The increasing focus on Women's Rights in the United States during the 1980s focused attention on the fact that many drugs being prescribed for women had never actually been tested in women of child-bearing potential, and that there was a relative paucity of basic research into women's health. In response to this the National Institutes of Health (NIH) created the Office of Research on Women's Health (ORWH) in 1990 to address these inequities. In 1993 the National Institutes of Health Revitalisation Act officially reversed US policy by requiring NIH funded phase III clinical trials to include women. This resulted in an increase in women recruited into research studies. The next phase was the specific funding of large scale epidemiology studies and clinical trials focussing on women's health such as the Women's Health Initiative (1991), the largest disease prevention study conducted in the US. Its role was to study the major causes of death, disability and frailty in older women. Despite this apparent progress, women remain underepresented. In 2006 women accounted for less than 25% of clinical trials published in 2004, A follow up study by the same authors five years later found little evidence of improvement. Another study found between 10–47% of women in heart disease clinical trials, despite the prevalence of heart disease in women. Lung cancer is the leading cause of cancer death amongst women, but while the number of women enrolled in lung cancer studies is increasing, they are still far less likely to be enrolled than men.
Nutrition interventions that target mothers alone inadequately address women's needs across their lives: during adolescence, preconception, and in later years of life. They also fail to capture nulliparous women. The extent to which nutrition interventions effectively reach women throughout the life course is not well documented. In this comprehensive narrative review, we summarized the impact and delivery platforms of nutrition-specific and nutrition-sensitive interventions targeting adolescent girls, women of reproductive age (nonpregnant, nonlactating), pregnant and lactating women, women with young children <5 y, and older women, with a focus on nutrition interventions delivered in low- and middle-income countries. We found that although there were many effective interventions that targeted women's nutrition, they largely targeted women who were pregnant and lactating or with young children. There were major gaps in the targeting of interventions to older women. For the delivery platforms, community-based settings, compared with facility-based settings, more equitably reached women across the life course, including adolescents, women of reproductive age, and older women. Nutrition-sensitive approaches were more often delivered in community-based settings; however, the evidence of their impact on women's nutritional outcomes was less clear. We also found major research and programming gaps relative to targeting overweight, obesity, and noncommunicable disease. We conclude that focused efforts on women during pregnancy and in the first couple of years postpartum fail to address the interrelation and compounding nature of nutritional disadvantages that are perpetuated across many women's lives. In order for policies and interventions to more effectively address inequities faced by women, and not only women as mothers, it is essential that they reflect on how, when, and where to engage with women across the life course.
The gym is in the basement with seemed like slow ceiling and dim lighting. I tried to attend a zumba class -- the class was in the middle floor, cramped and crowded. I couldn't see the instructor (in fact I didn't even know who the instructor and what was going on) people looked lost in the class. I kept bumped into one of the cycles. After 10mins of frustration, I gave up on zumba and just hopped on a treadmill, only to find the treadmill was placed on unleveled with a hole on the floor! My treadmill was flip-flopping with each step. I then went to the stretching area hoping to may just suck it up for the next 30 minutes and call it a day. I found the mat to be dirty and the corner for stretching was dark and tight. There's not enough lockers to use. The shower stalls look small and dirty. I just didn't get an good feeling after this first class.
Women's health is positioned within a wider body of knowledge cited by, amongst others, the World Health Organization, which places importance on gender as a social determinant of health. While women's health is affected by their biology, it is also affected by their social conditions, such as poverty, employment, and family responsibilities, and these aspects should not be overshadowed.
Adult women, and particularly women with children, were the primary targets for empowerment interventions. Empowerment interventions were predominantly delivered through community-based programs, including home visits, community groups, and community centers (5, 161, 163). There was some evidence that empowerment interventions that included delivery platforms such as radio and television, as a complement to the community- and home-based delivery platforms (5), could have some impact on reaching a wider audience. Adolescent girls were largely not the target of empowerment interventions, except for those relating to reproductive health (158), and could potentially benefit from them.
Grains, vegetables and fruits are essential to getting the vitamins, minerals, complex carbohydrates (starch and dietary fiber) and other nutrients you need to sustain good health. Some of these nutrients may even reduce your risk of certain kinds of cancer. But experts say we rarely eat enough of these foods. To make matters worse, we also eat too much of unhealthy types of food, including fat (and cholesterol), sugar and salt.
Fiber is an important part of an overall healthy eating plan. Good sources of fiber include fortified cereal, many whole-grain breads, beans, fruits (especially berries), dark green leafy vegetables, all types of squash, and nuts. Look on the Nutrition Facts label for fiber content in processed foods like cereals and breads. Use the search tool on this USDA page to find the amount of fiber in whole foods like fruits and vegetables.
Social protection interventions are intended to support vulnerable households by providing them with in-kind (e.g., food) or cash transfers. The impact of social protection on women's nutrition was nuanced, as such interventions were associated with protecting against adverse nutrition outcomes, but were also associated with excess weight gain in some settings. In-kind transfers, including food baskets, fortified foods, and school lunches, improved women's and adolescent girls’ energy and micronutrient intakes, as described in the preceding sections. Both CCTs and unconditional cash transfers were common around the world and were associated with improvements in health care utilization and increased food expenditures (5, 14, 195, 196). CCTs were dependent on “conditions” such as school attendance and health care utilization. For children in Burkina Faso, CCTs were associated with greater numbers of preventative health visits compared with unconditional cash transfers (197), and this could be relevant to adult women's health care utilization as well. Unconditional cash transfers, such as old-age pensions, were also common, including in low- and middle-income countries (5, 198). Older women who received pensions had fewer missed meals (199), although evidence was mixed (200). In South Africa, granddaughters who cohabitated with women who received pensions had improved anthropometric measures and fewer missed meals, indicating spillover effects of pension transfers (199, 201).
