U.S. Department of Health and Human Services, Health Resources and Services Administration

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Introduction

In 2008, females represented 50.7 percent of the 304 million people residing in the United States. In most age groups, women accounted for approximately half of the population, with the exception of people aged 65 years and older; within this age group, women represented 58 percent of the population. The growing diversity of the U.S. population is reflected in the racial and ethnic distribution of women across age groups. Black and Hispanic women accounted for 9.0 and 6.8 percent of the female population aged 65 years and older, respectively, but they represented 14.1 and 22.4 percent of females under 15 years of age. Non-Hispanic Whites accounted for 79.9 percent of women aged 65 years and older, but only 55.2 percent of those under 15 years of age. Hispanic women now account for a greater proportion of the female population than they did in 2000, when they made up 17.5 percent of the population under age 15 and only 4.9 percent of those 65 years and older.

America’s growing diversity underscores the importance of examining and addressing racial and ethnic disparities in health status and the use of health care services. In 2008, 63.4 percent of non-Hispanic White women reported themselves to be in excellent or very good health, compared to only 48.1 percent of Hispanic women and 48.4 percent of non-Hispanic Black women. Minority women are disproportionately affected by a number of diseases and health conditions, including HIV/AIDS, sexually transmitted infections, diabetes, and asthma. For instance, in 2008, rates of new HIV cases were highest among Black and Hispanic females (56.0 and 13.3 per 100,000 females, respectively). In 2008, 36.0 percent of non-Hispanic White women had ever been tested for HIV, compared to 57.0 percent of non-Hispanic Black and 50.6 percent of Hispanic women.

Hypertension, or high blood pressure, was also more prevalent among non-Hispanic Black women than women of other races. In 2005–2008, 21.3 percent of non-Hispanic Black women were found to have high blood pressure, compared to 16.3 percent of non-Hispanic White, 10.6 percent of Mexican American, and 12.4 percent of other Hispanic women.

Diabetes is a chronic condition and a leading cause of death and disability in the United States, and is especially prevalent among minority and older adults. Among women with diabetes, however, non-Hispanic Black women
were most likely to have been diagnosed with the condition by a health professional (63.7 percent), compared to only 49.1 percent of non-Hispanic White women.

In addition to race and ethnicity, income and education are important factors that contribute to women’s health and access to health care. Regardless of family structure, women are more likely than men to live in poverty. Poverty rates were highest among women who were heads of their households with no spouse present (25.7 percent). Poverty rates were also high among non-Hispanic Black, non-Hispanic American Indian/Alaska Native, and Hispanic women (23.2, 22.7, and 22.3 percent, respectively). Women in these racial and ethnic groups were also more likely to be heads of households than their non-Hispanic White and non-Hispanic Asian/Pacific Islander counterparts.

Mental health is another important aspect of women’s overall health. A range of mental health problems, including depression, anxiety, phobias, and post-traumatic stress disorder, disproportionately affect women. In 2008, non-Hispanic American Indian/Alaska Native and non-Hispanic women of multiple races were more likely than women of other races and ethnicities to report ever having had depression (40.0 percent each), followed by non-Hispanic White women (36.5 percent). Women in these racial and ethnic groups were also more likely than other women to report ever having had generalized anxiety.

Some conditions and health risks are more closely linked to family income than to race and ethnicity, including asthma. Rates of asthma decline as income increases, and women with higher incomes are more likely to manage their asthma effectively. Nearly 14 percent of women with household incomes of less than 100 percent of poverty had asthma in 2008, compared to 8.4 percent of women with incomes of 200- 399 percent of poverty and 7.3 percent of women with higher incomes.

Severe headaches and migraines were also more common among women with lower household incomes and were more likely to affect women than men. In 2008, 25.9 percent of women with household incomes below 100 percent of poverty had experienced severe headaches or migraines in the previous 3 months, compared to 17.6 percent of women with incomes of 200 percent or more of poverty.

