With less than one week to go until Election Day, we’re taking a look at some of the women’s health issues at stake. Want to add more? Leave links to blog entries or other resources in the comments.

One other note — I can’t believe some folks aren’t voting. If you know anyone who plans on sitting this one out, please urge them to consider the importance of their vote on local and state issues, in addition to what’s obviously a national turning point for women’s reproductive rights and access to health care.

Still wondering about the differences between the health care reform proposals of senators John McCain and Barack Obama? You might want to review this non-partisan report, “Health Care Reform and the 2008 Election - A Guide for Women.”

Through the stories of seven “fictional women,” each with a different set of health problems and insurance coverage, readers can understand what each candidates’ health reform plan means to them. The report was published by the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital.

And don’t forget Kaiser Family Foundation’s excellent Health08.org, which includes in-depth comparisons of the candidates’ health care plans and positions on issues.

Turning to ballot propositions, USC’s Initiative and Referendum Institute (IRI) offers a good overview (PDF) of the 153 ballot propositions before voters in 36 states, including headline issues of same-sex marriage and abortion (also the subject of discussion on Monday’s “Talk of the Nation”).

Measures to ban gay marriage are on the ballot in California, Arizona and Florida, with most eyes on California, which the IRI refers to as a “critical firewall in the battle over gay marriage.” This document (PDF) analyzes the likelihood of passage in each of the three states, and it features a list of all same-sex marriage propositions. Did you know that 29 of 30 measures banning same-sex marriage — some proposed by initiative, others by state legislatures — have passed?

BallotPedia.org is another comprehensive site. It’s easy to search and it does a nice job of listing initiatives by category, including abortion, marriage and health care. These pages include not only this year’s ballot items, but also initiatives coming up next year — and even those that failed to get on the ballot. Very cool.

Here’s a look at some of the discussions on three specific ballot items:

1. Colorado Amendment 48 Definition of Person: This amendment seeks to define “person” and grant constitutional rights from the “moment of fertilization.” It’s also been tied to “Horton Hears a Who” (”a person’s a person, no matter how small”) — much to the consternation of thinking Dr. Seuss fans everywhere.

Protect Families, Protect Choices has a good fact sheet about the far-reaching consequences of this amendment, including:

• Emergency contraception for rape and incest victims would be banned. By giving legal rights to fertilized eggs, this amendment could ban birth control options like the Pill and IUD’s. (These kinds of birth control can prevent a fertilized egg from implanting in the uterus.)
• Establishing rights from the moment of fertilization would ban some stem cell research being used to find cures for chronic disease and disabilities. In vitro fertilization could be banned since fertilized eggs used in these processes would have full legal rights.
• A woman with cancer could be denied access to life saving medical treatment because it could endanger a fertilized egg.

Former U.S. Rep. Patricia Schroeder recently wrote: “Years ago, when I was asked how I could be both a mother and a Congresswoman, I replied, ‘I have a brain and a uterus and I use both.’ On November 4, I urge Coloradans to use their brains and protect women’s uteruses. Vote no on Amendment 48.”

2. South Dakota Abortion Ban Initiative: Following South Dakota’s failed attempt in 2006 to ban abortion, this kindler, gentler initiative “now makes convoluted exceptions for rape, incest and, when there is a full moon and Mount Rushmore spouts Strawberry Quik, the health or life of the woman.” It’s being pushed by anti-choice activist Leslee Unruh, who has trouble following the facts of life (including her own).

South Dakota Campaign for Healthy Families has an incredible amount of useful information, including statements in opposition to the initiative submitted by the South Dakota State Medical Association and the South Dakota section of the American College of Obstetricians and Gynecologists.

Plus: Katha Pollitt this week spotlights Women Run! South Dakota, the umbrella organization for progressive pro-choice Native American women running for the state legislature.

3. California Proposition 4 (”Sarah’s Law)”: In an editorial, the L.A. Times came down against this parental notification proposal, noting:

The initiative purports to protect California girls from dangers associated with abortions by requiring that their parents be notified. But Proposition 4 attempts to solve something that isn’t much of a problem. There’s no evidence that California’s teenage girls are harmed by abortions with any frequency, whether or not their parents have been notified. [...]

In fact, under the guise of protecting underage girls, this proposal really is just the latest attempt to impose any obstacle in the exercise of reproductive freedom. This represents the third try in recent years to pass such a measure. California should reject it again.

The editorial goes on to note, in no uncertain terms, the ridiculousness of the measures included to protect girls in abusive situations:

Proposition 4’s writers say they crafted a measure that would permit girls in potentially abusive situations to get an abortion without their parents being notified. To do so, they would need to tell another adult relative. But a girl can use this option only if she makes a written accusation alleging that her parents are repeat child abusers, with the complaint to be turned over to authorities. Spoiler language like this makes it hard to believe that Proposition 4 is chiefly about girls’ safety.

