Women's Health Issues Expand beyond Traditional Areas

Article excerpt

Never before have women meant so much to so many. Recognized as the health care system's biggest customers, they are being treated as such: researched and marketed to, tracked and talked about.

Consider: Premarin, an estrogen replacement, is the most widely used prescription drug in the United States. From 1991 to 1992, the number of hospitals with a women's health center rose 19 percent, according to a survey by the American Hospital Association.

In many cities, Atlanta and Dallas among them, hospitals are competing for pregnant Medicaid patients; among the lures are free Disney movies for the older children, infant car seats, baby showers, insulated beverage flasks and monogrammed blankets. Even the women who coalesced 30 years ago into something loosely called the women's health movement are struck by the mix of responsive medicine and commercial grasping that the 1990s have delivered. It is both more and less than these mothers of intervention bargained for. "As a lasting legacy of the women's movement, health care is one of our shining moments," said Dr. Susan Reverby, a professor of women's studies at Wellesley College, who recently served on an obstetrics and gynecology advisory panel for the federal Food and Drug Administration. While acknowledging that "the health care system is relentless in its ability to figure out where the next buck is coming from," Reverby said the medical profession had become more aware of women's concerns, especially those beyond the gynecologic. "There's much more consciousness about what women's issues are," she said. "We can now talk about heart disease and about AIDS." But not all women applaud the results of that new consciousness. Rachel Fruchter, an associate professor of obstetrics and gynecology at the State University of New York Health Science Center in Brooklyn, said she was appalled that women were pursued so avidly as consumers, particularly by pharmaceutical companies whose advertisements picture radiant middle-aged women and counsel, "Ask your doctor." "The pretense that that's what the women's health movement wanted is a bad joke," Fruchter said. In the beginning, the women's health movement talked mostly about abortion and contraceptives. But as its baby boomer leaders have reached the age of influence -- and the age of menopause -- the health concerns of older generations have taken on new urgency. That urgency is also fueled by the fact that women are living longer -- on average, more than seven years longer than men -- and are thus suffering from the crippling diseases of old age, like arthritis and osteoporosis. At the same time, women have not just been complaining about doctors but have been becoming doctors. The influx has made female patients happier and helped bring new emphasis to the doctor's role as interviewer, said Dr. Charlea Massion, a family doctor at the Santa Cruz Medical Center in California and a clinical faculty member at Stanford University. "Women physicians do have, and linguistic studies show this, a different way of communicating," Massion said. "I don't think women physicians are necessarily interested in women's health just by being women, and I don't think women physicians are more open-minded or have a more comprehensive approach just because they are women. …


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