Receipt of oral health care and oral health status among women also varies dramatically with household income. In 2005–2008, women with incomes of 300 percent or more of poverty were more likely to have had a dental restoration (89.9 percent) and significantly less likely to have untreated dental decay (10.3 percent) than their lower-income counterparts. Fewer than 69 percent of women with incomes below 100 percent of poverty had had a tooth restored, while 30.3 percent were found to have untreated dental decay.

Among older adults, physical disabilities are more prevalent among women than men as well. Disability can be defined as impairment of the ability to perform common activities like walking up stairs, sitting or standing for 2 hours or more, grasping small objects, or carrying items like groceries. Therefore, the terms “activity limitations” and “disabilities” are used interchangeably throughout this book. Overall, 68.4 percent of women and 54.4 percent of men aged 65 years and older reported having an activity limitation in 2008.

Men, however, bear a disproportionate burden of some health conditions, such as HIV/ AIDS, high blood pressure, and coronary heart disease. In 2008, for instance, the rate of newly reported HIV cases among adolescent and adult males was more than 3 times the rate among females (35.9 versus 11.5 per 100,000, respectively). Despite the greater risk, however, a smaller proportion of men had ever been tested for HIV than women (37.6 versus 40.9 percent, respectively).

Certain health risks, such as cigarette use and illicit drug use, occur more commonly among men than women. In 2008, 23.1 percent of men smoked cigarettes, compared to 18.3 percent of women. Similarly, 29.1 percent of men consumed 4 or more drinks per week in the past year, cof women. In addition, men were more likely than women to lack health insurance.

Many diseases and health conditions, including some of those mentioned above, can be avoided or minimized through good nutrition, regular physical activity, and preventive health care. In 2008, 76.3 percent of women aged 40 and older reported having had a mammogram in the previous 2 years. In 2005–2008, 72.5 percent of women aged 20 and older reported having had a cholesterol screening in the previous 5 years. More than 68 percent of women aged 65 years and older also reported receiving flu vaccine; however, this percentage ranged from 60.2 percent of women with incomes below 100 percent of poverty to 70.5 percent of women with incomes of 200 percent or more of poverty.

There are many ways women (and men) can promote health and help prevent disease and disability. Regular physical activity is one of these. In 2008, 14.9 percent of women participated in at least 2.5 hours of moderate intensity physical activity per week or 1.25 hours of vigorousintenity activity per week, in addition to muscle- strengthening activities on 2 or more days per week. Non-Hispanic White women and women with higher incomes were most likely to meet this level of physical activity.

Healthy eating habits can also be a major contributor to long-term health and prevention of chronic disease. In 2005‒2008, however, only 24.5 percent of women met or exceeded the recommended Adequate Intake of calcium, which is critical in reducing the risk of osteoporosis and preventing bone loss.

While some behaviors have a positive effect on health, a number of others, such as smoking, illicit drug use, and excessive alcohol use can have a negative effect. In 2008, 58.2 percent of women reported any alcohol use in the past year, but relatively few women (8.3 percent) reported moderate drinking (more than three and up to seven drinks per week) and even fewer (5.0 percent) reported heavy drinking (more than seven drinks per week). In the same year, 11.5 percent of women used illicit drugs, including marijuana, cocaine, hallucinogens, inhalants, and prescription-type drugs for nonmedical purposes.

Cigarette, alcohol, and illicit drug use is particularly harmful during pregnancy. The use of tobacco during pregnancy has declined steadily since 1989. Based on data from 22 States and reporting areas, 10.4 percent of pregnant women reported smoking during pregnancy in 2007. This rate was highest among non-Hispanic American Indian/Alaska Native women (24.4 percent) and lowest among non-Hispanic Asian/Pacific Islander women (1.5 percent). Women’s Health USA 2010 can be an important tool for emphasizing the importance of preventive care, counseling, and education, and for illustrating disparities in the health status of women from all age groups and racial and ethnic backgrounds. Health problems can only be remedied if they are recognized. This data book provides information on a range of indicators that can help us track the health behaviors, risk factors, and health care utilization practices of women and men throughout the United States.

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