This issue features articles on subjects critically important to women's health and well-being. To these familiar topics, the authors bring fresh assessments of the multifaceted components of health for women today, a collection as timely as tomorrow's news, and as basic to social work practice as health itself. Each article focuses on some aspect of social behavior that is critically important to women's world. The unifying theme in all the articles is that when women are not healthy, society is ill.
Until recently, women's health was barely addressed in health research. In 1990 the National Institutes of Health (NIH) established the Office of Women's Health Research to be a focal point for women's health initiatives. It became a permanent entity in 1993 as part of the NIH Revitalization Act of 1993 (Benderly, 1997). Its aim since then has been to promote the visibility of women in the national health research agenda. In 1993 the NIH funded the Women s Health Initiative (WHI) to examine the major health issues after menopause, including coronary heart disease, breast cancer, and osteoporosis (Thaul & Hotra, 1993). WHI is also addressing social and economically generated ill health endemic to women, such as male battering, HIV, and substance use.
Many diseases present differently in women than they do in men, occurring at different ages and developmental periods in their lives. For example, heart disease, the nation's leading cause of death, accounts for 31 percent of mortality annually. Although heart attacks occur at later ages in women, women actually have poorer outcomes than men after a heart attack; 44 percent of women die within a year compared with 27 percent of men (Centers for Disease Control and Prevention, 2001). Twenty-six percent of women over age 20 have hypertension, and cholesterol and overweight are also significant problems. Women are more vulnerable to cardiovascular disease than is commonly thought.
Women's realities--biological and environmental--also differ from men's in significant ways that affect their physical and mental health. Women, for example, tend to be less physically active. "They are at greater risk for Alzheimer's disease than men are and twice as likely as men to be affected by major depression" (U.S. Department of Health and Human Services [DHHS], p. 11). And depression is even more prevalent among women who are low-income, are on welfare, are less educated, are unemployed, are disabled, are older, and have coexisting medical conditions. Misuse of alcohol and drugs is less likely in women, but its social costs can be much greater in women, affecting children and family stability.
Finally, women's specific health problems related to reproduction, such as pregnancy, perimenopause, menopause, endocrinology, and hormonal effects are only beginning to be understood. Although overall death rates for women are somewhat lower than for men, women have shown increased death rates over the past decade in areas where men have experienced improvements, such as lung cancer.
Women live longer than men do, accounting for 60 percent of people over age 65, but in old age women are much more likely to live alone. Women also have higher rates of arthritis, osteoporosis, and other disabling chronic diseases. All of these biological and behavioral aspects of gender differences need research to clarify their causes and relatedness to all body systems.
Just as more research is needed in medical research and treatment to eliminate the gaps in knowledge about men and women's health issues, a more sophisticated inquiry also is needed in health social work to address women's needs and the approaches that help them best. Investigations are needed into prevention and early identification of diseases and conditions, innovative interventions, behavioral and cognitive approaches to coping, new treatment modalities, and more creative long-term care alternatives. …