Surprisingly, the subject of women’s health, bodies and care is no longer simply a physician and patient discussion, or one among family members only. Women’s health issues and policy continue to dominate the news and political dialogue. At the same time, the advent of the Affordable Care Act (ACA) is significantly impacting the current landscape involving women’s health clinical research, wellness and prevention, treatment and coverage.
The changes affect every aspect of patient care, including the push to outcomes-based measurement for providers, payers, pharmaceutical companies and overall health services. The department of Health and Human Services reports in 2015 that, during our last Open Enrollment, nearly 11.7 million Americans signed up or were re-enrolled through the Health Insurance Marketplace. And since several of the ACA coverage provisions began to take effect in 2010, about 16.4 million uninsured people have gained health coverage. That’s the largest increase of uninsured adults in four decades. But, many problems remain for women’s healthcare. Five major hurdles include:
1. Women Are More Insured, But Less Informed
It’s true that the ACA is providing coverage for many women who were uninsured. However, according to recent population-based surveys, many women, especially socially disadvantaged groups, have limited understanding of its health benefits, including its relevance for their own health service coverage and utilization. A need exists for continued research, policy and practice, with implications for whether, when and how improved coverage will translate to improved access and outcomes for U.S. women.1
The advances in technology are also noteworthy and the resulting data will continue to help shift care and provide outcomes and analysis necessary to properly include women in clinical studies as well as determine the overall health of a women. Overall health includes:
- Mental health
- Quality of life issues
- Balancing demands, family and stress
Connected devices, advances in genomics and personalized medicine, and new and increased data will continue to improve learning and create targeted treatment plans.
2. EMRs and Comprehensive Patient Data
Working in digital health, and with the amount of innovative solutions and technology available, it is shocking that in 2015 we still do not have a universal standard for electronic medical records (EMR). Scores of patients are still sitting in waiting rooms filling out clipboard ready forms over and over again. This is a huge problem because unless the female patient is very sophisticated in managing her health and being an advocate for herself, professionals are not seeing a comprehensive view into their diagnosis, history and treatments.
What is still desperately needed: Comprehensive electronic health records to measure, track and design interventions specific to the individual needs of the patients. And a system that allows physician leaders to measure progress, provide physician-specific feedback and learn from those who achieve the best outcomes to improve patient care.
3. Sex Disparity in Clinical Studies
It has long been determined that there is a lack of data for women-specific conditions, which is due to the fact that the studies themselves primarily involve male subjects. In June 2015, the NIH announced expectations that “sex” as a biological variable must be included into research design and analysis in studies of animals and humans. Understanding how sex influences health and disease needs to move to a programmatic approach that includes the study of sex-specific conditions. A programmatic approach will assure the advancement of knowledge to improve women’s health.2
The next critical issue to tackle for women: The disparity of care and access, especially if you are African-American, Latino or poor. “Your healthcare depends on who you are,” according to a 2014 report from the Robert Wood Johnson Foundation, the nation’s largest philanthropy dedicated to health. “Race and ethnicity continue to influence a patient’s chances of receiving many specific healthcare interventions and treatments.” The foundation estimates Latinos and African-Americans experience 30% to 40% poorer health outcomes than white Americans.
4. Limited Access to Healthcare
Access to care remains a prevailing problem. From the most recent National Healthcare Disparities Report: 35% of Latinos and low-income individuals reported difficulties getting the care they need, compared to 25% of white Americans and 15% of high-income earners. For example, the death rate from breast cancer for African-American women is 50% higher than for white women. Racial and economic inequities in screening and treatment options contribute to this divide. In the U.S., 60% of low-income women are screened for breast cancer. Before the implementation of the ACA, African-Americans and Latinos were more likely to be uninsured than white Americans.
Of course, a variety of other factors contribute to disparities in clinical outcomes. Among them: conscious and unconscious bias, limited access to healthy foods and inadequate community-wide healthcare resources. The U.S. Department of Health and Human Services reports:
- African-Americans have the highest mortality rate of any racial and ethnic group for cancer generally and for most major cancers individually.
- Latino communities also suffer from disproportionate rates of illness, including cervical cancer.
- Asian Americans and Pacific Islanders are more likely to have hepatitis B than non-Hispanic whites, African-Americans and Latinos.
- American Indians are all more likely to have diabetes.
5. Culturally Appropriate Health Education
If we want health equity, we need to make health literacy a priority. We need to improve and provide innovative, culturally appropriate health education tools for each segment. All healthcare systems, providers and pharmaceutical companies must invest in high-quality translation and interpretation services for all patient education materials that include bilingual, bicultural modules so patients can receive care in their preferred language. There also must be continued partnering with community organizations, leaders and churches to bring healthcare to all female patients, especially those who can’t miss work or obtain transportation.
Women’s healthcare is a top priority as the cornerstone of our society and communities; as individuals, majority of the workforce, leaders, mothers and heads of families. We must create healthcare equity across gender, race, sexual orientation and economic disparities. This is critical for the health of the system itself and a priority of reform and access. Healthy women equate to better health of our families and our economy.
Sidebar: Women are Onboard with the Digital Revolution
For all women wanting improved access and information, digital becomes critical to widespread dissemination. I firmly believe, that with the universal use of smartphones, information is the cure. The use of mobile, social media and all devices continues to grow among women—and their purchasing power and is staggering. Most women, according to studies by Neilson for example, are connected, on mobile, Facebook, Twitter and many other sites.
Mobile is a Tremendous, Nearly Untapped, Resource
Pharmaceutical companies, payers, health systems and governments, however, are still not spending enough to reach consumers on mobile devices, making it a tremendously underutilized resource for information, services, data and access. The great news: It is only growing and is a tremendous resource for the challenges women face in healthcare now and in the future.
Marketers must immediately increase spend in mobile initiatives past the pilots and take advantage of almost 24-hour access to their customers. They must also consider mobile media and multicultural media as an equally important spend almost equal to general market at this point. For any OTC brand, eCommerce strategies, mobile at shelf and mobile couponing and co-pay are absolute necessities, and it is time we finally stop and move budgets, training and leadership into enterprise-wide digital transformation. Connected customers means mobile first.
1. “Women’s Health and the Affordable Care Act: High Hopes Versus Harsh Realities,” Hall KS, Fendrick AM, Zochowski M, Dalton VK, Am J Public Health, 2014 Aug.
2. “Sex Differences Research, Precision Medicine, and the Future of Women’s Health,” Miller VM, Rocca WA, Faubion SS, 9 1 15.