Policy & Practice


Women Lack Cholesterol Knowledge

Despite the best intentions to manage their cholesterol, fewer than a third of women know their cholesterol levels, according to a survey commissioned by the Society for Women's Health Research. The survey found that women are aware of the health risks of cholesterol. For example, 85% of women know that high cholesterol can lead to stroke. However, about 36% of women did not know that high cholesterol has no symptoms and nearly half of the women surveyed were not familiar with terms such as LDL and HDL cholesterol. “Clearly, strides have been made in educating women on the risks of high cholesterol, but the disconnect between awareness and action needs to be addressed,” Phyllis Greenberger, president and CEO of the Society for Women's Health Research, said in a statement. The telephone survey included 524 adult American women.

Including Women in Research

The participation of women in clinical trials is essential to understanding how medical conditions and therapies affect men and women differently, according to a committee opinion from the American College of Obstetricians and Gynecologists. In the opinion, the ACOG Committee on Ethics outlined a number of recommendations for including women, and in particular pregnant women, in research trials. For example, the committee recommended that researchers evaluate protocols for their potential impact on both the woman and the fetus and make that evaluation part of the informed consent process. The committee also advised that only the informed consent of the pregnant woman is necessary for research. However, informed consent must be obtained from the father when federal regulations require it for research that could benefit the fetus only. The ACOG statement is an update to a committee opinion on research involving women, which was published in 2004. The committee opinion was published in the September issue of Obstetrics & Gynecology.

Distributing HPV Vaccine

The 7,500 publicly funded family planning clinics around the country may be a natural fit for providing education about the human papillomavirus (HPV) vaccine and distributing it, according to an analysis by the Guttmacher Institute. These clinics reach a large number of reproductive-age women and in particular those at high risk. In 2002, one-third of women aged 15–24 years who obtained reproductive health services received that care at a family planning clinic. “Clinics are an especially important source of health information and services for low-income women and minority women, who are at particularly great risk of developing and dying from cervical cancer,” Rachel Benson Gold, the article author, said in a statement. However, these clinics will also face some challenges if they try to provide the HPV vaccine and related counseling, Ms. Gold wrote. Cost is one potential barrier. The three-shot regimen costs about $300 per individual, even with the discount provided to clinics. In addition, family planning clinics will have to decide what population to offer the vaccine to and how to ensure that women return for all three shots. The analysis, which appeared in the summer issue of the Guttmacher Policy Review, was supported by a grant from the Ford Foundation.

Infant Mortality Drops Slightly

The infant mortality rate was 6.79 per 1,000 births in 2004, a less than 1% drop from 2003, according to final 2004 data released by the Centers for Disease Control and Prevention. The small decrease in infant mortality was not statistically significant. With the exception of 2002, the infant mortality rate has decreased or remained steady from 1958 through 2004, according to CDC. In 2004, the 10 leading causes of infant death were congenital malformations, low birth weight, sudden infant death syndrome, maternal complications, unintentional injuries, cord and placental complications, respiratory diseases of the newborn, bacterial sepsis of the newborn, neonatal hemorrhage, and circulatory diseases. These 10 causes accounted for more than 68% of infant deaths in the United States in 2004.

Small Practices Fall to One in Three

Physicians are shying away from solo and two-physician practices, according to a new report from the Center for Studying Health System Change. Although these small practices are still the most common practice arrangements, between 1996–1997 and 2004–2005 researchers saw a shift from solo and two-person practices to midsized, single-specialty groups of 6–50 physicians. The percentage of physicians who practiced in solo and two-person practices fell from 41% in 1996–1997 to 33% in 2004–2005. During the same time period, the percentage of physicians practicing in midsized groups rose from 13% to 18%. The biggest declines in physicians choosing small practices have come from medical specialists and surgical specialists, whereas the proportion of primary care physicians in small practices has remained steady at about 36%. “Physicians appear to be organizing in larger, single-specialty practices that present enhanced opportunities to offer more profitable ancillary services rather than organizing in ways that support coordination of care,” Paul B. Ginsburg, Ph.D., president of the Center for Studying Health System Change, said in a statement. The report's findings are based on the group's nationally representative Community Tracking Study Physician Survey.

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