Healthy People 2000 Consortium Meeting November 7, 1997

Summary of Breakout Group Discussion Concerning Women's Health

Objectives discussed:

1. The groups discussed the need to have exceptions to the breastfeeding objective because of the possible exposure to the HIV virus or to environmental chemicals. The lactation consultant felt that the goal of 75% allowed for exceptions, and that nothing needed to be added to the background.
   
   She felt that the Lactation groups need to link with the HIV Aids Women's groups to discuss this problem. La Leche, Academy of Pediatrics, ACOG, APA, social workers, etc should be involved in this discussion.
2. Data was requested on the number of pregnant women who are HIV positive in the age range 15-44, for all women and for minorities.
   
   For objective 18.1, the group suggested an objective to slow the rise in the HIV incidence rates in women of childbearing age
3. An International Objective was suggested related to HIV screening: the percentage of women of childbearing age who are counseled, screened and treated for HIV infectivity should be increased.
4. A new definition of breastfeeding was discussed that would take into account full, partial and no breastfeeding definitions used by the ILCA.
5. The group requested that a developmental objective for breastfeeding be considered for workplaces that would make more time and resources available to women in the workplace to pump. Or to increase the number of workplaces with policies conducive to breastfeeding/pumping.
6. An objective was also suggested regarding the training of physicians in breast feeding management. ACOG needs to be involved with this objective.
7. A new objective needs to be developed in maternal and infant health on the availability of postnatal care to women 2 weeks after delivery and up to 6 months postpartum. This not only relates to breastfeeding support, but for infections, episiotomy problems, etc.
8. The group also discussed the broad issue of osteoporosis.
   
   An objective needs to be developed for the increase of calcium stores in girls and women from age 11 to the 30's.
   
   Another objective needs to be considered for insurance coverage for the diagnosis and treatment of osteoporosis. Developing HEDIS indicators for this was suggested.
9. Statistics were requested for the percentage of women with osteoporosis.
10. For objective 2.8, it was suggested we add guidelines for after menopause.
11. The group asked whether we should have a lower age for objective 9.7.
12. It was felt osteoporosis should be placed in chapter 17.
13. It was also felt that an Ovarian Cancer objective should be added to chapter 16 on both decreasing mortality from ovarian cancer from 50% to 30% (with the advice of NCI experts... and a developmental objective to increase ovarian cancer screening with CA125 and ultrasound
14. For objective 16.12, it was suggested to add a GYN exam with a pap test, since there is a disturbing trend now of administering pap tests with no gyn exam.
15. An objective needs to be added to reduce the rates of hysterectomy.
    
    Likewise, an objective needs to be considered to increase education of physicians about endometriosis, both diagnosis and treatment.

Participants

Suzanne G. Haynes, Public Health Service, Office on Women's Health
Nancy Schweers, International Lactation Consultant Association
Margaret Stapleton, Kentucky Department of Health