contraception, concluded that 20 percent of women experienced pregnancy coercion and 15 percent experienced birth control sabotage.
The FVPF is calling for immediate action based on this latest evidence: “This study is extremely important because it identifies an effective solution that can be implemented relatively easily,” said Soler. “We need to build on these results by making this intervention the norm in health care settings throughout the nation as quickly as possible.”
Princeton University is hosting a conference this fall (October 15 & 16), “Open Hearts, Open Minds and Fair Minded Words,” featuring speakers from around the country on the topic of abortion.
Explore new ways to think and speak about abortion.
Approach issues related to abortion with open hearts and open minds.
Define more precisely areas of disagreement and work together on areas of common ground.
Get to know those on multiple sides of the issues more personally.
Speakers will include experts in law, bioethics, medicine, theology, and other topics. The full program is available online, and includes panels on topics including morality, prevention of unintended pregnancy, conscience clauses, Constitutionality, and other issues.
The American College of Nurse-Midwives (ACNM) issued a press release [PDF] today responding to the American College of Obstetricians and Gynecologists’ (ACOG) recently revised recommendation on vaginal birth after cesarean. The ACNM calls for “concerted efforts to expand access to vaginal birth after cesarean (VBAC) in the U.S.” (for background, see our previous post).
The ACNM release is accompanied by a more complete statement [PDF] that reviews the ACOG recommendation and outlines ACNM’s response. It includes a discussion of how the ACOG’s specific recommendation that VBAC be undertaken at “facilities capable of emergency deliveries” may continue to limit women’s ability to choose VBAC.
Last night, talk show host Rachel Maddow discussed tactics used by anti-choice activities to restrict women’s access to abortion. She focused on Virginia Attorney General Ken Cuccinelli II, who has issued an opinion [PDF] indicating that the state may impose additional restrictions on providers of first trimester abortions, including allowing the Board of Health to regulate them as “hospitals.” An article in the Roanoke Times explains:
Cuccinelli’s opinion notes that health centers specializing in reproductive services are characterized as physicians’ offices that are exempt from state hospital licensure requirements. Forcing those facilities to meet hospital standards would bring more demanding requirements for space, equipment and staffing that abortion rights supporters argue would limit access to legal, first-trimester abortions.
Maddow spoke to NARAL Pro-Choice Virginia President Tarina Keene about what this could mean for abortion access in that state. Keene indicated that such regulations could potentially close 17 of the state’s 21 abortion clinics (making our past discussions of the difficulties provider face integrating abortion into their office practices all the more relevant). The organization has issued a statement arguing that:
This move has nothing to do with upholding the law or protecting women’s health, and everything to do with ideology and politics. Attorney General Cuccinelli is trying to accomplish through brute force of executive power what he couldn’t accomplish through the democratic process in his time as a State Senator – restricting women’s access to reproductive healthcare by shutting down abortion providers. These targeted regulations of abortion providers (TRAP) laws have nothing to do with safety and have everything to do with ideology.
Those who support the change will inevitably ask, “Don’t you want women to be as safe as possible when they have abortions?” Of course pro-choice women’s health and reproductive rights advocates want abortion to be safe. But this seemingly innocuous question ignores the fact that those pushing for such changes are working to restrict abortion access, rather than responding to any demonstrated need for improved facilities.
As Keene observes in the interview, “They have hijacked the language, and, unfortunately, what they’ve also done is make people feel like abortion is dangerous and it’s also scary.”
In reality, the data shows that legal abortion in the first trimester is very safe — far safer than continuing a pregnancy.
While it’s not strictly women’s health, I wanted to pass along these resources on keeping up with food recalls (especially in light of the current egg recall estimated to affect around half a million eggs). The resources below can help keep you informed about product safety in this and future recall events.
First, some good resources for keeping up with product recalls in general:
Recalls.gov: news about and links to recalls of food, medicines, cosmetics, and other consumer products (you can also sign up for alerts from various government agencies through this site)
The summer 2010 Guttmacher Policy Review includes a piece, Off Base: The U.S. Military’s Ban on Privately Funded Abortions, which describes current military policy on abortion, including the existing ban on public funding and debate about lifting the ban on privately funded abortions in military medical facilities.
For context, the piece explains:
Earlier this year, the Senate Armed Services Committee moved toward restoring abortion rights to some 200,000 active duty women in the U.S. military, by voting to reverse current policy prohibiting the performance of abortions in military facilities, even in cases when U.S. servicewomen pay out-of-pocket for the procedure.The amendment to change the policy was sponsored by Sen. Roland Burris (D-IL) and is now attached to the pending Department of Defense (DOD) authorization bill.
The ban on privately funded abortions was apparently put in place in 1988, lifted by former President Clinton in 1993, and reinstated by Congress in 1995. According to the author, the ban particularly affects servicewomen stationed overseas, where legal abortion may not be available in the country’s own facilities. The author makes an argument that the policy against privately funded abortion in Department of Defense facilities not only strips women of their right to an abortion and endangers their health and safety, but that the policy may have negative effects on the military through the loss of women who would otherwise choose abortion.