Read more editorials against Proposition 4. Planned Parenthood has posted a number of videos about how the proposition would endanger teens, including the one below, “Jane’s Journey,” which shows the complexity of the judicial maze that teens would be forced to navigate if they can’t talk to their parents.

Did you see Ellen weigh in on Sarah Palin and same-sex marriage? It’s one minute and 28 seconds of total goodness:

I doubt if anyone else could have touched on so many valid points in under 90 seconds — and with a truly humorous twist. Read the full transcript.

Gay Marriage Legal in California, Massachusetts and now Connecticut: The Connecticut Supreme Court on Friday struck down the state’s civil union law with a 4-3 ruling that same-sex couples have a constitutional right to marry. From The New York Times:

The ruling, which cannot be appealed and is to take effect on Oct. 28, held that a state law limiting marriage to heterosexual couples, and a civil union law intended to provide all the rights and privileges of marriage to same-sex couples, violated the constitutional guarantees of equal protection under the law.

Striking at the heart of discriminatory traditions in America, the court — in language that often rose above the legal landscape into realms of social justice for a new century — recalled that laws in the not-so-distant past barred interracial marriages, excluded women from occupations and official duties, and relegated blacks to separate but supposedly equal public facilities.

View the full ruling here (PDF). Opponents spoke of steps to enact a constitional ban on same-sex marriage, but on Friday night the plaintiffs in the original court case filed four years ago and their supporters were jubilant.

Garret Stack, 59, introduced his partner, John Anderson, 63, and said: “For 28 years we have been engaged. We can now register at Home Depot and prepare for marriage.”

Group Sues Over Required Ultrasound: The Center for Reproductive Rights has filed a challenge to an Oklahoma law that mandates a woman must have an ultrasound and listen to the doctor describe what her fetus looks like before she have an abortion. And that’s not all:

At the same time, the law prevents a woman from suing her doctor if he or she intentionally withholds other information about the fetus, such as a severe developmental defect. The statute also requires doctors to use a specific regimen for administering the medical abortion pill, despite that regimen being less effective and more costly than the one strongly recommended by the American College of Obstetricians and Gynecologists (ACOG).

The lawsuit, filed Thursday in Oklahoma County District Court, says the requirement intrudes on a woman’s privacy, endangers her health and assaults her dignity.

Set to go into effect on Nov. 1, the law would make Oklahoma the fourth state to require the viewing of ultrasounds before an abortion. The other states are Alabama, Louisiana and Mississippi.

South Dakota Abortion Ban 2.0: Lynn Harris of Broadsheeet offers a full, and funny, assessment:

Remember how South Dakota’s 2006 Margaret Atwood honorary abortion ban was defeated in referendum by a (none-too-cushy) 55-44 margin?

The ban’s primary liability, according to polls, was that it contained virtually no exceptions. But as ringleader Leslee Unruh of Vote Yes for Life said at the time, like Jason popping up out of Crystal Lake, “We started something here in South Dakota.” And now, as you may have heard, abortion opponents there are aiming to get the job done. Which means: The ban is back (PDF), in sheep’s clothing. It now makes convoluted exceptions for rape, incest and, when there is a full moon and Mount Rushmore spouts Strawberry Quik, the health or life of the woman.

Unruh (who says that over 90 percent of women seeking abortion are using it as “birth control”) calls Abortion Ban 2.0 “more moderate, more reasonable, more of a middle ground.” Yeah … no.

Plus: Visit South Dakota Campaign for Healthy Families for more information.

Birth Control Watch: While some voters think access to birth control is not a political issue, those of us who follow the activities of the Bush administration and legislatures around the country know better. Birth Control Watch has a great section on federal and state proposals that will limit our individual decision making and access — it’s called extreme schemes.

An excellent resource to pass along, it includes information on Colorado Proposition 48, a constitutional amendment that seeks to establish legal personhood from the moment of fertilization (which even self-described “pro-life” Catholic Gov. Bill Ritter opposes), and the proposed HHS regulations that would limit patients’ access to information and services.

The two-minute activist gives a concise run-down of actions you can take, and the press room tracks related stories.

Speaking of the HHS regulations, more than 150 Congressional Democrats stated their opposition in letters to HHS. The Senate letter concludes that the proposed rule is “damaging to the health care needs of women, their families and all Americans and will only serve to cause havoc, not clarity, among employers and employees in the health care field.”

Courts Failing Domestic Violence Victims: “For every man convicted in a Cook County court of beating his wife or girlfriend, five men brought in on similar charges walk away legally unscathed. And despite official promises to help women pursue abuse complaints, that conviction rate is only getting worse,” reports the Chicago Tribune.

The Trib also looks at a specialized unit of the Cook County state’s attorney office with a much higher conviction rate. The unit, Target Abuser Call, employs a more intensive investigatory approach for the most serious cases.

Plus: Programs for batterers are underfunded but should be supported to break the habit of abuse, say domestic violence experts. “No matter how many women you take in, it isn’t going to cure the problem,” said Toby Myers, vice chair of the National Center on Domestic and Sexual Violence.

