Study Finds Health Care Disparities For Female Veterans

Female veterans do not receive the same quality of outpatient care as male veterans at about one-third of the 139 Department of Veterans Affairs facilities that offer it, according to a report released on Friday by VA, the AP/Philadelphia Inquirer reports. Women account for about 14% of the U.S. Armed Forces and about 5% of VA's population, but that number is expected to nearly double in the next two years. The VA's review found the health care disparity even as women are serving on the front lines at historic levels.

The review found a need for more physicians trained to address the health care needs of women, as well as more equipment for women's health. The report noted that other studies had found better surgical outcomes and decreased mortality for women at VA hospitals compared with women enrolled in Medicare Advantage plans or those receiving private care. Other studies also have shown better performance of breast and cervical cancer screenings among women receiving care through VA than those enrolled in private or other government-sponsored health plans.

William Duncan, associate deputy undersecretary at VA, said the disparity between men and women's health is unacceptable and the department is working to address the issue. He said, "We're striving to understand the reason for these health disparities in veterans health care based on personal characteristics." The report states that VA has made some progress, such as creating on-site mammography services and women's clinics at most VA facilities. VA also is trying to recruit more clinicians with training in women's care, according to the report (Hefling, AP/Philadelphia Inquirer, 6/16).


Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Government Calls For Conference To Look At Bacterium That Caused Deaths Of Four California Women Who Took Mifeprex

The federal government has called for a conference to look at the Clostridium sordellii bacterium, which caused the deaths of four California women who were taking Danco Laboratories' Mifeprex, the New York Times reports (Harris, New York Times, 2/11). Mifeprex -- which is known generically as mifepristone -- when taken with misoprostol, can cause a medical abortion. FDA in July 2005 issued a public health advisory warning for physicians to watch for any signs of sepsis or other infections among women taking the drug, which the agency approved in 2000 for the termination of pregnancies of 49 days or less. FDA officials on Nov. 4, 2005 updated the advisory after they discovered that the deaths of four California women who took the drug all were caused by C. sordellii, a rare and deadly bacterium. According to a report published in December 2005 in the New England Journal of Medicine, the deaths of the women were linked to toxic shock caused by the bacterium, but the researchers found no direct link among the deaths of the four women and concluded that the risk of infection in conjunction with taking the drug is "low." CDC has said the one factor that ties the four cases together is that misoprostol was administered vaginally instead of orally, which is considered "off-label use" (Kaiser Daily Women's Health Policy Report, 12/8/05). According to the Times, "another intriguing mystery" is that all four cases happened in California. An FDA official speaking on the condition of anonymity said 15 to 20 scientists have been asked to present their research on the bacterium at a May 11 conference at CDC in Atlanta. "We hope to keep the focus on the science," the official said, adding that officials are worried the debate over medical abortion might hinder the scientific discussion. He said, "We're holding this in a secure government facility for a reason" (New York Times, 2/11).


"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . ?© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Vitamin D2 Supplements Might Lower Risk Of Some Older Women Falling Down

High-risk older women, especially those from sunny climates, and especially during the winter, may benefit from a reduced risk of falls if they take Vitamin D2 supplements, according to an article in Archives of Internal Medicine (JAMA/Archives), January 14th edition.


The researchers explain "Approximately one-third of women older than 65 years fall each year, and 6% sustain a fracture as a result of the fall. In addition, fear of falling is a major problem in older people."


Richard L. Prince, M.D., Sir Charles Gairdner Hospital, Nedlands, Australia, and team carried out a year-long clinical trial involving 302 women aged 70-90 years - they all lived in Perth, Australia. As vitamin D is produced as a response to exposure to sunlight and the study was carried out in a sunny place, the scientists selected women whose blood vitamin D levels for below 24 nanograms per milliliter, the median for the area.


All the women in the study had a history of falls in the previous year. They were given 1,000 milligrams of calcium citrate per day. 50% of them were then randomly selected to receive either 1,000 international units of vitamin D2 (ergocalciferol) while the other 50% received an identical placebo. The researchers gathered data on falls every six weeks.


During the study period 53% of the vitamin D2 women and 62.9% of the placebo women had at least one fall. They found that vitamin D2 therapy reduced the risk of having at least one fall by 19%, even after factoring in such variables as height.


The researchers wrote "When those who fell were grouped by the season of first fall or the number of falls they had, ergocalciferol treatment reduced the risk of having the first fall in winter and spring but not in summer and autumn, and reduced the risk of having one fall but not multiple falls."


They also wrote "It is interesting that the ergocalciferol therapy effect was confined to those who were to sustain one fall but not those destined to have more than one fall. Older people who fall frequently tend to have more risk factors for falling, including greater degrees of disability and poorer levels of physical function."


Perhaps chemically correcting vitamin D levels in the blood in these women is insufficient to prevent falls, they noted.


The authors concluded "Ergocalciferol, 1,000 international units per day, added to a high calcium intake is associated with 23 percent reduction of the risk of falling in winter/spring to the same level as in summer/autumn."


"Effects of Ergocalciferol Added to Calcium on the Risk of Falls in Elderly High-Risk Women"

Richard L. Prince; Nicole Austin; Amanda Devine; Ian M. Dick; David Bruce; Kun Zhu

Arch Intern Med. 2008;168(1):103-108

Click here to view abstract online

U.N. Officials Call For Increased Action To Prevent Spread Of HIV Among Women, Children In Asia-Pacific Region

More needs to be done to prevent and treat HIV/AIDS among pregnant women and infants in the Asia-Pacific region, U.N. officials said on Monday at the opening of the first Asia-Pacific Joint Forum, the AP/International Herald Tribune reports. At the five-day conference, health experts, nongovernmental organizations and HIV-positive people from 22 countries plan to promote a strategy to prevent HIV transmission among pregnant women and children, with a focus on improved integration of HIV/AIDS and maternal health services. "Linking HIV prevention efforts with reproductive health care can strengthen and improve access to both," Chaiyos Kunanusont, an adviser to the U.N. Population Fund, said. Delegates plan to establish a framework that aims to strengthen links between counseling and testing for HIV and other sexually transmitted infections and maternal and child health, family planning and sexual health. The United Nations estimates that the number of HIV-positive women in the Asia-Pacific region from 2001 through 2004 increased by 16% to more than two million, compared with the global increase of 8%. In addition, roughly 90% of the 411,000 HIV-positive children in the region contracted the virus as a result of mother-to-child transmission, according to the AP/Herald Tribune (AP/International Herald Tribune, 11/6).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.