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Women and Health Care Issues and Responses

Pay inequity between women and men:
  • A higher percentage of women have low pay, non-union part-time employment that generates a much lower income than do their male counterparts. As a result, women are twice as likely as men to be underinsured.Women earn only 71 cents for each dollar a man earns. For women of color the problem is more severe.The chances of a single mother bringing in the comparable income to a married couple is extremely small.Women represent two-thirds of all Medicaid recipients. Welfare reform poses an additional threat to this population by cutting Medicaid benefits in a two-year time period for recipients. With employment opportunities limited, more families of women and their children may face the possibility of not having health coverage.
  • Reductions in the eligibility income standard for welfare has also been a factor in the increase of the number of families without health coverage. The reduction from 55% to 47% of the poverty line precludes more families from being eligible for Medicaid benefits.
  • Minority women face lower levels of education, higher levels of unemployment and poverty, and the lack of private or public health insurance coverage.Among poor black families, 78.3 percent were maintained by women with no husband present.Hispanics are the fastest growing minority in the United States. Poverty and lack of health insurance are the greatest impediments to health care for Hispanics.American Indians fall 31.6% below the poverty level, an 18.5% difference over all other U.S. races.In 1990, 13.4% of American Indian women age 16 and older were unemployed, compared with 6.2 percent for the U.S. females of all races.Lesbians experience discrimination and stigmatization on the basis of gender and sexual orientation. Homophobic attitudes and behaviors by providers play an important role in access. When lesbians feel unsafe or unwelcome in health care settings they may not seek out medical attention as quickly or readily as do heterosexuals.Legal restrictions against homosexual marriages limits lesbian’s access to spousal insurance benefits.
  • The paucity of research conducted on lesbians and women of color is also an area of concern.

After strong and collective advocacy efforts by consumers and advocates the Centers for Disease Control and Prevention expanded the AIDS definition in 1993 to include some female specific symptoms.Globally in 1993 there were approximately 3 million women living with HIV/AIDS. Currently there are an estimated 14 million women living with HIV/AIDS (UNAIDS 1998).The number of women living with AIDS in the United States continues to increase. In 1993 there were 24,323 reported AIDS cases among women. This number grew to 115,907 in 1998.Women continue to be understudied, underreported and underdiagnosed.

  • Women currently make up 32% of new HIV cases in the United States yet they make up only 17% of federally funded research studies.
  • The majority of federally funded studies involving women are focused on HIV transmission and pregnancy. However most women living with HIV/AIDS in the United States are not pregnant.

While the percentage of women in the United States living with AIDS in a specific racial/ethnic category has remained fairly constant, women within minority racial/ethnic groups are continuously over-represented in proportion to their percentage of the population.

1999 Female AIDS cases Percentage of U.S. Population
White (22%) 71.7
Black (55%) 12.2
Hispanic (20%) 11.6
Asian Pacific Islander (1%) 3.8
American Indian/Alaska Native (1%) 0.7

HIV/AIDS infected women with limited economic resources are often forced to serve as their families primary caregiver. The socioeconomic stressors involved with this responsibility may heighten the physical and mental symptoms of HIV/AIDS.*Statistics drawn from UNAIDS, CDC, and www.thebody.com (1999).

Global Response:

I. Offer more health care options for working women in low-pay, non-union jobs.II. Offer monetary incentives for women with children who wish to further their education (i.e. tax deductions).III. Community health centers.
Physical and logistical factors which include the proximity of health services to where women live and the availability of transportation can determine access to health care. Community health centers would provide an affordable and readily available option for women.IV. Advocate for more research in the area of women’s health and women’s health care, including minority populations.V. Pay equity legislation.
Pay equity legislation would eliminate the disparities by increasing women’s pay to be comparable to that of men, thereby increasing women’s ability to afford quality health care.

NASW’s Response:

I. Educate SWs on issues of women’s health care through conferences and workshops.

  1. Access to health care.
  2. How discrimination against women and especially poor women, minority women, and women with HIV/AIDS, effects their access to health care.

II. Integrate women’s health and health care content into NASW programs.

  1. Include women’s health and access issues into Baltimore Conference (1997) and future conference.

III. Advocate for legislative responses to women’s health issues.

  1. Include women’s health care issues into NASW’s policy statements.

IV. Advocate for funding for research on women’s health in relation to social work and to support women’s health activities.V. Define and develop the social worker’s role in women’s health.

  1. Inform social workers about the issues in women’s health (i.e. access) through trainings at state chapters.
  2. Provide background information on the issue, skills in advocating for legislative change, and ways in which social workers can ameliorate the problem within their client population.

VI. Establish a network for chapter’s and members to access information on women’s health issues.

  1. Provide information through NASW’s home page on the internet.

Content authored by Aniya Dunkley, MSW (1997); HIV/AIDS content updated by Fatimaah Carmichael, MSW Intern (2000).
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