In 2012, the Supreme Court upheld the Affordable Care Act (Obamacare). Although the law had been passed in 2010, judicial resolution gave the green light to going through with the program, most of which is actually scheduled for 2014. This affirmation was the most significant women's health victory of 2012 in the United States.
The law benefits women in several important ways:
Prohibits health insurance discrimination against women. Health care insurers must stop charging women more for coverage than they charge men. Female "pre-existing conditions" such as pregnancy, C-section, breast or cervical cancer, and sexual abuse and assault are no longer uninsurable.
Provides access to and entitlement for preventive services. All women receive comprehensive preventive services without co-payment, co-insurance, or deductible. Includes mammograms, PAP screens, other prevention: contraceptive methods/counseling, sexually transmitted infections testing/ counseling; Well Women Visits for prenatal and postnatal counseling and care, gestational diabetes screens, breastfeeding support/supplies/counseling; and screening/counseling for interpersonal and domestic violence.
Other benefits for women
- State-based health insurance exchanges implemented by 2014 or earlier (some in the works today) will ensure dependable, continuous, uninterrupted coverage for women and families.
- Those who wouldn't be able to afford insurance otherwise will initially receive assistance through tax credits.
- Over 7 million women who do not receive affordable insurance through their employers will be eligible for subsidies.
- 10 million uninsured women will receive coverage because of expanded access to Medicaid.
Fungal meningitis corporate "mistake" with injectable steroids kills 39, injures hundreds
Around May 21, 2012, a small. 100% family-owned business, the New England Compounding Center, made a huge mistake. As usual, they custom-mixed their 80mg/ml formulation of preservative-free methylprednisolone acetate for hospitals and doctors' offices. The formulation was intended to inoculate patients suffering debilitating pain, usually from advanced arthritis. But three of the batches NECC made up last summer included common fungi, not traditionally been known to cause meningitis, that contaminated hundreds, perhaps thousands of doses of the shots.
The error illustrates the paralysis of negotiating health care through large, politicized, fractious forums like the U.S. Congress. Powerful special interests and cruelly deprived families dance at piecemeal solutions while the major problems go unsolved. This particular drug's method of administration, the blurriness of protections between very large and very small drug companies, and the competence of NECC--one particular manufacturer--have all been called in question for at least ten years. How long can it take?
Bullying highlighted nationally by schools and media and universally condemned.
The outcry against bullying reached its highest pitch ever in 2012. It's now recognized as a serious threat to anyone who perceives herself or himself as weaker than others. Social scientists have observed cyber-bullying as a phenomenon of third-millenium social media. Schools and media have both played a major part in addressing the unacceptability of bullying behavior.
What once worked for preschoolers not sharing their toys, 11-year-old boys tormenting the runt of the team, teen girls giving the silent treatment to others who lack style or poise, or young men verging on vicious sarcasm or even a punch--is unacceptable behavior. Despite increased violence on TV (especially in cartoons, where an actor will not be damaged), Americans are beginning to understand that resistance is not futile, and they tolerate much less adult social and workplace bullying.
For women, the trend is most poignant and most dangerous in the case of rape. With more sexual violation of men being revealed, and more "shame" suicides coming to light, sex without consent has become a subject Americans can address more openly. However, the intensity of ignorant backlash is alarming, especially in public servants/politicians.
Gun violence goes over the top.
Aurora, Colorado, a Denver suburb, suffered two mass killings within the past six months. In all, seven mass shootings occurred in the United States in 2012. We now refer to slaughter incidents by the names of the killer(s) or the cities and schools in which they occurred. We can't count them by the year or decade or century any more.
The massacre of 20 children aged 5 to 7 in Newtown, Connecticut, in mid-December caused ten times as much discussion in the first three days of social media commentary as a mass shooting at the beginning of the year. Even more costly than the ghastly medical and financial complications, the severity of the gun debate tears at the heart and moral fabric of the nation.
The arguments of this controversy are older than the Second Amendment to the U.S. Constitution. Right to bear arms, centuries of social change, prevalence of mental illness, availability and types of weapons, international norms, and so on go out the window when someone is actually facing you with a deadly weapon in hand. The outcry over weapons may be more extreme in 2012 and going forward as 50 years ago when John Kennedy and Martin Luther King were assassinated. This pervasive dichotomy and the associated name-calling seem to threaten our path toward reasonable social solutions. Meanwhile, the carnage continues. Unlike most fistfights, it ends only in death, and over time, the power of the weapons only becomes more lethal.
More/better results from the huge NHLBI Women's Health Initiative and other studies.
The Women's Health Initiative (WHI) study was a major multi-year program to research the most common causes of death, disability, and poor quality of life in postmenopausal women (over about 50 years old).
The results of the Women's Health study, which caused major fears in the 1990s and stopped many women from receiving beneficial short-term estrogen therapy, were reappraised last year. The medical community confirmed that estrogen was very effective in combatting hot flashes, night sweats, irregular vaginal bleeding, and other suffering involved in early menopause and that "the age when women start hormone replacement therapy makes a huge difference" in risk of cancer and heart disease. New data showed that the risks of these killer diseases usually appear only in older menopausal women who begin taking estrogen later in the change of life.
In 2012, researchers also found specific evidence of the link between earlier mortality and race. For many reasons (among them more aggressive cancers and fewer social and economic resources, black women have the highest death rates of all racial and ethnic groups. They are 40% more likely to die of breast cancer than white women. Now that we know the problem, we can press for a solution: more timely follow-up and improved access to high-quality treatment for this group of people.