Plus: A judge in Canada tells a woman not to bother calling police if she goes back to her partner. via Feministing

Nobel Prize Winners: The 2008 Nobel Prize in Physiology or Medicine went to Harald zur Hausen of Germany, who discovered the human papilloma viruses that causes cervical cancer, and Luc Montagnier and Francoise Barre-Sinoussi, French researchers who discovered HIV, the virus that causes AIDS.

Montagnier and Barre-Sinoussi later told President Nicolas Sarkozy that they fear the world financial crisis will affect funding to fight AIDS.

One-Year Distribution Update On Gardasil: “About a quarter of the nation’s teenage girls received the controversial cervical cancer vaccine Gardasil last year in its first full year of distribution, federal authorities said Thursday,” reports the L.A. Times.

The Realities of Addiction: Writing in the Washington Post, Jacqueline M. Duda shares the painful story of her daughter’s drug addiction and death — including the difficulty the family had finding adequate medical treatment for addiction.

“Surely, we thought, college-educated suburbanites like us could locate professional help: drug counselors, doctors, therapists specializing in addiction. Surely detoxification centers would treat desperate addicts and work out a payment plan. Surely we could check her into some kind of residential treatment program with a minimum of delay,” writes Duda. “We were wrong.”

PSA to Raise Awareness Around “That’s So Gay”: “For the first time since the Advertising Council was founded in 1942, the organization — which directs and coordinates public service campaigns on behalf of Madison Avenue and the media industry — is introducing ads meant to tackle a social issue of concern to gays and lesbians,” writes Stuart Elliot in The New York Times.

The campaign, created pro bono by the New York office of Arnold Worldwide, urges an end to using derogatory language, particularly labeling anything deemed negative or unpleasant as “so gay.” That is underlined by the theme of the campaign: “When you say, ‘That’s so gay,’ do you realize what you say? Knock it off.”

There will be television and radio commercials, print and outdoor ads and a special Web site devoted to the campaign (thinkb4youspeak.com). Some spots feature celebrities, the young actress Hilary Duff and the comedian Wanda Sykes, delivering the message.

Check out the Wanda Sykes PSA below:

Dear Gov. Sarah Palin: Lynn Paltrow, executive director of National Advocates for Pregnant Women, wrote an open letter to the newly picked vice presidential candidate that begins with this:

Many Americans agree with your position regarding abortion — they do this as a matter of faith, ethics, personal experience and sometimes politics. I am just wondering though, if you have thought about what would happen if you succeeded in getting your position — that fetuses have a right to life — established as the law of the land? Did you know that it not only threatens the lives, health and freedom of women who might want or need someday to end their pregnancies, it would also give the government the power to control the lives of women — like you who — go to term?

Go read the rest. Seriously. It’s amazing.

The Privilege of White Woman’hood/ Mommy’Hood: “Sarah Palin wants to put herself out there as ‘every woman.’ She wants to be seen as ‘just your average hockey mom,’ and other mommies see themselves and their reality reflected through Palin, except, mamis of color, that is,” writes Maegan “La Mala” Ortiz at Racialicious (and at her site, Mamita Mala).

What Women Want: There’s video up from the This Is What Women Want speakout in Boston (Aug. 21), including Rita Arditti advocating for health care as a universal right; Cynthia Enloe on lifting the global gag rule; and Kety Esquivel on treating immigrants as human beings.

The next speakout is Sept. 25 in Oxford, Miss. But you can always speak out right now, right here.

Smoother Transitions: “Across the country, particularly at larger companies, transgender workers are being protected and assisted in ways that were hardly imaginable a few years ago,” writes Lisa Belkin, author of the Life’s Work column in The New York Times.

Currently, 125 of the Fortune 500 companies include “gender identity” in their nondiscrimination policies, compared with “close to zero” in 2002, according to Jillian T. Weiss, an associate professor of law and society at Ramapo College of New Jersey, and an expert on transgender workplace diversity. [...]

“It is a different world,” said Dr. Weiss, who attributes the change, in part, to the slow adoption of laws banning discrimination on the basis of gender identity (20 states and roughly 100 cities have such laws), but mostly to the work of the Human Rights Campaign, the largest gay, lesbian, bisexual and transgender civil rights organization in the nation.

Yes, HRC, which releases the Corporate Equality Index — a measure of how receptive a company is to diversity. Questions concerning gender-identity protection and transgender benefits have been included since 2002.

High Rate of C-Section Births is Health Concern for Women: “One in four Washington mothers now give birth through C-section, according to the Department of Health, and the rate of the surgical procedure has been increasing by 6 percent every year for nearly a decade,” reports the Seattle Post-Intelligencer.

“The U.S. Centers for Disease Control and Prevention says we should have no more than 15 percent of low-risk births delivered by C-section,” said Joe Campo, director of research at the [state agency's Center for Health Statistics]. “It’s important for us to know what’s driving this increase.”