This debate is not about the morality or legality of abortion, but whether women who enlist in the military, and especially those who are living overseas, should be discriminated against as a result…It’s time that we stop treating women in uniform as second-class citizens by denying them timely access to a legal, Constitutionally protected health care service their civilian counterparts can freely obtain.
Earlier this summer, we wrote about the President’s Cancer Panel report on environmental causes of cancer. Relatedly, the National Institutes of Health announced this week the formation of a committee to focus in part on environmental factors related specifically to breast cancer.
The committee will “develop and coordinate a strategic federal research agenda on environmental and genetic factors related to breast cancer.” It will apparently review current federal breast cancer research activities and make recommendations for improving these programs.
The committee is composed of representatives from the EPA, CDC, National Cancer Institute, the National Institute of Environmental Health Sciences, and other federal agencies, along with several physicians and scientists, and representatives from the advocacy groups Zero Breast Cancer, Breast Cancer Options, Academy for Cancer Wellness, Huntington Breast Cancer Action Coalition, National Breast Cancer Coalition, and the Breast Cancer Fund.
In June, we wrote about the FDA’s Advisory Committee for Reproductive Health Drugs recommendation to approve ulipristal acetate (brand name “ella”) for emergency contraception. On Friday, the FDA did approve the drug, as a prescription-only emergency contraceptive to be taken up to 120 hours (5 days) after contraceptive failure/unprotected sex. Existing “Plan B”-type emergency contraception is currently approved for use up to 72 hours.
Despite the five-day use window for this drug (and the three-day window for others), some media outlets persist in calling it a “morning-after” pill. Ahem.
At the time of our June post, a transcript of the Advisory Committee meeting – which includes the text of presentations and detailed discussion of the drug – was not yet available. That transcript is now online [PDF], including comments from representatives of Planned Parenthood and the National Women’s Health Network.
See our previous post for further discussion of the new emergency contraceptive.
The National Institute of Environmental Health Sciences (NIEHS) has long studied the various potential health effects of low-level exposure to chemicals called endocrine disruptors that interfere with development and function. These substances, both natural and man-made, include pharmaceuticals, dioxin and dioxin-like compounds, polychlorinated biphenyls, DDT and other pesticides, and plastics such as bisphenol A (BPA).
Very little action has been taken on the basis of these studies, but new legislation working its way through Congress aims to change that.
The Endocrine Disruption Prevention Act of 2009 was introduced last December in the Senate (S-2828 [pdf]) by Sen. John Kerry (D-Mass.) and in the House of Representives (HR-4190 [pdf]) by Rep. Jim Moran (D-Va.).
TEDX , the Endrocine Disruption Exchange, provides a thorough overview:
Simply put, the main purpose of the program proposed in the bill is to develop reliable and reproducible methods to identify chemicals that can disrupt the human endocrine system. These protocols will:
address the full range of possible health outcomes (including reproductive, behavioral, intellectual, metabolic, and endocrine disorders);
be sensitive enough to detect effects at exposure levels relevant to human exposure (and not rely on the assumption that a lower dose produces less effect);
consider the effects of exposure to multiple chemicals
The program will rely on a panel of scientific experts, free of conflict of interest, to design research efforts that will be conducted at the NIEHS and on academic campuses across the country. The panel will then evaluate the findings and determine their level of concern (taking into account routes and sources of exposure).
Kerry recently sent a letter to other members of the Senate looking for co-sponsors of the bill. TEDX is urging everyone to call their senators and encourage their sponsorships. And while the House bill has several co-sponsors, more is always better. See “How You Can Help.”
To get a feel for the full political context, read Elizabeth Grossman’s call for “Fixing Our Broken Chemicals Policy,” inspired by the introduction of the bill.
As we know, the majority of U.S. counties lack an abortion provider, and ensuring that proper training in the procedure is available to future healthcare providers is one key aspect of making and keeping abortion available. As the new school year approaches and new medical and nursing students are arriving at campuses all over the country, we thought we’d list resources for students interested in organizing to promote and protect abortion training in their programs. Two organizations working hard to provide information and resources on abortion training and availability are Medical Students for Choice and Nursing Students for Choice.
Medical Students for Choice provides student organizing resources including tips on curriculum reform and tools for student leaders, a list of U.S. and Canadian ob/gyn and family practice residency programs that offer abortion training, recommended reading, and other tools and support. The organization is also on Facebook and Twitter.
Nursing Students for Choice is a relatively new organization that focuses on reproductive health training for nursing students. Their website provides resources for getting involved and for starting campus chapters. The organization also has a new blog as well as Facebook presence.
