Very Short
By Abby Tallmer
Happy Mother’s Day to all. In honor of this May occasion, all Very Short items in this issue will be dedicated solely to women’s health-related concerns. Gender parity will be achieved next month, when the Very Short column will be given over entirely to – what else? – men’s health, just in time for Father’s Day.
102-Year-Old Woman Golfer Hits Hole-in-One
Who says “old ladies” are hopeless at competitive sports? This April, 102-year-old Elsie McLean certainly blew this ageist/sexist myth out of the water when in Chico, California, she became the oldest golfer in the United States ever to make a hole-in-one on a regulation course. (The previous record was held by a Harold Stiltson, who hit a hole-in-one in 2001 at age 101.) According to the Associated Press, at first Ms. McLean couldn’t see where her ball had landed and feared it was lost. (“Where’s my ball?” McLean was reported as asking despondently.) Her friends Kathy Crowder and Elizabeth Rake soon located it –- in the cup.
The centenarian took her record-breaking feat in stride. “Everybody wants a hole-in-one,” she told TV station KNVN. “I said: ‘Why can’t I have [one too]?’ ” The closest the modest golfer came to bragging was when she summed up her achievement with: “For an old lady, I still hit the ball pretty good.” Indeed. Think about Elsie McLean next time you are tempted to skip the gym, ladies. If she can hang in there, so, no doubt, can you. (For the AP wire story, as reprinted in the Charlotte Observer, go to www.charlotteobserver.com.)
Health-Insurance Plans Place Unfair Burden on Women
A recently released Harvard Medical School study finds that high-deductible health-insurance plans offered by employers end up being markedly more expensive and less advantageous for women than for men. Researchers looked at costs in these plans by age group and by gender. In a pool of nearly 33,000 people, the median health-care costs for men ages 18 to 44 with these plans was $463, compared with $1,266 for women of the same age. Among people aged 45 to 64, the median health-care cost for men with these plans was $1,849; for women, $2,871.
A large part of the differential can be ascribed to the fact that women typically need many more routine exams, tests, and services (mammograms, cervical-cancer vaccines, Pap tests, birth-control and pregnancy related assistance, to name a few) than do men. Dr. Steffie Woodlander, the study’s lead author, nicely summed up its findings: “High deductible [health-insurance] plans punish women for having breasts and uteruses and having babies.” For more on the Harvard Health Insurance Study, see health.yahoo.com/news.
And on That Same Subject...
In another study with significant implications for women, researchers at the State Health Access Data Assistance Center of the University of Minnesota looked at inequities in health coverage between high- and low-income families. The report, “Whose Kids Are Covered? A State-by-State Look at Uninsured Children,” found that only 47 percent of parents in families earning less than $40,000 annually have employer-provided health insurance, versus 78 percent of parents in families earning $80,000 a year or more.
Other findings of the report:
• In the past decade, employers’ offers of health insurance to lower-income parents have fallen three times as fast as offers to higher-income parents.
• 75 percent of uninsured children in the U.S. live with someone who works full time.
This study is of particular relevance to the many women, young and old, who head single-parent households – single parents who, living paycheck to paycheck, fall into the category of the working poor, those households with annual incomes beneath the federally set poverty line. (The complex socioeconomic reasons for all this include, but are not limited to, the difficulty/impossibility many women face when attempting to collect child support and/or alimony from their ex-husbands and/or fathers of those children; the fact that often the primary and often sole responsibilities and expenses for childcare fall to the woman / mother / grandmother rather than to the man / father / son-in-law; the fact that minimum-wage and/or extremely low-paying hourly work is vastly more attainable for women than are middle- or upper-level professional jobs; and the sad and rather astounding fact that still, even in this 21st-century, American women on average earn only 76.2 cents for every dollar that men make. This is actually a slightly optimistic distortion of the pay inequities between men and women in the U.S.; when race as well as gender is factored in, the latest data indicates that African-American women earn just 63 cents for every dollar earned by white men, while Hispanic women earn only 53 cents for every dollar that white men take in. (See “Wage Gap is Wider for Women of Color” by Marianne Sullivan at www.womensenews.org for the source of these figures.)
For more details about the Robert Wood Johnson-funded University of Minnesota study, see Philanthropy News Digest foundationcenter.org.
Exercise as a Coping Tool for Menopause
More than 1.5 million U.S. women, generally between the ages of 45 and 55, reach menopause each year. Of these, roughly 80 to 85 percent are plagued with the mood swings, irritability, hot flashes, and night sweats that seem to come along with the change. Now a study by researchers at Penn State University suggests that regular exercise diminishes the impact of certain of these menopausal symptoms. Some 160 primarily sedentary female subjects were divided into three sections. One batch never exercised at all; a second batch participated in twice-weekly 90-minute yoga sessions; the third group walked for one hour three times a week.