About 13,300 of the 21,800 total C-sections are first-time procedures and about 8,500 are repeat procedures, Campo and his colleagues found. Of the total, state officials believe at least 2,200 are clearly unnecessary. A fairly sophisticated analysis of the C-section rates allowed for a geographic comparison that found an especially pronounced increase in the use of the surgical procedure in the Puget Sound region.

Plus: In a guest column penned in response to the SI story, Sara L. Ainsworth, senior legal and legislative counsel at Northwest Women’s Law Center, wrote that the high rate of caesarean sections “raises alarms for those who care about women’s reproductive health and patients’ rights.”

In addition to the potential health risks of the surgery, women who have C-sections face consequences that even conscientious health care providers may not recognize or discuss with their patients.

In many parts of this state, having one C-section delivery will require another at a subsequent birth, even over the objection of the pregnant woman and her doctor. Several Washington hospitals refuse to allow doctors to provide labor and delivery services to pregnant women who have had a previous C-section unless those women submit to a second C-section delivery.

Breast Cancer Rates: The Kaiser Family Foundation has published a state-by-state breakdown of breast cancer incidence rate per 100,000 women in 2004. Massachusetts has the highest rate (134 per 100,000 women), followed by Oregon, Washington, Rhode Island and Connecticut. Arizona has the lowest rate (102.9), followed by Idaho, Arkansas, Nevada and Indiana.

Plus: Feminist Peace Network reports on Molecular Breast Imaging (MBI), a new procedure that may be useful for women with dense breasts who have a higher risk of breast cancer. The downside? Patients receive 8 to 10 times more radiation from MBI’s than from mammograms.

With Child, With Cancer: The New York Times Magazine profiles women who are undergoing cancer treatments during pregnancy and covers the medical history of treating pregnancy-associated breast cancer.

Health Reporters Not Helping Readers: A study by University of Missouri journalism professors found that “the majority of health journalists have not had specialized training in health reporting and face challenges in communicating new medical science developments.”

Of the journalists surveyed, only 18 percent had specialized training in health reporting and only 6.4 percent reported that a majority of their readers change health behaviors based on the information they provide. The journalists had an average of 18 years of journalism experience and seven years experience as health journalists.

“Health journalists play an important role in helping people effectively manage their health,” [assistant professor Maria] Len-Ríos said. “However, we found that many journalists find it difficult to explain health information to their readers, while maintaining the information’s scientific credibility. They have to resist ‘bogging down’ the story with too much technical science data and ‘dumbing down’ the story with overly simplistic recommendations.”

Journalists reported quoting medical experts, avoiding technical terms, and providing data and statistics as the three most important elements to making health information understandable. However, understanding numbers is a challenge for many people, [assistant professor Amanda] Hinnant said.

Celebrate the Anti-Wedding: Read what happens when death and taxes decide to get married and stage a protest against weddings. And there’s video.

Returning for the Final Time to the Republican National Convention: Jon Stewart drives home the hypocrisy of Republican attitudes toward reproductive rights with guest Newt Gingrich, while Samantha Bee tries to remember what that word is …

FDA Report Says No Risk From BPA: I’ve written before about the dangers associated with bisphenol A, or BPA, a chemical used in hard, clear plastics, such as Nalgene and baby bottles, as well as in the linings of food cans and baby formula.

The chemical, which mimics a human hormone, has been linked to hormonal changes in animal studies. Canada recently banned polycarbonate infant bottles, and the U.S. National Toxicology Program earlier this year acknowledged “some concern” that BPA may affect neural and behavioral development “in fetuses, infants, and children at current human exposures.”

But according to a draft assessment released by the Food and Drug Administration yesterday, BPA does not pose a health hazard when used in food containers. From the Washington Post:

The report stands in contrast to more than 100 studies performed by government scientists and university laboratories that have found health concerns associated with bisphenol A (BPA). Some studies have linked the chemical to prostate and breast cancers, diabetes, behavioral disorders such as hyperactivity and reproductive problems in laboratory animals.

Exposure to the small amounts of BPA that migrate from the containers into the food they hold are not dangerous to infants or adults, the draft said.

Here’s the kicker:

The chemical industry and the agencies that regulate the use of BPA, the FDA and the Environmental Protection Agency, have deemed the chemical safe, largely on the strength of two industry-funded studies that found no problems. The American Chemistry Council welcomed the findings of the new report.

“Clearly, their effort was to minimize people being concerned about this,” Diana Zuckerman, president of the National Research Center for Women and Families, told the Post. “It just seems that whenever there is an opportunity to look at a new, important issue, they just seem to be siding with industry’s point of view.”

Wal-Mart and Toys R Us aren’t waiting around for the government to take action — as of January, both businesses will stop selling any childrens’ products made with BPA.

Marrying, or Divorcing, for Health Insurance: “In a country where insurance is out of reach for many, it is not uncommon for couples to marry, or even to divorce, at least partly so one spouse can obtain or maintain health coverage,” reports The New York Times. “There is no way to know how often it happens, but lawyers and patient advocacy groups say they see cases regularly.”