Globally, women's access to health care remains a challenge, both in developing and developed countries. In the United States, before the Affordable Health Care Act came into effect, 25% of women of child-bearing age lacked health insurance. In the absence of adequate insurance, women are likely to avoid important steps to self care such as routine physical examination, screening and prevention testing, and prenatal care. The situation is aggravated by the fact that women living below the poverty line are at greater risk of unplanned pregnancy, unplanned delivery and elective abortion. Added to the financial burden in this group are poor educational achievement, lack of transportation, inflexible work schedules and difficulty obtaining child care, all of which function to create barriers to accessing health care. These problems are much worse in developing countries. Under 50% of childbirths in these countries are assisted by healthcare providers (e.g. midwives, nurses, doctors) which accounts for higher rates of maternal death, up to 1:1,000 live births. This is despite the WHO setting standards, such as a minimum of four antenatal visits. A lack of healthcare providers, facilities, and resources such as formularies all contribute to high levels of morbidity amongst women from avoidable conditions such as obstetrical fistulae, sexually transmitted diseases and cervical cancer.
Women who have very low levels of sunlight exposure or have naturally very dark skin are at risk of vitamin D deficiency. Those affected may include women who cover most of their body when outdoors, shift workers, those who are unable to regularly get out of their house or women in residential care. Women who have certain medical conditions or are on some medications may also be affected.
The impact of income-generation interventions on women's nutrition has not been sufficiently evaluated. Income-generating interventions were associated with increases in women's income, empowerment, and household decision-making (161, 164–166). However, these gains were often at the expense of more work for women (5). Income-generation interventions have been associated with increased food-related expenditures, improved household food security, and greater household dietary diversity (160, 161, 165–168). Income-generating interventions targeting adolescents improved their social status; however, these showed no impact on their access to food, nor on individual and household food security (169). There was also limited evidence of impacts of income-generating interventions on women's anthropometric and biochemical nutrition outcomes (5, 169, 170). Increased income was associated with reductions in maternal underweight and anemia, but the reductions were modest (171). Studies suggested that the limited impact was related to continued poor access to health services (167), poor measurement, and the need for longer evaluation periods (164, 165, 167, 169).
You know it's easier to fall off the healthy-eating wagon when the person across the table from you is going whole-hog on mozzarella sticks, but science still felt the need to study this. And evidence presented at the 2013 Agricultural and Applied Economic Associations annual meeting backs you up: In the study, people made similar dining choices as their companions did, possibly because we simply want to fit in. Not all eating partners make a bad influence, though. The report further speculates that if you're eating with a health-conscious person, you may be more likely to order something more nutritious as well.
The delivery platforms of birth spacing and family planning interventions were often associated with health clinics and community health posts (148–150). Many interventions targeted lactating women during the follow-up with their young children (148, 151–153). Home visits by community health workers and service provision at community health posts and mobile clinics were also used to target women and adolescents who were married, and were found to be effective at increasing use of contraception (150, 154). School-based programs were also effective at reaching adolescent girls and increased their knowledge about contraceptives and sexually transmitted infections, use of contraception, and treatment of sexually transmitted infections (155). In high-income settings, school-based interventions were most effective at reducing pregnancies and repeated pregnancies among adolescents when contraception was also available on-site (107). This might have implications for their effectiveness in low- and middle-income countries, as well. In addition, formative work of 2 ongoing studies suggested that mass media, mobile devices, texting, and community mobilization could also be used as platforms to reach adolescent girls and women of reproductive age (156, 157). Community-based programs that target men, families, and communities, beyond those that reach married and postpartum women alone, have potential to change cultural norms and enhance women's health outcomes; however, these are not well captured in the literature.
It’s one thing to tell women that their curves are awesome; it’s another thing to depict women who actually have them, making Shape’s #LoveMyShape section the most inspiring part of its site, much more than that bit about those last five pounds. Showing always trumps telling. Ramping up the normal-sized body movement might actually help get women on the road to “Hot & Happy”—as they realize that the order of those two adjectives should be transposed.
While the rates of the leading causes of death, cardiovascular disease, cancer and lung disease, are similar in women and men, women have different experiences. Lung cancer has overtaken all other types of cancer as the leading cause of cancer death in women, followed by breast cancer, colorectal, ovarian, uterine and cervical cancers. While smoking is the major cause of lung cancer, amongst nonsmoking women the risk of developing cancer is three times greater than amongst nonsmoking men. Despite this, breast cancer remains the commonest cancer in women in developed countries, and is one of the more important chronic diseases of women, while cervical cancer remains one of the commonest cancers in developing countries, associated with human papilloma virus (HPV), an important sexually transmitted disease. HPV vaccine together with screening offers the promise of controlling these diseases. Other important health issues for women include cardiovascular disease, depression, dementia, osteoporosis and anemia. A major impediment to advancing women's health has been their underrepresentation in research studies, an inequity being addressed in the United States and other western nations by the establishment of centers of excellence in women's health research and large scale clinical trials such as the Women's Health Initiative.
So we can applaud some of the efforts of Women’s Health. As editor Amy Keller Laird announced in that Jan/Feb issue, the magazine “will no longer be using fitness models in our monthly ‘15-Minute Workout.’ We’ll feature readers of various body types and sizes,” like the refreshingly normal-sized Morgan Gibson Kanner, hurling a weight plate around in stretchy workout clothes. As progressive as the layout is, Laird points out that “it’s logistically difficult to book nonmodels who have day jobs”; sounds like she should hook up with Willcox’s modeling service.