Improving Women’s Health
Written by Gabrielle Carrero and Monique Cuvelier
A comprehensive resource for community health managers, providers, and others working on the front lines of women’s health and preventive care.
Gender matters when it comes to health. Not only do women have different health issues from men, but they are often not given the same kind of care. Many live in rural areas where they don’t have access to family planning services or gynecological care. Political policies have reduced access to care for many women, especially low-income. The Title X program has been dismantled, which helped provide affordable access to birth control, cancer screenings, and sexually transmitted infections.
The result is stark. The death rate among women aged between 15-54 has risen steadily. A woman in the US is 50% more likely than her mother to die in childbirth. U.S. has the worst rate of maternal deaths in the developed world.
Women’s Health Needs Attention
We need to increase care to women, and community-facing workers, such as community health workers (CHWs), promotores, and others can help. They can:
- educate women about health services that uniquely affect a woman’s physical and emotional well-being,
- increase access to screenings, such as breast cancer and cervical cancer screenings,
- reach women in remote areas,
- connect clients with maternal health and other services that will improve their overall wellness, and
- advise women about treatment and diagnosis of diseases and conditions that affect women more than men, such as anxiety and depression, or sexually transmitted diseases.
About This Guide
Women’s health is too often equated with reproductive health, but it goes far beyond that. Below are the top 10 health issues unique to women, plus resources for managers, administrators, and employees of programs that are dedicated to expanding care for women.
Share this resource among your teams–the health of women, families, and entire communities depend on it.
10 Things To Fix in Women’s Health
Women have unique health concerns that are exclusive to them alone, including cervical cancer, menopause, and pregnancy.
1. Breast Cancer
Breast cancer is the second leading cause of women’s death, after heart disease (see below). In 2020, The American Cancer Society estimates 279,480 new cases and 42,170 deaths in women by breast cancer.
This disease, in which a malignant tumor develops from cells in the breast, is especially dangerous. The cancer cells can reach lymph nodes: small structures under the arm that filter harmful substances that can spread to other parts of the body.
Detecting breast cancer early makes the disease easier to treat, and screening tests like mammograms are important for all women over the age of 50.
- CHWTraining Opens New Course on Breast Cancer Screening for 2020
- How CHW Teams Improve Breast Cancer Screening
2. Gynecological Cancers
Women are also dying to gynecological cancers, especially among Black and Latina or Hispanic women. The American Cancer Society estimates 113,520 new cases and 33,620 deaths in 2020 by gynecological cancers.
There are five main gynecologic cancers:
These cancers are the uncontrolled growth and spread of abnormal cells that begin in a woman’s reproductive organs. Women can inherit genes that increase their chance of gynecological cancer, and other factors like smoking, aging, or the environment can increase risk.
In addition, HPV, or Human Papillomavirus, is known to cause cervical cancers, as well as some vagina and vulva cancers. All women with reproductive organs are at risk for developing gynecological cancers, so prevention through routine yearly pelvic exams are critical.
- CHWTraining Adds “Cervical Cancer and HPV” to its Chronic Illness Online Course Library
- Chronic Illness Training
3. Reproductive Health
Health problems related to reproductive health, such as endometriosis and uterine fibroids, are dangerous for women.
For example, endometriosis is a tissue that is similar to that which lines the uterus but grows in another part of the body like the uterus, ovaries, or bladder. It can cause very heavy periods or pain in the abdomen, pelvic areas, or lower back. It can cause infertility.
Uterine fibroids can also cause reproductive complications like infertility, miscarriages, or early labor. These noncancerous tumors grow in the wall of the uterus or womb and can cause painful periods, frequent urination, painful sex, and pain in the lower back.
Encouraging women to make routine health examinations with their providers is an effective tool to gather history, have open conversations on pain and symptoms, and provide necessary care.
- Community Engagement the Right Way with Outreach Skills
- State Requirements for Insurance Coverage of Contraceptives, Kaiser Family Foundation
4. Maternal Health
Women are vulnerable to issues during and after their pregnancy. If a woman enters a pregnancy with previous health problems like asthma, diabetes, uterine fibroids, obesity, eating disorders, depression, thyroid disease, or sexually transmitted infections (STIs), these issues can challenge the health of the mother, the fetus, or both.
Pregnancy presents its own issues, including anemia, hypertension, gestational diabetes, fetal problems, and placenta problems. As many as 1 in 5 women have a pregnancy that ends in miscarriage. The changes that a woman’s mind and body go through during pregnancy and afterbirth can cause postpartum depression in new mothers.
Postpartum depression can cause women to feel empty, emotionless, overwhelming sadness, and a lack of connection in love or care for their baby. Obstetricians can treat problems that occur during pregnancy, but these mental health problems often go untreated. Encourage women to discuss signs or symptoms of depression to keep them and their family safe.