Here’s more on the Kaiser Family Foundation study mentioned in the story.

Report: “Failing Women, Withholding Protection”: The female condom first made its debut 15 years ago, but a lack of investment and marketing on the part of policymakers has limited the condom’s availability and marginalized its role in protecting women from HIV-infection and other sexually transmitted diseases, according to a new report issued by Oxfam International and the World Population Foundation. The report was presented at the International AIDS Conference in Mexico City. The full text is available here.

“This is a 15-year scandal born of ignorance and inertia. It has been made doubly worse as the HIV epidemic is now affecting women at a higher rate than men, especially in Sub-Saharan Africa. We now know that millions of women might have been spared HIV, unwanted pregnancies, and empowered themselves in the process, if they had access to this simple method,” said Oxfam spokeswoman Farah Karimi.

“The female condom is the only method that women have to protect themselves. It has been embraced in many countries and cultures, it works and it is cost-effective,” added Karimi. “Political leadership and funding are needed now. No more excuses.”

Plus: Here are some facts about the female condom from “Our Bodies, Ourselves,” and our previous coverage on the condom’s redesign and how U.S. global policy affects condom promotion.

APA Report: Abortion Not a Threat to Mental Health: “The best scientific evidence published indicates that among adult women who have an unplanned pregnancy the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy.”

That’s one of the conclusions put forth by the American Psychological Association Task Force on Abortion and Mental Health, which just issued this comprehensive report (PDF), an evaluation of all English-language studies published in peer-reviewed journals post-1989 comparing the mental health of women who had an induced abortion to the mental health of comparison groups of women.

Plus: For a closer look, read Lynn Harris’ good analysis at Broadsheet.

Coming Out as an Abortion Provider: Nell, who also blogs at Abortion Clinic Days, writes at the new Feministing Community site about her experience meeting her partner’s Republican grandparents and explaining what she does. Yes, there’s a happy ending.

Obesity Study Looks Thin: That’s the word from “The Numbers Guy,” aka Carl Bialik, who has a different take on a recently published study that projects 100 percent of American adults could be overweight by 2048.

What’s in a Midwife’s Bag?: Writing at Offsprung, Diane Dawson, a homebirth midwife, opens up her big black bag to reveal what she brings with her to deliver a baby. “I think that most people still think I show up with a smile and rabbit’s foot for luck. And maybe an herb or two in my purse. For the vast majority of pregnancies, this may well be enough, but I like to be a bit more prepared. …”

New State Law Calls for GPS Tracking on Abusers: “Gov. Rod Blagojevich signed a measure to create a new early warning system by allowing satellite tracking of people who violate orders of protection,” reports the Chicago Tribune. “Opponents of domestic violence and prosecutors say the Cindy Bischof Law will add teeth to the orders, which some deride as mere pieces of paper ineffective in protecting people from stalkers or abusers. Bischof was among at least four women in the Chicago area killed this year by men with orders of protection against them.”

Congratulations to Del Martin, 87, and Phyllis Lyon, 84 — longtime gay rights activists who were the first to wed in San Francisco Monday, on the eve of the legalization of same-sex marriage throughout California.

“When we first got together we weren’t thinking about getting married,” said Lyon before cutting a wedding cake, according to The New York Times. “I think it’s a wonderful day.”

It was actually their second wedding — their first took place four years ago, also in San Francisco, when Mayor Gavin Newsom sanctioned same-sex weddings. The California Supreme Court later invalidated those marriages.

From the San Francisco Chronicle:

Martin and Lyon have been at the forefront of the gay-rights movement since they moved in together in 1953. They’ve fought for equality for gays and lesbians in the workplace, housing, the medical establishment, the feminist movement and, most recently, the institution of marriage.

Martin wore a purple pantsuit and stood up from her wheelchair to face Lyon, dressed in a blue pantsuit. During the six-minute ceremony, the two held hands as they recited their vows to love and honor each other, for richer or poorer, in sickness and in health. Their eyes welled with tears.

Lyon was the first to say “I do,” her voice resonating in the room. Martin’s “I do,” which came next, was more muted, audible only to those close by. They exchanged rings - the ones they’ve worn before - hugged, and then kissed each other lightly.

The room erupted in cheers - and tears.

For more coverage, check out the Chronicle’s multimedia section on same-sex marriage, which includes profiles of couples saying, “I do”; multiple photo albums; and Chronicle reporter Jim Doyle discussing the recent history of same-sex marriage.

The L.A. Times, meanwhile, looks at the high number of marriage licenses issued as of 5 p.m. Tuesday in California. Here’s a map that shows how counties are handling same-sex marriages; a report on the tactics of opponents (who are apparently lying low for now); and a reader Q&A that even answers questions like this: “Our friend was ‘ordained’ by the ‘Church of the Latter-Day Dude’ and performed his sister’s ceremony in South Carolina last month. Does he need to do anything else to be able to marry us in California?”

