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INTRODUCTION
In 2003, women represented 51 percent of the nearly 283 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
almost 58 percent of the population. The growing diversity of the
United States population is reflected in the racial and ethnic distribution
of women across age groups. Black and Hispanic women account for
9 and 6 percent of the female population aged 65 and older, respectively,
but they represent 16 and 20 percent of females under 15 years of
age. Non-Hispanic Whites account for 82 percent of women aged 65
years and older, but only 60 percent of those under 15 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 2003, 63 percent
of non-Hispanic White females reported themselves to be in excellent
or very good health, compared to only 53 percent of Hispanic women
and 51 percent of non-Hispanic Black women. Minority women are disproportionately
affected by a number of diseases and health conditions, including
AIDS, diabetes, hypertension, and overweight and obesity. For instance,
in 2003 non-Hispanic Black and Hispanic women accounted for more
than three-fourths of women with AIDS. In 1999, AIDS was the fifth
leading cause of death among women aged 25 to 44 years, but was
the third leading cause of death among African American women of
the same age. Just over one-third of non-Hispanic White women have
ever been tested for the Human Immunodeficiency Virus (HIV), compared
to 54 percent of non-Hispanic Black women and 47 percent of Hispanic
women.
Diabetes is a chronic condition and a leading cause of death and
disability in the United States. It is especially prevalent among
non-Hispanic Black women, among whom it occurs at a rate of 91 per
1,000 women, compared to 61 per 1,000 non-Hispanic White women.
Hispanic women are also affected at a rate of 61 per 1,000 women,
and the lowest rate (47 per 1,000 women) occurs among Asian women.
Hypertension, or high blood pressure, is also more prevalent among
non-Hispanic Black women than women of other races. This disease
occurs among non-Hispanic Black women at a rate of 360 per 1,000
women, compared to 261 per 1,000 non-Hispanic White women and 195
per 1,000 Hispanic women.
Overweight and obesity are occurring at an 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 25.0 or greater is considered overweight, and a BMI of 30.0 or
greater is considered obese. In a survey conducted between 1999
and 2002, 27 percent of non- Hispanic Black women were overweight,
as were 33 percent of Hispanic women. Obesity follows the same trend,
and was most prevalent among non-Hispanic Black women, occurring
in 45 percent of that population. Overall, 73 percent of non-Hispanic
Black women, 67 percent of Hispanic women, and 56 percent of non-Hispanic
White women are considered overweight or obese.
Some conditions, such as arthritis, disproportionately affect White
women. In 2003, the rate of arthritis among non-Hispanic White women
was 281 per 1,000 women, compared to 239 per 1,000 non-Hispanic
Black women and 144 per 1,000 Hispanic women. Mental illness is
also more prevalent in non-Hispanic White women than women of other
races and ethnicities. The 2002 suicide rate among non-Hispanic
White females aged 15 and older was 5.1 per 1,000 women; this was
the highest rate of women of any race or ethnicity. American Indian/
Alaska Native women had the second- highest suicide rate (4.1 per
1,000), followed by Asian/ Pacific Islander women (3.0 per 1,000),
Hispanic women (1.8 per 1,000) and Black women (1.6 per 1,000).
Many diseases and health conditions can be avoided or minimized
through preventive health care. In 2002, 10.1 percent of physician
office visits made by non-Hispanic Black women included a Pap smear
to screen for cervical cancer, compared to 7.6 percent of visits
made by non-Hispanic White women. Conversely, 5.3 percent of visits
by non-Hispanic White women included a mammogram, compared to 4.0
percent of visits made by non-Hispanic Black and Hispanic women.
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 2003, 45 million Americans were without
health insurance (15.6 percent of the population and 14.4 percent
of females). Among women, Hispanics are most likely to be uninsured,
at 29.6 percent. Asian and Black women also had high rates of uninsurance
(18.5 and 17.8 percent, respectively); non-Hispanic White women
are least likely to be uninsured (10.4 percent). Non-Hispanic White
women were most likely to use an office-based source of care (91
percent), while Hispanic women were least likely to do so (76 percent).
Among non- Hispanic Black women, almost 2 percent used an emergency
department as their usual source of care, compared to 0.4 percent
of non-Hispanic White women. Among Hispanic women, 20 percent did
not have a usual source of care, compared to 8 percent of non-Hispanic
White women.
Many behaviors can promote health and help prevent disease and disability.
Physical activity is an important lifestyle factor that directly
impacts health, yet only 23 percent of non- Hispanic Black women
and 22 percent of Hispanic women engaged in the recommended amount
of physical activity in 2003. Non-Hispanic White women were the
most likely to engage in recommended activity (33 percent). Some
forms of contraception, when used properly, can prevent unintended
pregnancy and the spread of sexually transmitted diseases (STDs).
In 2002, 34 percent of non-Hispanic White women who were using contraception
chose the contraceptive pill, making it the most popular form of
contraception among that group. Female sterilization was the most
common method of contraception among non-Hispanic Black and Hispanic
women (used by 39 and 34 percent, respectively). However, these
forms of contraception do not prevent the spread of STDs or HIV.
Condoms, which can both prevent pregnancy and the spread of STDs,
are the primary form of contraception for only 17 percent of non-Hispanic
White women, 19 percent of Hispanic women, and 20 percent of non-Hispanic
Black women.
While some behaviors positively impact health status, a number of
other behaviors, such as cigarette smoking and drug use, can have
the opposite effect. In 2002-2003, 36 percent of non-Hispanic White
women reported cigarette use in the past year. Asian women were
least likely to report cigarette use (13 percent), followed by Hispanic
women (19 percent) and non-Hispanic Black women (25 percent); American
Indian/Alaska Native women were most likely to report cigarette
use in the past year (52 percent). Binge drinking—five or
more drinks on the same occasion—is another behavior that
can negatively impact health. Similar to cigarette use, American
Indian/Alaska Native women reported the highest rate of past-month
binge alcohol use in 2002-2003 (35 percent), followed by non-Hispanic
White women (26 percent), non-Hispanic Black women and Hispanic
women (19 percent each). Asian women were least likely to report
binge alcohol use in the past month (9 percent).
Preventive care during pregnancy is important to the health of both
mother and baby. In 2003, 89 percent of non-Hispanic White women
began prenatal care in the first trimester, compared to 85 percent
of Asian/Pacific Islanders, 77 percent of non-Hispanic Blacks and
76 percent of Hispanics; American Indian/ Alaska Native women were
least likely to receive first trimester care (71 percent). Breastfeeding
positively affects the health of children, and it has been shown
to improve maternal health as well. In 2003, Asian women were most
likely to breastfeed in the hospital (74 percent), followed by White
women (71 percent), and Hispanic women (64 percent); Black women
were least likely to do so (48 percent). Behaviors such as smoking
and drinking during pregnancy can negatively affect the health of
women and their unborn children. In 2002-2003, 18 percent of pregnant
women reported cigarette use in the past year with pregnant non-Hispanic
White women reporting the highest rate of past-year cigarette use
(25 percent). Binge drinking was far less common among pregnant
women with only 4 percent reporting it in the past month.
Women’s Health USA 2005 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, and
this data book provides information on indicators that can help
us to track the health behaviors, risk factors, and health care
utilization practices of women throughout the United States.
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