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PRESIDENT’S
MESSAGE
Happy Mother’s Day —
Assessing Women’s Issues
By Leah Jacobson, MD, 2017 BCMS President
May is a time to celebrate the women in our lives — our mothers,
grandmothers, sisters, wives, and daughters. At this time, it is im-
portant for physicians to reflect on the many important health topics
that affect women just as much, if not more than, their male coun-
terparts.
According to Dr. Flavia Bustreo, Assistant Director General for
Family, Women’s and Children’s Health, World Health Organiza-
tion, the top issues for women's health in 2015 were and are still:
Cancer: Two of the most common cancers affecting women are
breast and cervical cancers.
Reproductive health: Sexual and reproductive health problems
are responsible for one third of health issues for women between the
ages of 15 and 44 years.
Maternal health: Women are now benefitting from massive im-
provements in care during pregnancy and childbirth introduced in
the last century. But those benefits do not extend everywhere and
in 2013, almost 300,000 women died from complications in preg-
nancy and childbirth.
HIV/Sexually transmitted infections: Three decades into the
AIDS epidemic, it is young women who bear the brunt of new HIV
infections. It is important to protect against HIV and human pa-
pillomavirus (HPV) infection (the world’s most common STI). It
is also vital that we do a better job of preventing and treating diseases
like gonorrhea, chlamydia and syphilis. Untreated syphilis is respon-
sible for more than 200,000 stillbirths and early fetal deaths every
year, and for the deaths of over 90,000 newborns.
Violence against women: Women can be subject to a range of
different forms of violence, but physical and sexual violence — ei-
ther by a partner or someone else — is particularly insidious. Today,
one in three women under 50 has experienced physical and/or sexual
violence by a partner or non-partner.
Mental health: Evidence suggests that women are more prone
than men to experience anxiety, depression, and somatic complaints.
Depression is the most common mental health problem for women
and suicide a leading cause of death for women under 60.
Non-communicable diseases: In 2012, some 4.7 million women
died from non-communicable diseases before they reached the age
8 San Antonio Medicine • May 2017
of 70 — most of them in low- and middle-income countries. They
died as a result of road traffic accidents, harmful use of tobacco,
abuse of alcohol, drugs and substances, and obesity — more than
50 percent of women are overweight in Europe and the Americas.
Helping girls and women adopt healthy lifestyles early on is key to
a long and healthy life.
Being young: Adolescent girls face a number of sexual and repro-
ductive health challenges: STIs, HIV, and pregnancy. About 13 mil-
lion adolescent girls (under 20) give birth every year.
Getting older: Having often worked in the home, older women
may have fewer pensions and benefits, less access to health care and
social services than their male counterparts. Combine the greater
risk of poverty with other conditions of old age, like dementia, and
older women also have a higher risk of abuse and generally, poor
health.
In the United States, the Department of Health and Human Serv-
ices, has developed the Healthy People (HP) 2020 (HP 2020) ini-
tiative which provides science-based, 10-year national objectives for
improving the health of all Americans. Healthy People 2020 has es-
tablished benchmarks and monitored progress over time in order to
encourage collaborations across communities and sectors; empower
individuals toward making informed health decisions; measure im-
pact of prevention activities.
Women and girl’s health goals are addressed in sixteen of the 42
topic areas of HP 2020. Some of the women and girls’ objectives
for the HP 2020 initiatives include:
• Arthritis, Osteoporosis, and Chronic Back Conditions (Reduce
hip fractures among older adults), Cancer (Reduce the female
breast cancer and cancer of the uterine cervix death rates, increase
the proportion of adults who were counseled about cancer screen-
ing consistent with current guidelines),
• Environmental Health (Reduce exposure to selected environmen-
tal chemicals in the population, such as mercury and lead),
• Family Planning (Increase the proportion of pregnancies that are
intended, reduce the proportion of females experiencing preg-
nancy despite use of a reversible contraceptive method, and in-
crease the proportion of adolescents who received formal