Finally, here’s a look at reaction from other countries. Bruce Wallace writes:

Many parts of Europe have reacted with a collective shrug to the California Supreme Court ruling that found the ban on same-sex marriage to be discriminatory. Same-sex marriage has been legal in the Netherlands since 2001, in Belgium since 2003 and in Spain since 2005. The move by the second U.S. state to join them brought only cursory news coverage.

Elsewhere, Canada has officially recognized same-sex marriage since 2005. South Africa stands out as the exception on a continent where homosexuality is largely taboo. It passed a law in 2006 to recognize homosexual marriages after a Constitutional Court ruling said anything less would treat gays and lesbians as inferior.

And Norway happened to legalize same-sex marriage today.

Wide Disparities in Health Care by Race and Region: “Race and place of residence can have a staggering impact on the course and quality of the medical treatment a patient receives, according to new research showing that blacks with diabetes or vascular disease are nearly five times more likely than whites to have a leg amputated and that women in Mississippi are far less likely to have mammograms than those in Maine,” reports The New York Times.

The study was conducted by researchers at Dartmouth and was commissioned by the nation’s largest health-related philanthropy, the Robert Wood Johnson Foundation, which announced a three-year, $300 million initiative intended to narrow health care disparities across lines of race and geography.

Repairing the Damage, Before Roe: “With the Supreme Court becoming more conservative, many people who support women’s right to choose an abortion fear that Roe v. Wade, the 1973 decision that gave them that right, is in danger of being swept aside,” writes Waldo L. Fielding in this op-ed. “When such fears arise, we often hear about the pre-Roe ‘bad old days.’ Yet there are few physicians today who can relate to them from personal experience. I can.” Read on.

Legal Effects of Marriage for Same-Sex Couples: The San Francisco Chronicle has a comprehensive run-down of the legal and financial changes same-sex couples face if they get married in California.

Plus: What happens to the status of couples already married if the November initiative to ban same-sex marriage passes? Expect heavy litigation and a decision ultimately decided by the California Supreme Court, says UCLA law professor Brad Sears.

Paying for Health Care in Retirement - Good Luck: “I write about health care, and still the realization hit me like a ton of bricks today after I put down a just-released report from the Employee Benefit Research Institute. None of the presidential candidates have been talking about how to fix Medicare," writes Judith Graham at the Chicago Tribune.

Here’s the sobering EBRI report (PDF), effectively titled: “Savings Needed to Fund Health Insurance and Health Care Expenses in Retirement: Findings from a Simulation Model.”

On Becoming a Woman: In case you were looking for some, er, real-life advice, Blinky has excerpts from this 1950’s guide. Here’s analysis from Echidne, who calls it “a fascinating trip into the sexual politics of the past.”

“On the other hand,” she adds, “almost everything in those excerpts is advocated in this country somewhere, right this very moment. Abstinence is the responsibility of girls, for example. Women gentle and home-directed while men are strong and outer-directed? I was just told this by a liberal guy.”

Speaking of Abstinence: The National Abstinence Education Association has launched a $1 million campaign to recruit 1 million parents to “lobby local schools to adopt sex education programs focusing on abstinence and to work to elect local, state and national officials who support the approach,” reports the Washington Post.

The campaign comes as Congress is debating whether to authorize about $190 million in federal funding for such programs, which have come under increasing criticism because of a series of reports that concluded they are ineffective. Such criticism has prompted at least 17 states to refuse federal funding for such programs.

The group hopes to counter that trend, in part with a provocative video that asserts that comprehensive sex education encourages sexual activity by teenagers and a Web site that offers advice to parents about sex education.

Plus: Five days later, the same WaPo reporter, Rob Stein, wrote a page-one story about a new study by the Centers for Disease Control that found “a decade-long decline in sexual activity among high school students leveled off between 2001 and 2007, and that the rise in condom use by teens flattened out in 2003.”

The new figures renewed the heated debate about sex-education classes that focus on abstinence until marriage, which began receiving federal funding during the period covered by the latest survey and have come under increasing criticism that they are ineffective.

“Since we’ve started pushing abstinence, we have seen no change in the numbers on sexual activity,” said John Santelli, chairman of the department of population and family health at Columbia University. “The other piece of it is: Abstinence education spends a good amount of time bashing condoms. So it’s not surprising, if that’s the message young people are getting, that we’re seeing condom use start to decrease.”

Not surprisingly, proponents of abstinence-only programs blamed comprehensive sex-ed.

Hands Up if You’ve Experienced Street Harassment: The F-Word is gathering comments here, in response to comments here.

Breast Cancer News from ASCO Conference: Several breast cancer-related studies presented at the annual American Society of Clinical Oncology conference in Chicago are summarized here by Daily Women’s Health Policy Report. Meeting abstracts from the conference are available here.

Eat Locally, Think …: “The local food movement typically has been about improving the health of the planet,” writes Tara Parker-Pope. “But now researchers are trying to find out if eating locally farmed food is also better for your health. A team of researchers at the University of North Carolina at Chapel Hill has received a grant to study the public health impact of moving toward a local, sustainable food system.”