- 10 Signs You Need to Make a Behavioral Health Referral
- Build Skills in These 3 Areas To Stop Diabetes Killing People
5. Heart Disease
Heart disease is a leading killer of women in the U.S. In 2017, heart disease killed almost 300,000 women here.
Many women don’t know heart disease is as much as a risk for them as it is for men. In fact, women are more likely to have silent heart attacks or a heart attack that does not cause obvious symptoms. Unlike men, women are more likely to experience pain from a heart attack in their back, neck, jaw, or throat than chest pain or discomfort.
Women have worse outcomes than men after heart attacks, and they can die within a year of their attack.
Luckily, heart disease is manageable and even preventable, and that starts with educating women on what they can control will save lives.
- 10 skills CHWs can learn right now—without leaving the couch
- Nearly One in Four Workers are at High Risk of Serious Illness with COVID-19, Posing Challenges for Employers as They Reopen, Kaiser Family Foundation
6. Mental Health
Many women in the U.S.—more than 1 in 5—have a mental health condition like depression, an eating disorder, or post-traumatic stress disorder (PTSD).
Gender is a great influence in mental health, because such conditions as depression and bipolar disorder affect women differently. Some are unique to women because of their hormones. And because women describe symptoms that are unlike men’s, they often go undiagnosed.
When women are brave enough to speak about what difficulties they are facing, it is up to health care providers to respond with sensitivity and the readiness to get them the help they need. Encourage your clients to speak up.
7. STDs, STI, and HIV
Sexually active young people between ages 15 to 24 have a reported 20 million new STD (sexually transmitted disease) infections each year according to the CDC. Women who become pregnant with an STD are especially vulnerable because it can cause health problems for a developing baby.
Similarly, HPV is a sexually transmitted infection (STI), and some types of HPV can lead women to have warts and cancers. Women can also get the human immunodeficiency virus (HIV) through unprotected sex or sharing needles with an infected individual.
Dedicating resources into STD and HIV prevention through safe sex practices like latex condoms helps keep women, their partners, and their families. Empowering women to become responsible sexual partners who want to share accountability with men in sexual encounters should be a goal. For HPV, parents should be educated on the vaccines available for prevention.
- 7 Outreach Resources for National Latinx AIDS Awareness Day
- 7 Recursos de Proyección Comunitaria para el Día de Concientización Latinx sobre el SIDA
8. Violence Against Women
Women and girls are experiencing physical, sexual, and mental abuse at disturbing rates. The World Health Organization (WHO) reports that around the globe, 1 in 3 women have “experienced physical and/or sexual violence by an intimate partner or non-partner sexual violence.”
Domestic violence, sexual assault, and gender-based violence are some forms of trauma that a woman can endure at any age, environment, and by anyone. Most critically, violence against women has severe health consequences including short and long-term physical, mental, sexual, and reproductive problems.
Strong prevention tools by providers includes training in responding to a survivor’s needs holistically and empathetically. Referral and supports prevents recurrence.
- Sex and HIV Education, Guttmacher Institute
- What COVID-19 Means for Immigrants’ Reproductive Health, Guttmacher Institute
Many transgender people need support for the sexual and reproductive health needs above. However, they have unique and significant barriers to care for insurance and provider support. Providers might be unprepared, uneducated, or unwilling to cross those barriers.
Members of the trans community are often afraid to seek routine medical care because their biological reproductive organs remain intact. For example, a trans woman may feel afraid or embarrassed to come in for their annual health care visit for a prostate exam. They might have trouble accessing hormonal or mental health therapy or have their surgeries classed as “elective.”
Instead of treating the bodies of trans women as difficult or confusing, it is up to health care providers to offer sensitivity and commitment to their care.
- More to Be Done: Individuals’ Needs for Sexual and Reproductive Health Coverage and Care, Guttmacher Policy Review
- Resources for Transgender People, GLADD
Different stages of a woman’s life bear their own health challenges. A girl comes of age when she reaches puberty. At this time, the changes to their body adds to the rest of their adolescent troubles and can feel overwhelming.
When women become sexually active, they are faced with decisions to use contraception as birth control, planning or handling a pregnancy, or exploring other family planning options because of their health. They handle this all while in school, managing a career, or becoming a parent.
Women’s bodies face steep changes when they reach menopause and hormones levels fluctuate, all while she is managing her life responsibilities. The challenges that occur during these stages in a woman’s life can be eased with knowledge and communication about what to expect.
- Major reproductive health milestones in women’s lives, Guttmacher Institute
- How I Started a Community Health Initiative and How It Can Make Your Clients Healthier