May 9-15, 2004 is the 5th Annual National Women’s Health Week. National Women's Health Week is a national effort by an alliance of government organizations to raise awareness about manageable steps women can take to improve their health. The focus is on the importance of incorporating simple preventive and positive health behaviors into everyday life. In celebration of National Women’s Health Week, the following article examines health status, health promotion and behaviors among women 18 years of age and older in Southeastern Pennsylvania and among vulnerable population groups using data from PHMC’s 2002 Southeastern Pennsylvania Household Health Survey.

Mortality and morbidity

In 2002, 37,225 women died in Southeastern Pennsylvania. Cancer was the leading cause of death for these women. Nearly 9,000 women died from cancer during that year, representing a cancer mortality rate of 228.99 per 100,000 women. Seven thousand women died from coronary heart disease and 2,533 women died from stroke, representing rates of 187.54 and 65.82 per 100,000 women, respectively.(1)

The majority of women in Southeastern Pennsylvania report that they are in excellent or good health. One in five women (20.7%), however, report that their health is fair or poor.

• African American women are most likely to be in fair or poor health (32.4%) compared to white (16.7%), Asian (12.5%) and Latina (29.5%) women.
• Poor women are nearly three times as likely as non-poor women to report fair or poor health (44.7% and 17.0%, respectively).

More than one-quarter (27.6%) of women in Southeastern Pennsylvania suffer from a chronic health condition, which requires ongoing care or management. One in four (26.6%) women have arthritis, one in ten (10.4%) women have asthma, one in thirteen women (7.5%) have diabetes and one in four (27.5%) women have hypertension.

• Asthma prevalence is highest among Latina women (17.9%), followed by African American (13.3%), white (9.3%) and Asian (4.4%) women. Poor women are twice as likely as non-poor women to have asthma (18.6% and 9.2%, respectively).
• African American women are most likely to have diabetes (12.0%) compared to Latina (8.2%), white (6.2%) and Asian (2.1%) women. Women who are poor are nearly twice as likely to be diabetic than non-poor women (14.2% and 6.4%, respectively).
• Hypertension is much more prevalent among African American women than women of other racial groups. More than one in three African American women (38.4%) have high blood pressure compared to less than one in four white (24.9%) and Latina (23.6%) women and one in thirteen Asian women (7.3%). Poor women (38.6%) are also more likely to be hypertensive than are non-poor women (25.8%).

Health promotion and disease prevention

Most women in Southeastern Pennsylvania have been to the doctor in the past year (88.4%). A significant number of women (28,900), however, have not been to the doctor in three or more years. Although the majority of women are routinely receiving preventive tests, a sizeable percentage of women are not receiving these critical screenings.

• Sixteen percent of women have not had a Pap test in the past two years. Asian women (28.3%) are most likely not to have had a Pap test in the recommended time, compared to white (17.8%), African American (10.8%) and Latina (13.6%) women. Uninsured women are more than twice as likely as insured women to not have had a Pap test in the past two years (32.9% and 15.7%, respectively).
• One-quarter (24.2%) of women 18+ have not had a clinical breast exam in the past year and nearly one-third (32.9%) of women 40+ have not had a mammogram in the past year. Asian women are more likely to not have had a clinical breast exam or mammogram (41.7% and 40.3%) in the past year compared to Latina (27.4% and 35.9%), white (24.3% and 33.4%) and African American (21.1% and 30%) women. Uninsured women are twice as likely to not have had either a clinical breast exam (47.9%) or mammogram (63.7%) in the recommended time compared to insured women (22.6% and 31.6%).
• Nearly half of women 50+ have not had a blood stool test (41%) to test for colorectal cancer in the past two years or a sigmoidoscopy or colonoscopy (46.1%) in the past 5 years. These tests are much more common among insured women than uninsured women. Seventy percent of uninsured women have not had a blood stool test and 84.2% have not had a sigmoidoscopy or colonoscopy in the recommended time compared to only 40.4% and 53.3% of insured women.

Health behaviors

One in five Southeastern Pennsylvania women currently smoke cigarettes; slightly more than one-half (54.6%) of these women have tried to quit in the past year.

• Smoking prevalence is highest among African American women (23.9%) compared to white (20.2%), Latina (19.0%) and Asian (5.7%) women.
• Poor women are much more likely than are the non-poor to smoke cigarettes (29.8% and 19.1%, respectively).

Based on BMI calculations of height and weight (2), more than half (51.1%) of women are considered overweight or obese; one-quarter of all women (23%) are obese.

• African American women (71.9%) are much more likely to be considered overweight or obese compared to Latina (59%), white (45.6%) and Asian (13.4%) women.
• Poor women (66.8%) are much more likely to be overweight and obese than are non-poor women (48.7%).

Greater than one-half (53.5%) of women do not exercise three or more times a week.

• Asian women (64.3%) are least likely to receive regular exercise than are white (50.2%), African American (60.9%) and Latina (61.3%) women.
• Poor women are more likely not to exercise regularly than are non-poor women (62.2% and 52.1%, respectively).

For more information on women’s health in Southeastern Pennsylvania, please contact Ilisa Stalberg at (215) 985-6238 or ilisa@phmc.org. For more information on National Women’s Health Week, visit http://www.4woman.gov/whw/2004/

Notes:

(1) Data on mortality are from the PA Department of Health and the Philadelphia Department of Public Health and prepared by PHMC’s Community Health Data Base.

(2) Obesity level is based on BMI (Body Mass Index), calculated from self-reported height and weight. The respondents’ BMI level was matched to standard BMI scale. A person is overweight if they score 25-29; a person who scores 30 or greater is considered obese. This scale has been recommended in evaluating obesity by the National Heart, Lung and Blood Institute and Center for Disease Control.