Chicago can’t hold a carrot stick to California when it comes to the availability of locally grown produce, but the farmers markets rock during the summer and fall. How ’bout where you live?

If I Could Be Anywhere Right Now: It would be here.

New York Governor Faces Suit Over Same-Sex Marriage Order: “An Arizona-based conservative Christian group said on Friday that it planned to sue Gov. David A. Paterson to block his directive to state agencies to recognize same-sex marriages performed outside New York,” reports The New York Times.

The group suing is the Alliance Defense Fund, which was founded by the Rev. James C. Dobson and others, all of whom are for limiting marriage to heterosexuals. The story also discusses how Senate Republican leaders plan on responding to the governor’s directive. Read our earlier post about plans in New York to recognize (but not yet allow) same-sex marriage.

The Rest of Us: In today’s Boston Globe Sunday Magazine, Rebecca Steinitz describes how mothers without an army of nannies and who have not “opted out” make it through summer vacation.

[I]t’s neither superwomen nor supermoms that I see when I drop my younger daughter off at school. While the first-graders zoom around us, I strategize about summer vacation with the preschool teacher and the nurse, the freelance film producer and the nutritionist who’s currently managing her husband’s plumbing business, the law professor and the stay-at-home moms — not to mention the dads. And, tales of mommy wars notwithstanding, we’re all talking to one another.

Do I live in some anomalous corner of working motherhood? I don’t think so. Despite frequent sightings of weekday-morning stroller-pushing moms and the much-ballyhooed dip of about a percentage point in the rate of women in the workforce between 2000 and 2004, statistics show that more than two-thirds of mothers work.

The story is chock-full of good statistics. Give it a read.

Do All Women Have the Right to Become Mothers?: “In many ways, access to and the affordability of infertility treatments speaks to our society’s view of who is considered worthy of motherhood,” writes Pamela Merritt at RH Reality Check.

Decades after eugenics was debunked and fell out of favor as a movement to “improve society,” the residue lingers: there is a strongly held belief that pregnancy and income should be connected. President Reagan tapped into that sentiment with his infamous comment about a “welfare queen,” but the core belief is as old as the American Dream: people who are poor are considered lazy, deserving of poverty and undeserving of anything it takes money to buy. Low-income women who are faced with infertility and seek treatment are suspected of trying to work the system and defraud society.

Plus: On Tuesday, June 3, RH Reality Check and Americans for UNFPA will host an online forum at 1 p.m. on global women’s health and the Republican and Democratic Party platforms. “Are the World’s Women Part of Our Political Agenda?” kicks off with a video statement from Anika Rahman, Americans for UNFPA president, and the insights of Democratic and Republican activists about their parties’ treatment of women’s issues. Rahmam will monitor the comments section through 4 p.m. to follow the discussion and respond to ideas on how to prioritize women’s health internationally.

Two Kinds of End-Of-Life Care: “There are two starkly different paths toward death in New York City’s hospitals, one for patients at elite private institutions, another for those at public hospitals, according to new data compiled as part of a consumer rating system,” reports The New York Times. Anemona Hartocollis and Ford Fessenden write:

Most elderly patients in their last two years of life have more intensive treatment, more tests, more days of hospitalization — and more out-of-pocket costs — at private teaching hospitals like N.Y.U. and Lenox Hill than their counterparts at Bellevue and the city’s other municipal hospitals, which have historically served the neediest New Yorkers. [...]

The rankings, compiled by Consumer Reports from a 15-year research project based at Dartmouth College, have huge implications for administrators, doctors and patients as they consider which model of care is best for those suffering from chronic, fatal illnesses like cancer, congestive heart failure, lung disease and dementia.

The study does not address the question of whether longer stays and more intervention prolong patients’ lives, and the Dartmouth researchers argue, in general, that less-aggressive treatment does not change.

Holy Smokes!: New York state on Tuesday will almost the double the tax on cigarettes — to $2.75 from $1.50, putting the price of a pack of cigarettes in New York City to around $8.50 (that also includes a $1.50 city tax).

From City Room: "It’s not clear whether the messages will have much effect on die-hard smokers, but social scientists have concluded that raising the cost of cigarettes has been a strong factor in bringing down the smoking rate. The city believes that cigarette-tax increases in 2002 helped bring about a 21 percent drop in adult smoking and a 52 percent drop in smoking among public high school students in the city."

Plus: World No Tobacco Day was May 31. Here’s more from the World Health Organization.

Did You Have an Abortion in Iowa?: If so, and if you experienced financial barriers at any point in the process, the Emma Goldman Clinic would like to hear about your experience. The information (which can be kept anonymous) will help the clinic in their work to provide assistance to women in similar situations.

Insight and Action: The website of the International Center for Research on Women is a terrific resource for background, research and advocacy information on issues such as HIV/AIDS, poverty reduction and violence against women.

