MIDLIFE WOMEN’S HEALTH

MIDLIFE WOMEN’S HEALTH

DHHS OFFICE ON WOMEN’S HEALTH

WOMEN’S POLICY, INC.

CONGRESSIONAL CAUCUS FOR WOMEN’S ISSUES

WOMEN’S HEALTH TASK FORCE

Women’s Health and Healthy Aging:Living Longer, Living Better

Darlene Yee-Melichar, EdD, CHES

Professor and Coordinator, Gerontology Program

San Francisco State [email protected]

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Overview Demographic Imperatives

Aging in America

Feminization of America

Diversity in Aging America

Health Indicators

Life Expectancy

Leading Causes of Death

Multiple Chronic Conditions

Activity Limitations and Disabilities

Health Care Challenges

Healthcare Access for Midlife Women

Multi-Level Approach to Healthy Aging

Consumer Health and Health Literacy

Comprehensive Geriatric Assessment

Midlife Women and Caregiving

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Aging in Americahttp://www.aoa.gov/aoaroot/aging_statistics/Profile/2011/docs/2011profile.pdf

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Feminization of Americahttp://www.cdc.gov/nchs/data/ahcd/agingtrends/07olderwomen.pdf

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Diversity in Aging

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Diversity in America

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Life Expectancy

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Leading Causes of Death for White American Women

http://www.4woman.gov/owh/pub/minority/table1.htm

White American Females

Cause of Death Number of

Deaths

All Causes 1,064,096

1 Diseases of the Heart 320,168

2 Malignant Neoplasms (cancers) 232,608

3 Cerebrovascular Diseases (including stroke) 89,642

4 Chronic Lower Respiratory Diseases 58,024

5 Alzheimer’s Disease 32,936

6 Influenza and Pneumonia 32,912

7 Diabetes Mellitus 29,552

8 Unintentiaional Injuries 29,262

9 Nephritis, Nephrotic Syndrome and, Nephrosis 15,213

10 Septicemia 14,088

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Leading Causes of Death for African American/Black Women


African American/Black Females


Deaths

All Causes 140,642


2 Malignant Neoplasms (Cancers) 29,128



5 Nephritis, Nephrotic Syndrome, and Nephrosis 3,837

6 Unintentional Injuries 3,746


8 Septicemia 3,341


10 Human Immunodeficiency Virus (HIV) 2,448

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Leading Causes of Death for Hispanic Women


Hispanic Females


Deaths

All Causes 47,082





5 Unintentional Injuries 2,134



8 Certain Conditions Originating in the Perinatal Blood 951

9 Chronic Liver Disease and Cirrhosis 875

10 Nephritis, Nephrotic Syndrome, and Nephrosis 841

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Leading Causes of Death forAsian/Pacific Islander Women


Asian/Pacific Islander Females


Deaths

All Causes 15,857




4 Unintentional Injuries 621

5 Diabetes Mellitus 556

6 Influenza and Pneumonia 528

7 Chronic Lower Respiratory Diseases 411

8 Nephritis, Nephrotic Syndrome, and Nephrosis 273

9 Essential (primary) Hypertension and Hypertensive Renal Disease

179

10 Septicemia 170

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Multiple Chronic Conditions Among Adults Aged 45 and Over: Trends Over the Past 10 Years

1999–2000 2009–2010

Age in years Percent SE Percent SE

45–64

Total 16.1 0.3 21.0 0.4

Men 15.2 0.5 20.6 0.6

Women 16.9 0.4 21.3 0.5

65 and over

Total 37.2 0.5 45.3 0.6

Men 39.2 0.8 49.0 0.9

Women 35.8 0.6 42.5 0.8

NOTE: SE is standard error.

SOURCE: CDC/NCHS, National Health Interview Survey.

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Activity Limitations and Disabilities http://www.aoa.gov/aoaroot/aging_statistics/Profile/2011/docs/2011profile.pdf

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Healthcare Access for Midlife Women

Access to health care for midlife women is a challenge:

• Cost: may not have health insurance and often can’t afford it

• Transportation: have no way to get to a doctor or other health care providers

• Sandwich generation: have major caregiving duties for younger and/or older family members

• Low health literacy: don’t understand the language and/or the health information

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Multi-Level Approach to Healthy Agingand Continuum of Health Care

Primary Prevention

(health promotion and disease prevention)

Secondary Screening

(monitoring and tracking the disease)

Tertiary Treatment

(rehabilitation and treatment)

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Consumer Health and Health Literacy

The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions (U.S. DHHS, 2000).

Low health literacy is a widespread problem, affecting more than 90 million adults in the U.S.

Results in patients’ inadequate engagement in, and benefit from, health care advances as well as medical errors.

Is likely to be a major contributor of adverse health outcomes.

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Comprehensive Geriatric Assessment and Geriatric Care Coordination

History and Physical Examination

Functional Assessment

Mental Assessment

Psychological Assessment

Social Assessment

Values Assessment

Health Promotion and Disability Prevention

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Midlife Women and Caregiving

• Estimates of the percentage of family or informal caregivers who are women range from 59% to 75%.

• The average caregiver is age 46, female, married and working outside the home earning an annual income of $35,000.

• Although men also provide assistance, female caregivers may spend as much as 50% more time providing care than male caregivers.

• One study concluded that the caregiving time burden falls most heavily on lower-income women: 52% of women caregivers with incomes at or below the national median of $35,000 spend 20+ hours each week providing care.

