“Uninsured and underinsured women suffer from high rates of cardiovascular and other chronic diseases. WISEWOMAN is helping to reduce heart disease and stroke by identifying and helping those at greatest risk among this especially vulnerable population.”

Darwin R. Labarthe, MD, MPH, PhD
Director, Division for Heart Disease and Stroke Prevention, CDC

Increased Health Risks for Low-Income and Uninsured Women

Cardiovascular Disease: The Leading Cause of Death Among Women

Although heart disease and stroke are commonly believed to affect men much more than women, more than half of all people who die of these diseases are women. Heart disease and stroke are the first and third leading causes of death among American women. Beyond deaths, heart disease and stroke pose a tremendous burden to women in terms of disease and disability. Nearly 43 million U.S. women have a history of heart disease and stroke, including 7.3 million women who have coronary heart disease and 3.4 million women who have suffered a stroke.

Low-Income and Uninsured Women

In 2008, the total cost of heart disease and stroke for the United States is projected to be more than $448 billion. This cost includes health care expenditures and lost work productivity. This economic burden disproportionately affects people with limited resources. Low-income women are more likely to be uninsured or underinsured; to have less access to health care services; and to be unable to pay for needed prevention, screening, and treatment services.

In terms of their health, low-income women are more likely to smoke and be overweight, which increases their risk for developing heart disease and stroke. They also are less likely to be physically active and aware of their blood pressure and cholesterol levels. Addressing these and other risk factors, such as diabetes, an unhealthy diet, and physical inactivity, greatly reduces women’s risk for illness and death from heart disease and stroke.

Unfortunately, prevention, screening, and treatment are often beyond the reach of uninsured and underinsured women. Low-income adults in the United States are less likely to be screened for high blood pressure and high cholesterol, and they are less likely to be advised by a health care professional to lose weight and quit smoking.

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CDC’s Leadership in Promoting Healthy Lifestyles for Women

WISEWOMAN: Well-Integrated Screening and Evaluation for Women Across the Nation

Initially funded in 1995, the WISEWOMAN program helps low-income women reduce their risk for heart disease, stroke, and other chronic diseases. WISEWOMAN services are offered in local communities, usually through clinics and public health departments. Through its programs, WISEWOMAN provides uninsured or underinsured women aged 40–64 years with the knowledge, skills, and interventions they need to live healthier lifestyles and reduce their risk for cardiovascular disease. Through fiscal year 2007, CDC funded 13 state health departments and two tribal organizations to offer WISEWOMAN programs.

Across the country, the number of women participating in WISEWOMAN programs has grown steadily, with more than 10,000 new women entering the program each year. Eligible participants are enrolled through the National Breast and Cervical Cancer Early Detection Program. Many of these women are also members of racial and ethnic minority populations.

Health care providers who work with the WISEWOMAN program screen their patients to identify their level of risk for developing heart disease and stroke. These screenings include assessments for high blood pressure, high cholesterol, tobacco use, and diabetes. Women who receive WISEWOMAN screenings often are found to have risk factors for heart disease and stroke. For example, a study of this population found that 74% of WISEWOMAN participants were overweight or obese, 29% smoked, 30% had high blood pressure, 24% had diabetes, and 41% had high cholesterol. Participants with these and other risk factors receive medical referrals when needed.

Beyond screenings, WISEWOMAN offers a wide range of lifestyle interventions that are tailored to specific population groups and cultures. These interventions help women address risk factors for heart disease and stroke, including high blood pressure, high cholesterol, high blood glucose (sugar), and smoking. Health care providers offer counseling on specific behavioral changes that can improve their patients’ diet and physical activity levels, support them to quit smoking, and help them improve their overall health. Participants also engage in activities such as goal-setting, developing social support systems, and applying new knowledge to everyday situations.