The organization also features a special section on child marriage, which includes this photo exhibit as well as this six-minute video with images taken by award-winning photojournalist Stephanie Sinclair that depict the lives of girls in Afghanistan, Ethiopia and Nepal who marry as children.

Screening for Domestic Abuse: Erin Marcus, associate medical director of the Institute for Women’s Health at the University of Miami Miller School of Medicine, writes in The New York Times about the need for better methods to screen patients for domestic abuse.

"Those who support routine questioning say domestic violence is as or more common in women than many diseases for which doctors regularly check, including breast and colon cancer, and its health risks are well documented," notes Marcus. "Despite these recommendations, screening for domestic abuse in seemingly healthy women is nowhere near as widespread among doctors as testing for breast cancer or high cholesterol."

Who is the EPA Protecting Again?: Here's a story I meant to highlight earlier — an Environmental Protection Agency official told a Senate committee hearing in May that there’s "a distinct possibility" the EPA would not limit the amount of perchlorate, a toxic ingredient of solid rocket fuel, that is allowable in drinking water. Percholate is found in food crops, as well as human breast milk and baby formula. The L.A. Times has coverage of the EPA sitting on its hands:

State officials and water suppliers across the nation have been waiting for the EPA to set a standard for several years because perchlorate has contaminated the water supplies of at least 11 million people. Last
year, California, impatient with the EPA’s indecision, set its own standard.

Benjamin H. Grumbles, the EPA’s assistant administrator for water, said the EPA would decide by the end of the year whether to regulate perchlorate. Scientific studies have shown that the chemical blocks iodide and suppresses thyroid hormones, which are necessary for the normal brain development of a fetus or infant.

Sen. Barbara Boxer (D-Calif.), who chairs the committee, is understandably ticked:

"Congress will not sit idle while EPA fails to adequately protect our children. We must step in to require action that will ensure that our children and families can turn on their taps and be assured that what comes out is safe to drink," Boxer said.

Much of the water contamination comes from military bases and aerospace plants, as well as fireworks companies.

The Pentagon and its contractors for years have been lobbying against a federal standard, saying there are no proven health effects at levels to which people are exposed, and that cleaning up perchlorate could cost billions of dollars.

Much news to cover this week concerning same-sex marriage on opposite coasts. First up, wedding bells will ring for gay and lesbian couples in California starting June 17, the first day marriage licenses can be issued.

That day was decided upon by the state’s Office of Vital Records, in order to allow the state Supreme Court the maximum time to consider any challenge to its ruling before it takes effect, reports the San Francisco Chronicle.

The Office of Vital Records also announced how the new marriage forms will be worded — the forms refer to applicants simply as “Party A” and “Party B.”

And here’s more good news in California: The statewide Field Poll that has been conducted in that state for 30 years found, for the first time ever, a majority of voters support same-sex marriage. The majority was slim — only 51 percent — but it’s still a big step. Back in 1977, when the Field Poll first asked the question, only 28 percent favored same-sex marriage.

“This is a milestone in California,” Mark DiCamillo, the poll’s director, told the Chronicle. “You can’t downplay the importance of a change in an issue we’ve been tracking for 30 years.”

View the full poll (PDF), which breaks down responses by age, region, party, political ideology and religion.

New York, meanwhile, is poised to recognize same-sex marriages performed in other jurisdictions. Gov. David A. Patterson acted on a directive issued by legal counsel May 14, which notified state agencies that gay couples married elsewhere “should be afforded the same recognition as any other legally performed union.”

Jeremy W. Peters writes in The New York Times:

The directive cited a Feb. 1 ruling by a State Appellate Court in Rochester that Patricia Martinez, who works at Monroe Community College and who married her partner in Canada, could not be denied health benefits by the college because of New York’s longstanding policy of recognizing marriages performed elsewhere, even if they are not explicitly allowed under New York law. The appeals court said that New York must recognize marriages performed in other states that allow the practice and in countries that permit it, like Canada and Spain.

Monroe County filed an appeal with the state’s highest court, the Court of Appeals, but it was rejected on technical grounds. The county has not decided whether to file another appeal, a county spokesman said on Wednesday. The Court of Appeals has previously ruled that the state’s Constitution did not compel the recognition of same-sex marriages and that it was up to the Legislature to decide whether do so.

Groups that oppose gay marriage said the governor was essentially trying to circumvent the Legislature.

“It’s a perfect example of a governor overstepping his authority and sidestepping the democratic process,” said Brian Raum, senior legal counsel for the Alliance Defense Fund, a national organization opposed to same-sex marriage. “It’s an issue of public policy that should be decided by the voters.”

Gay rights advocates, however, applauded Mr. Paterson, saying the broad directive would make it clear that gay couples wed in other states were entitled to all of the benefits of marriage in New York and relieve them of the burden of challenging or suing individual agencies.

The majority leader of the State Senate, Republican Joe Bruno, told the Times on Thursday “that he and his staff would look at whether the gov