Women's Health USA 2004

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

INTRODUCTION

In 2002, women represented 51 percent of the 282 million people residing in the United States. In most age groups, women account for approximately half of the population, with the exception of people 65 years and older; among older Americans, women represent 57 percent of the population. The growing diversity of the United States population is reflected in the differing racial and ethnic distribution of women across age groups. Black and Hispanic women accounted for 9 and 6 percent of the female population aged 65 and older, respectively, but they represented 16 and 17 percent of those under 25 years of age. Non Hispanic Whites accounted for 83 percent of women aged 65 years and older, but only 61 percent of those under 25 years of age.

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 2002, 63 percent of non-Hispanic White females reported themselves to be in excellent or very good health, compared to 58 percent of Hispanic women and 56 percent of non-Hispanic Black women. In contrast, 15 percent of non-Hispanic Black women and 14 percent of Hispanic women rated their health as fair or poor, compared to 11 percent of non-Hispanic White women.

A number of diseases and conditions disproportionately affect minority women. One of these diseases is Acquired Immunodeficiency Syndrome, or AIDS. In 2002, non-Hispanic Black and Hispanic women represented less than one-quarter of the female population, but they accounted for more than three-quarters of all women living with AIDS in this country. In 1999, AIDS was the fifth leading cause of death among women aged 25 to 44 years, but the third leading cause of death among African American women of the same age. Nearly one-third of non-Hispanic White women have ever been tested for the Human Immunodeficiency Virus (HIV), the virus that causes AIDS, compared to 55 percent of non-Hispanic Black women and 43 percent of Hispanic women.

Diabetes is a condition that affects women of all races and ethnicities, but is especially prevalent among non-Hispanic Black women. Among women in this population it occurs at a rate of 99 per 1,000 women, compared to 56 per 1,000 non-Hispanic White women. Hispanic women are affected at a rate of 67 per 1,000 women, and the lowest rate (42.7 per 1,000 women) occurs among non-Hispanic women of other races (includes Asian/Pacific Islanders, American Indian/Alaska Natives, and individuals of more than one race). Non-Hispanic Black women are also disproportionately affected by hypertension, or high blood pressure, which occurs among this population at a rate of 328 per 1,000 women. This rate is much higher than the rate among non-Hispanic White women (249 per 1,000 women) and Hispanic women (183.8 per 1,000 women). Again, the lowest rate (174.8 per 1,000 women) occurs among non-Hispanic women of other races.

Overweight and obesity are occurring at an ever-increasing rate among Americans of all ages and both sexes. Body Mass Index (BMI) is a measure of the ratio of height to weight, and is often used to determine whether a person’s weight is within a healthy range. A BMI of 25 or greater is considered overweight, and a BMI of 30 or greater is considered obese. In 2002, 65 percent of non-Hispanic Black women over the age of 18 were overweight, as were 52 percent of Hispanic women, and 44 percent of non Hispanic White women. Overweight was least prevalent among non-Hispanic women of other races, at 29 percent. Obesity followed the same trend, and was most prevalent among non-Hispanic Black women, occurring in 38 percent of that population. Among Hispanic and non-Hispanic White women, 22 and 19 percent, respectively, were obese. Only 9 percent of non-Hispanic women of other races were considered obese.

Some conditions, such as arthritis and osteoporosis, disproportionately affect White women. In 2002, the rate of arthritis among non-Hispanic White women over 18 years of age was 264 per 1,000 women, compared to 151 per 1,000 Hispanic women and 241 per 1,000 non-Hispanic Black women. Osteoporosis is a disease which is characterized by low bone mass and can lead to bone fractures. Eighty percent of those affected by osteoporosis are women. In addition to being female, small body frame and Caucasian or Asian race are risk factors for osteoporosis. National data from 1999-2000 indicate that non-Hispanic White women are four times as likely as non-Hispanic Black women to be diagnosed with osteoporosis.

Non-Hispanic White women are also more prone to mental illness than women of most other racial/ethnic groups. The 2001 suicide rate among non-hispanic White women was 6.1 per 1,000 women compared to 2.3 among non-Hispanic Black women and 2.1 among Hispanic women. American Indian/Alaska Native women have a suicide rate (6.2 per 1,000 women) that exceeds that of non-Hispanic White women.

Many behaviors - such as substance abuse, tobacco use, physical activity, and use of health care - can influence health. Racial and ethnic differences are evident in these behaviors. The rate of binge alcohol use (having five or more drinks on one occasion) is higher among non-Hispanic White women than women of most other racial groups. In 2001-2002, 26 percent of non-Hispanic White women aged 15 to 44 reported binge drinking, while only 20 percent of non-Hispanic Black women and 19 percent of Hispanic women did so. American Indian/Alaska Native women had the highest rate of binge drinking, at 35 percent. Non Hispanic White women also have a higher rate of cigarette use (36 percent) than non-Hispanic Black women (25 percent) and Hispanic women (19 percent). American Indian/Alaska Native women have the highest rate of cigarette use (47 percent).

Physical activity is an important lifestyle factor that directly affects health, yet only 21 percent of non-Hispanic Black women and 21 percent of Hispanic women were found to engage in regular leisuretime physical activity. A greater proportion of non Hispanic White women (31 percent) reported that they are physically active on a regular basis.

Health insurance can be an important factor in women’s ability to stay healthy by improving access to regular medical care and use of preventive services. In 2002, 43.5 million Americans were without health insurance. Among women, Hispanics are most likely to be uninsured, at 29.5 percent. Asian/Pacific Islander and Black women also have a high rate of uninsurance (18 percent), followed by White women (12.9). In 2002, non-Hispanic White women were most likely to use an office-based source of care (90 percent), while Hispanic women were least likely to do so (74 percent). Among non-Hispanic Black women, 3 percent used an emergency department as their usual source of care, compared to less than one percent of non-Hispanic White women. Among Hispanic women, 21 percent did not have a usual source of care, compared to only 7 percent of non Hispanic White women.

Regular use of dental care is essential to maintaining good oral health. In 2002, 68 percent of non-Hispanic White women had seen a dentist in the past year, while the same was true for only 53 percent of non-Hispanic Black women. Hispanic women were most likely to go 5 or more years without visiting a dentist, while non-Hispanic White women were least likely to do so.

Health behaviors also varied by race and ethnicity among women during and around the time of pregnancy. Non-Hispanic White women are more likely to smoke cigarettes during pregnancy than women of other racial and ethnic groups, a primary risk factor for low birth weight and other health problems among newborns. In 2002, 24 percent of pregnant non-Hispanic White women reported having smoked cigarettes in the prior month, compared to only 7.3 percent of pregnant non-Hispanic Black women and 6.0 percent of pregnant Hispanic women. Other factors that can influence maternal and infant health are the use of prenatal care and breastfeeding. Non-Hispanic White women are most likely to enter prenatal care in the first trimester (88.6 percent), followed by Asian/Pacific Islanders (84.8), Hispanic women (76.7), non-Hispanic Black women (75.2), and American Indian/Alaska Native women (69.8). Breastfeeding immediately after delivery is most common among Asian mothers (80 percent did so), followed by White mothers (73 percent), Hispanic mothers (71 percent) and Black mothers (53 percent).

Women’s Health USA 2004 can be an important tool for illustrating important disparities in the health status of women from all ages, races, and ethnic backgrounds. Health problems can only be remedied if they are recognized, and this data book provides information on a range of indicators that can help us to track the health behaviors, risk factors, and health care utilization practices of women throughout the United States. Healthy women build healthy communities.