Women's Health: Illness and Prevention

A previous version of this article first published as Women's Health: Survey Highlights Illnesses, Care and Prevention onTechnorati.


The Henry J. Kaiser Family Foundation recently published their Women's Health Care Chartbook--Key Findings from the Women's Health Survey.  This report provides a snap shot of women's health in the U.S.  Chapters in the Chartbook cover a Profile of Women's Health, Health Coverage, Delivery System, Prevention and Screening, Access and Affordability and Work, Family and Caregiving.

Here are some of the highlights from the report:

The most common chronic health conditions reported by women in the survey include: arthritis 22%, hypertension 22%, high cholesterol 20%, obesity 16%, asthma/other respiratory disorder 15%, thyroid disorders 11%, diabetes 9%, and heart disease 5%.

Depression and anxiety problems are common.  Twenty six percent of women in the survey report being diagnosed with depression or anxiety in the past five years by a physician.  Depression and anxiety diagnosis is highest in women between 45 and 64, white women and women at less than 200% of the poverty income level. 

The leading causes of self-reported stress by women include: financial concerns 26%, job/career 23%, health problems of family member 16% and managing own health needs 13%.

Rates of going without health insurance for at least the past four years rose to 27% of all women in 2008 compared to 20% in 2004.

Use of mental health care in the last year was endorsed by 12% of all women in the survey.  This rate increased to 21% in those who reported their health status as fair or poor.

Seventy five percent of women reported receiving a mammogram in the past two years.   Pap smear, blood pressure screening and blood cholesterol screening were also reported by a majority of women.  However, only 40% of women over age 50 reported receiving colon cancer screening in the last two years.

A recently published CDC survey of preventive health screening confirms low rates for colon cancer screening in women.  The chart shows the percentage of women between 50 and 75 who were screened for colon cancer by one of three criteria: 

• Fecal occult blood test in last year or
• Flexible sigmoidoscopy in last 5 years or
• Colonoscopy in last 10 years

This lack of screening shows significant geographic variability.  The chart shows the highest rates for colon cancer screening are in the northeast with the lowest rates in the south and western U.S.

Percent of U.S. Women 50 to 75 Screened for Colon Cancer

Women commonly reported delaying or going without care due to a variety of reasons.  The most commonly reported reasons for delaying or going without care were: couldn't find the time 23%, couldn't take time off work 18%, no insurance 15%, child care problems 13%, and no doctor 13%.

A significant number of women (19%) spend 40 or more hours per week providing care for a sick or disabled family member.  Thirty two percent of women report they feel a lot of stress from their caregiving responsibilities.

This report is a great source of information about the most recent data on women's health and health care needs.  The complete report can be accessed at: http://www.kff.org/womenshealth/upload/8164.pdf

Henley SJ, King JB, German RR, Richardson LC, Plescia M, & Centers for Disease Control and Prevention (CDC) (2010). Surveillance of screening-detected cancers (colon and rectum, breast, and cervix) - United States, 2004-2006. MMWR. Surveillance summaries : Morbidity and mortality weekly report. Surveillance summaries / CDC, 59 (9), 1-25 PMID: 21102407

Aerobic Exercise, Resistance Training and Mortality

The research support for regular exercise to be associated with reduced risk of death is growing.  However, there is limited research that focuses on effects of aerobic versus strengthen (resistance) training.  Additionally, there is limited data comparing mortality in those with and without a general medical condition. 

Schoenborn and Stommel recently published a study addressing these issues in teh American Journal of Preventive Medicine.  They examined a large sample of U.S. adults and assessed whether they met  the 2008 USDHHS Activity Guidelines for Americans:

• 150 minutes per week of moderate intensity aerobic activity
• OR 75 minutes per week of high intensity aerobic activity
• Encourage two days per week of weight training of 7 large muscle groups

The study examined exercise levels and mortality by linking data from the 1997-2004 National Health Interview Survey and death registry data from 1997-2006.  Mortality examined in groups with no chronic medical conditions compared to those with one or more medical conditions including: diabetes, hypertension, vascular problems, lung disease (asthma/bronchitis), one or more functional limitations (any difficulty walking, climbing steps, standing, sitting, stooping, reaching, grasping, or lifting/pulling or pushing large objects).

This study was informative because it looked at the effect of aerobic versus strength versus both aerobic and strength on mortality.  Additionally, it examined the effect of exercise on mortality in four age categories: 18 and younger, 18 to 44 years of age, 45 to 64 years of age and 65 and older age groups.

>The key findings from the study were:

• Strength training alone was not associated with decrease mortality risk
• Aerobic exercise was linked to reduced mortality risk aerobic exercise with over 150 minutes per week somewhat better than less than 150 minutes per week ( although going above 300 minutes per week did not correlate with additional mortality reduction)
• Among those meeting aerobic exercise guidelines, adding strengthening showed a trend for correlation with an additional beneficial  mortality effect
• Older adults  with one or more chronic conditions appeared to have the strongest association between exercise and lower mortality risk

The chart below summarizes the magnitude of association between exercise levels and lower mortality rates in those in the 45 to 64 age category and those aged 65 and older with one or more medical conditions.  To aid in interpretation of the numbers the SMR for those 65 and older with one medical condition meeting both aerobic and strengthening exercise guidelines was .52.  This means during follow up they were 48% (1-SMR) less likely to die than those not meeting exercise guidelines for either aerobic or strengthening types.

This study is a correlational study and not a prospective controlled trial so the data need to be interpreted cautiously.  It may be that individuals with chronic medical conditions die not because they don't exercise but because their illness is so severe they are unable to exercise.  Nevertheless, this study adds to our knowledge of the relative correlation of aerobic and resistance training and mortality.  Additionally, it suggests that exercise may have a significant beneficial role in older adults who have one or more medical conditions.

Figure by author adapted from data provided in manuscript.

Schoenborn, C., & Stommel, M. (2011). Adherence to the 2008 Adult Physical Activity Guidelines and Mortality Risk American Journal of Preventive Medicine, 40 (5), 514-521 DOI: 10.1016/j.amepre.2010.12.029