Source: http://www.caregiver.org/jsp/content_node.jsp?nodeid=892&expandnodeid=480

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Midlife Women and Eldercare

One national study on women and caregiving highlighted the conflicting demands of work and eldercare. The study found that:

• 33% of working women decreased work hours

• 29% passed up a job promotion, training or assignment

• 22% took a leave of absence

• 20% switched from full-time to part-time employment

• 16% quit their jobs

• 13% retired early


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Negative Health Effects of Caregivingon Midlife Women

• As many as two out of three older women do not take advantage of preventive health services due to lack of information and high out-of-pocket costs.

• 25% of women caregivers have health problems as a result of their caregiving activities.

• Coronary heart disease (CHD) is one physical risk factor of caregiving. Women who spend nine or more hours a week caring for an ill or disabled spouse increase their CHD risk twofold.

• Other health effects include elevated blood pressure and increased risk of developing hypertension; lower perceived health status; poorer immune function; slower wound healing; and an increased risk of mortality.


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A Call for Action

• Call attention to the importance of midlife women’s health and its contribution to overall (family) health, the need for increased access to health care for midlife women, and the need for more research and training funds targeting women’s health and healthy aging.

• Increase funding for women’s health research, especially for subpopulations of women, including midlife women, older women, and women of color.

• Expand women’s health services and the education and training of geriatric physicians, gerontologists and other women’s health professionals.

• Reinforce the important need for the Consumer Bill of Rights in relation to improving consumer health and health literacy which are essential to midlife women’s health and healthy aging.

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ResourcesAoA website

http://www.aoa.gov/aoaroot/aging_statistics/Profile/2011/docs/2011profile.pdf

CDC website

http://www.cdc.gov/nchs/data/ahcd/agingtrends/07olderwomen.pdf

DHHS-OWH websites

http://www.womenshealth.gov/

http://www.4woman.gov/owh/pub/minority/index.htm


Family Caregiver Alliance

http://www.caregiver.org/jsp/content_node.jsp?nodeid=892&expandnodeid=480

HRSA website

http://mchb.hrsa.gov/whusa08/index.html

NIH-ORWH websites

http://www4.od.nih.gov/orwh

http://www4.od.nih.gov/orwh/decade-2.pdf

Women of Color Health Data Book

http://orwh.od.nih.gov/pubs/WomenofColor2006.pdf

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Resources (continued)

Agenda for Research on Women's Health for the 21st Century, Volume 7

(This is a brief summary of an 8 volume set. Volume 8 is available in Spanish) http://www4.od.nih.gov/orwh/agenda-vol7.pdf

NIH Publications on Women's Health Issues

(Contains women's health publications and contact information for each NIH Institute or Center)

http://www4.od.nih.gov/orwh/NIHPubs.pdf

Science Meets Reality: Recruitment and Retention of Women in Clinical Studies, and the Critical Role of Relevance

(Proceedings from a national meeting looking at lessons learned, continuing challenges and ethical and policy issues in recruiting and retaining clinical research participants). http://www4.od.nih.gov/orwh/SMR_Final.pdf

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Yee-Melichar, D., Flores, C.M., and Cabigao, E.P. Long-Term Care Administration and Management: Options, Issues and Trends in Effective Elder Care. New York, Springer Publishing Company. (pending)

Yee-Melichar, D. (2010). Resilience in Aging: Cultural and Ethnic Perspectives. In Resilience in Aging. Edited by Barbara Resnick, Lisa Gwyther and Karen A. Roberts. New York, NY: Springer-Verlag New York, Inc.

Yee-Melichar, D., Renwanz-Boyle, A. and Flores, C. (2010). Assisted Living Administration and Management: Effective Practices and Model Programs in Elder Care. New York, Springer Publishing Company.

Yee-Melichar, D. (2010). Key Moment in History—1987: GSA Launches Minority Issues Task Force. Gerontology News, 6(1), 7.

Yee-Melichar, D. (2010). Housing: Experts Corner—Assisted Living. In The Aging Network: A Guide to Programs and Services for Older Americans by K. Niles-Yokum and D.L. Wagner. New York, Springer Publishing Company.

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Yee, D. (2004) “Aging Asian Americans and Health Disparities.” In Closing the Gap: Improving the Health of Minority Elders in the New Millennium. Gerontological Society of America, Washington, DC.

Markson, E. and Yee, D. (2004). The Older Woman. In AGHE brief bibliography: A selective annotated bibliography for gerontology instruction [CD-ROM]. Washington, DC: Association for Gerontology in Higher Education.

Yee, D. “Overview of Asian American Women As Research Subjects.” In Proceedings of the First National Clinical Trials and Asian American Women Summit. Washington, DC: National Institutes of Health, 3(3):1-12, 1998.

Yee, D. "Issues and Trends Affecting Asian Americans, Women and Aging." In Women and Aging: A Research Guide. Edited by Jean M. Coyle. Westport, CT: Greenwood Publishing Group, Inc., 1997.

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Comments? Questions? Thank You.

Dr. Darlene Yee-MelicharProfessor and CoordinatorGerontology ProgramCollege of Health and Social SciencesSan Francisco State University1600 Holloway AvenueSan Francisco, CA 94132

(415) 338-3558

[email protected]

Documents

MIDLIFE WOMEN’S HEALTH