Women at higher risk of heart disease and cardiovascular dangers than commonly thought.
Cardiovascular disease, often thought to be a "male" problem, is actually the leading killer of women. Two of every three heart attacks women have do not involve the expected symptom of chest pain.
About one quarter (27.2%) of all American women's deaths relate to heart problems. According to the Women's Heart Foundation, 8.6 million women worldwide die from heart disease each year, and 8 million women in the U.S. are living with heart disease. Nearly half of those who get it (42%) die within a year. A woman under 50 having a cardiac arrest has double the risk of dying as a man of similar age. We know this--we need to act on it. The Affordable Care Act will help by assuring monitoring.
Insights into diabetes, obesity, and their complex relationship.
"Fifty years ago," Dr. David Allen of the University of Wisconsin said in the New England Journal of Medicine, "children [those who are now the grandparents of today's children] did not avoid obesity by making healthy choices."
They didn't have to. As children, today's older people and seniors "simply lived in an environment that provided fewer calories and included more physical activity for all." Lesson ONE for everyone born after the mid-1990s: listen to your grandparents. In most cases, they have a better idea of healthy ways of life.
One-third of Americans who have diabetes are not aware that they have it and are seriously compromised in terms of present and future health. The youth diabetes epidemic will worsen as children grow older. Complications arise more often in younger patients, many of them do not take meds as instructed, the disease progresses more rapidly in youths, and statistically, the longer one has diabetes, the worse are its effects.
The good news about the weight/diabetes relationship is that there are very simple ways to combat it.
Lose 5-7% of your total body weight (10 or more pounds for a 200-pounder), spend only two and a half hours per week (a little over half 20 minutes a day) in physical activity a week), and you can considerably reduce the risk of developing type 2 diabetes. For adults over 60, the risk reduction at this rate is a whopping 70%.
You can escape diabetes just by skipping overly sweet drinks and desserts most of the time and spending 20 minutes less time on the couch watching TV every night than the average 3 hours people spend there. The 66% of us who are overweight or obese all just need the energy to go for it.
Improvements in teen women's health.
The unintended pregnancy rate in the United States--our fantastically enabled, high-tech, leading nation--is one of the highest in the world. (Our related abortion rate is also one of the highest.) "[O]ur cultural view of premarital sex as morally tainted makes it harder for couples to engage in real talks about their sexual needs and desires before marrying, the same way they would talk about their religious values, how many kids they want, or whether the wedding cake will be chocolate or vanilla," says Jill Filipovic in The Guardian.
Only 5% of American couples wait until the honeymoon to have intercourse. But in 2012, the numbers of teens having sex in this country actually dropped. We should credit increased sex education (both teaching abstinence, which increases knowledge, and contraception talk) for this development. Teens have not gotten smarter, and birth control hasn't improved all that much, since the 1960s.
The best way to prevent unintended pregnancy among teen girls, American pediatricians officially stated last year is to get underage teenagers emergency contraceptives like Plan B before they start having sex, instead of waiting until "plan A" (whatever it is) doesn't work.
Also, 2012 showed great progress in identifying the presence and causes of depression in teenage girls. And self-esteem issues, the most prevalent low-level mental health problem among women (more than 60% incidence), rise to an astounding 80% in 18- to 24-year-olds. "Watching TV, reading magazines and newspapers, surfing the Net, we are bombarded with airbrushed images of perfect beauty and thinness."
The message always comes across that "you are not okay the way you are." Low self-esteem is a major source of trouble later on. It has been connected to depression, social isolation, violence, failure, conflict in the workplace, and bad marriages.
Progress in sexual awareness / better ability to space/limit children.
Girls reaching puberty have little or no knowledge about the facts of conception. Even college-age women and men have inaccurate ideas. They vastly overestimate the age at which women's fertility changes, the likelihood of pregnancy following unprotected intercourse, and the chances that in vitro fertilization will work in the case of age-related infertility.
Often, older women rely on gossip rather than science for their information. Remember how the facts in "Whisper down the lane," a childhood game, are distorted after about three people have whispered them?
Sixty-two percent of American women of reproductive age are currently using contraception. Of these, most (28%, or 10.6 million) use the pill and female sterilization (27%, or 10.2 million). Women are using intrauterine devices (IUDs) more, now that the Dalkon Shield victims are passing menopausal age.
Women seem to have higher Alzheimer's risk than men.
Alzheimer's disease is now thought responsible for 3.9% of deaths worldwide. Recent studies involving European and Asian populations show that women have a much higher risk of Alzheimer's than men. This may be linked to estrogen, which helps protect women against memory loss as they age. Reduced estrogen levels after menopause may increase women's risk of developing Alzheimer's.
Honorable Mentions for 2012
We don't have time to go through all the big health discoveries for women in 2012. However, let me just mention the turf war between ob/gyn and primary care, greater attention to fasciitis since the Aimee Copeland case, epidemic outbreaks (including the early flu), and yes, junk DNA, a landmark discovery, and not just for the 51%.
Based in Chicago, Sandy Dechert recently covered health care issues in the Presidential race and mental and physical health over the holidays. She also reported on Hillary Clinton's recent illness, the fungal meningitis outbreak, and the procedure that saved the life of Good Morning America cohost Robin Roberts.
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