Results? The women in both the walking group and the yoga group reported significant improvements in mood and general quality of life, while the women who did no exercise at all reported no such benefits. (It should be pointed out that the study’s results in terms of hot flashes and night sweats were less clear. Roughly half of the subjects reported some alleviation of hot flashes and night sweats; most, but by no means all, were in the exercising non-sedentary groups.)
Moral of the story? Regular exercise seems to be an important and as-yet largely untapped tool in coping with menopause, as well as an important vehicle for achieving and maintaining overall physical and mental health for all persons, male and female alike. For more on the Penn State study, see www.cnn.com.
A Necessary or an Unnecessary Evil?
More Doubts About Hormone-Replacement Therapy
For years, Hormone Replacement Therapy (or HRT) has been the standard front-line treatment prescribed for menopausal women – until recently, that is, when the largest longitudinal study to date of the effects of estrogen-plus-progestin and estrogen-alone therapies on menopausal women was swiftly halted because researchers were presented with many serious adverse health complications in women participating in the study. The trials, conducted by the Women’s Health Initiative, tracked 27,347 female subjects over the course of several years. Intended as a 15-year-long study, the estrogen-plus-progestin trial was stopped after only 5.6 years owing to a noticeable increased risk of breast cancer among participants, and because increased risks for heart attack, stroke, and blood clots were judged to far outweigh actual or potential benefits.
The plug was pulled on the estrogen-alone study after 6.8 years, because of increased risk of stroke and blood clots detected in female participants.
The dramatic and early end to these HRT trials has created a furor within the medical and scientific community and among women at large, especially women considering or already receiving HRT treatment for menopause.
With the National Institutes of Health’s April 2007 press release summarizing so-called “secondary analyses” by scientists who pored over the data gathered from the halted studies, it is unlikely that women’s confusion over the wisdom – or lack thereof – of HRT will be resolved any time soon. Experts involved in the secondary or retrospective analyses looked again at the data from the two halted HRT trials, this time with a focus on what the material tells us about how HRT affects women of different ages and with differing numbers of years since they hit menopause. The women who had participated in the now-halted HRT trials were divided into three age groups (50 to 59, 60 to 69, 70 to 79) and then into groups according to the number of years that had passed (less than 10, 10 to 19, 20 or more) between the time the participants hit menopause and when they started HRT.
The conclusions? Far from conclusive. To quote the NIH, the secondary analysis findings “suggest [these and all other italics within the NIH quote are my own] that women who begin hormone therapy within 10 years of menopause may have less risk of coronary heart [CHD] disease due to hormone therapy than women farther from menopause … [and that] the further a woman was from the onset of menopause when she began hormone therapy, the greater the risk of CHD due to hormone therapy appeared to be.” The NIH added that “these findings do not meet statistical significance” but merely “suggest that the health consequences of hormone therapy may vary by time from menopause.” (The foregoing and all further quotes are from the NIH’s April 3, 2007, press release entitled “Additional Analyses from the Women’s Health Initiative.”) Careful readers will note that the NIH’s use of such words and phrases as “may,” “suggest,” “appeared to be,” and, most crucially, “do not meet statistical significance” render these secondary analysis findings far from definitive.
Other results of the secondary analyses of the combined HRT trials released by the NIH include:
• “Confirmation that hormone therapy increases the risk of stroke, and this risk does not appear to be influenced by age or time since menopause.”
• “Even in women within 10 years of menopause, there appears to be an increased risk of breast cancer in women taking estrogen with a progestin.”
• “There was a trend (not statistically significant) towards reduced risk for death associated with hormone use in younger compared to older women.”
[Though not explicitly phrased this way by the NIH, logic would dictate that the latter sentence could be flipped and rephrased as: “There was a trend (not statistically significant) toward increased risk for death associated with hormone use in older compared to younger women.” At least that’s the way this author reads it.]
Perhaps in a nod toward the ambiguous and often frightening results of the combined HRT studies, the NIH press release announcing these findings notes that the project’s lead author, Jacques Rossouw, M.D., “is available for comment on the implications of the new study for women considering hormone therapy at different ages.” Interested parties can call the National Heart, Lung, and Blood Institute (NHLBI) Communications Office at (301) 496-4236 and/or email nhlbi_news@nhlbi.nih.gov.
Needless to say, any woman on HRT or considering it should, in the light of the recent studies, discuss the pros and cons thoroughly with her doctor, and if possible also become acquainted with some of the recent literature and news coverage (much is available on the Web). The full April 3, 2007, NIH press release on the secondary-analysis findings (entitled “Effect of Hormone Therapy on Risk of Heart Disease May Vary by Age and Year of Menopause”) can be found at www.nih.gov/news/pr/apr2007/nhlbi-03.htm. Gg
