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WISEWOMAN
Improving the Health of Low-Income
and Uninsured Women
At A Glance
2008
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“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.

[A text description of this map is
also available.]
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.

[A text description of this map is
also available.]
WISEWOMAN Works
Because the WISEWOMAN program works within the health care system, CDC
can explore new ways to promote cardiovascular health. CDC continuously
shares successful strategies with other members of the public health
community because many WISEWOMAN strategies are applicable to other chronic
disease prevention programs.
Working to Prevent Heart Disease and Stroke
The WISEWOMAN program is unique in that it addresses multiple health
needs of women by partnering with other CDC programs. As a program in the
Division for Heart Disease and Stroke Prevention, WISEWOMAN works with CDC’s
Office on Smoking and Health, Division of Diabetes Translation, Division of
Cancer Prevention and Control, and Division of Adult and Community Health to
help women stop smoking; reduce their risk for heart disease, stroke, and
diabetes; increase their physical activity levels; and improve their diet.
Since 2000, WISEWOMAN has screened more than 72,000 women, identifying
over 7,300 cases of previously undiagnosed high blood pressure, over 7,500
cases of undiagnosed high cholesterol, and more than 1,000 cases of
undiagnosed diabetes. The program also has provided more than 170,000
lifestyle intervention sessions since 2000. Tobacco quitline referrals and
smoking cessation intervention sessions offered through WISEWOMAN have
contributed to an average quit rate of 8% among smokers after 1 year.
In addition, a recent study found the WISEWOMAN program to be very
cost-effective because of its success in reducing risk for chronic diseases.
In this study, the program extended women’s lives at a cost of $4,400 per
estimated year of life saved, as opposed to a much higher cost of $26,000
per estimated year of life saved by heart bypass surgery.
WISEWOMAN
in Action
In North Carolina,
WISEWOMAN sites are located in 40 counties throughout the state. In
just 1 year, program participants decreased their systolic blood
pressure about 3% and their diastolic blood pressure about 4%. Their
total cholesterol level decreased more than 3%. As a result, women
participating in this program have sharply reduced their risk for
developing heart disease or stroke.
WISEWOMAN funds the
Southeast Alaska Regional Health Consortium to serve a
population that primarily includes Alaska Natives living in rural
areas. One-third of the women participating in this program smoked,
and 50% were obese. Patient educators use culturally appropriate
interventions to promote healthier lifestyles. Each year, an average
of 9% of participants who smoked have quit. In addition, the 5-year
risk of developing a cardiovascular disease has decreased 6.7% among
all participants.
In Michigan, the
WISEWOMAN program has conducted more than 15,000 screenings since
the program’s inception in October 2001. More than 25% of the cases
of high blood pressure diagnosed during this time had not been
detected previously. More than 39% of the cases of high cholesterol
diagnosed also were new cases. Of the women screened since 2006, 94%
have received an intervention session. Since the program began,
smoking rates, cholesterol levels, and 5-year cardiovascular disease
risk have all declined significantly among women participating in
this program. |
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Future Directions
For fiscal year 2008, the WISEWOMAN program received $18.6 million from
Congress. This year, WISEWOMAN will seek new programs to fund for its next
5-year funding cycle. All states, territories, and tribal organizations that
have a CDC-funded National Breast and Cervical Cancer Early Detection
Program, are eligible to apply. Program priorities will include the
following:
- Maximizing the reach of the program.
- Working to eliminate health disparities.
- Decreasing heart disease and stroke risk factors for the WISEWOMAN
population.
- Maximizing the number and variety of settings that deliver WISEWOMAN
services.
- Ensuring that the WISEWOMAN program is delivered as intended.
- Sustaining the benefits of WISEWOMAN over time at the individual
level.
For more information please contact
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
4770 Buford Highway NE, Mail Stop K–47, Atlanta, GA 30341-8151
Telephone: 770-488-2424 • Fax: (770) 488-6000
E-mail: cdcinfo@cdc.gov • Web:
http://www.cdc.gov/wisewoman
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Page last reviewed: April 15, 2008
Page last modified: April 15, 2008
Content source: National Center for
Chronic Disease Prevention and Health Promotion
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