As part of the week, the groups are asking supporters to contact their Congressional representatives “to ask the Department of Health and Human Services (HHS) to support comprehensive family planning services that include contraception as a key women’s health service under the Women’s Health Amendment.” As with many online action campaigns, you can put in your zip code to identify your Representative and Senators and send them a letter explaining that “Latinas, immigrants, and women of color will be disproportionately affected if contraception is not made affordable and accessible.”
There is also an online conversation about Latinas and contraception happening all week, with an inaugural blog post, My-So-Called-Sex-Education, up at Nuestra Vida, Nuestra Voz (NLIRH’s blog) on the need for information about and access to contraception. Further discussion will happen on Facebook, via Twitter (#latinaRJwk), and on partnering blogs such as VivirLatino. There are in-person events taking place in a few cities; check out this page for details.
The news today was celebratory, but the battle over Proposition 8 is far from over. From The New York Times:
Saying that it discriminates against gay men and women, a federal judge in San Francisco struck down California’s voter-approved ban on same-sex marriage on Wednesday, handing supporters of such unions at least a temporary victory in a legal battle that seems all but certain to be settled by the Supreme Court.
Wednesday’s decision is just the latest chapter in what is expected to be a long battle over the ban — Proposition 8, which was passed in 2008 with 52 percent of the vote. Indeed, while striking down Proposition 8, the decision will not immediately lead to any new same-sex marriages being performed in California. Vaughn R. Walker, the chief judge of the Federal District Court in San Francisco, immediately stayed his own decision, pending appeals by proponents of Proposition 8, who seem confident that higher courts would be less accommodating than Judge Walker.
But on Wednesday the winds seemed to be at the back of those who feel that marriage is not, as the voters of California and many other states have said, solely the province of a man and a woman.
“Proposition 8 cannot withstand any level of scrutiny under the Equal Protection Clause,” wrote Judge Walker. “Excluding same-sex couples from marriage is simply not rationally related to a legitimate state interest.”
The evidence shows that the movement of marriage away from a gendered institution and toward an institution free from state-mandated gender roles reflects an evolution in the understanding of gender rather than a change in marriage. The evidence did not show any historical purpose for excluding same-sex couples from marriage, as states have never required spouses to have an ability or willingness to procreate in order to marry.
Rather, the exclusion exists as an artifact of a time when the genders were seen as having distinct roles in society and in marriage. That time has passed.
* NYT editorial: “The decision [...] is a stirring and eloquently reasoned denunciation of all forms of irrational discrimination, the latest link in a chain of pathbreaking decisions that permitted interracial marriages and decriminalized gay sex between consenting adults.
“As the case heads toward appeals at the circuit level and probably the Supreme Court, Judge Walker’s opinion will provide a firm legal foundation that will be difficult for appellate judges to assail.”
* San Francisco Chronicle’s archive of the November 2008 California ballot measure and the state Supreme Court challenge to Prop. 8.
The Health on the Net foundation is conducting a survey of how people (both health professionals and patients) use the Internet for finding and accessing health information. They estimate that the survey will take 10-15 minutes, and it is available in both English and French.
You may have seen HON code certification on some health-related websites; the certification denotes that the site has met certain criteria for credibility and transparency, and has applied for certification and been approved. HON provides a list of some of the principles used in evaluating health websites.
Other guides for evaluating the quality and reliability of health information websites are provided by the National Library of Medicine (my current favorite, available in English and Spanish), the National Cancer Institute, and the Medical Library Association. NLM also provides an online tutorial with more visual examples (although I can’t seem to find captions or a transcript for the audio track).
If you’re interested in reading more about how people are using the internet for health information, the Pew Internet & American life Project provides commentary, presentations and reports on topics such as chronic disease, social media, e-patients, and the use of the web for health information in general. Additionally, e-patients.net is a great place for kind of geeky discussions by patients on how to become more informed about their health (largely via the internet) and more engaged in their own care.
I served as an official blogger again this year for the Medical Library Association annual conference, held in Washington, DC. In addition to blogging, I got to do two presentations myself!
Here’s a round-up of the posts I wrote, which generally include some good online resources related to the topics at hand. Various posts may be of interest to other med librarians, individuals with NIH-funded or other federally funded research grants, anatomy instructors, those interested in HIV/AIDS or vaccines or community outreach on health, PubMed searchers, and others:
Section Program: Vaccine Information – speakers from the CDC, a university, and a public health librarian on vaccine safety and information on communication, myths and misperceptions, outreach efforts related to the HPV vaccine, and other topics
I also have a post at my place on my conversation with an ACOG rep about how they disappear old guidelines when new ones become available.
My fellow medical librarians posted on various other topics throughout the event at http://npc.mlanet.org/mla10/.
My own presentations were an invited panel on informal publication methods, where I spoke about applying some benefits of informal methods such as blogs to our formal journals, and a paper presentation about approaches my library has taken over the past year to improve management of metadata for our electronic resources, including accountability features and distributing the workload beyond our tech services folks. A’Llyn has a post on the open forum on publication methods.
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