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Show excluded.5,31 It is important to note that these differences in self-reported illness may be due to differences in the ways in which women and men experience and report illness as opposed to an increased prevalence of illness among women.31 Women in Utah differ from women in other states in some important ways. On average, Utah women have more children than women elsewhere in the United States and, since 1980, have been more likely than other American women to work outside the home. The health effects of women's participation in the paid labor force have been the subject of numerous studies.32,33.34,35 Working outside the home may enhance women's self esteem and overall satisfaction with life.32 The multiple roles that working women, particularly working mothers, must juggle also create stress.33 Some infer that women who work outside the home are less healthy than those who don't, but this view is disputed by others who believe that women who combine paid employment with domestic responsibilities experience no increased health risk.35,36 Fortunately, many Utah women are hearing important health messages over the noise of everyday life. The vast majority of Utah women are seeking prenatal care in the first trimester of pregnancy. Over time, more women are having their cholesterol levels and blood pressures measured. More women are also undergoing screening tests for breast and cervical cancers. Clearly Utah women are taking responsibility for their health in several areas. But there is room for improvement as demonstrated by the disappointing trends in exercise levels and obesity. Access to health care influences whether a woman will seek preventive services and medical care. Recently published data from The Commonwealth Fund Survey conducted in 1993 identified several barriers that prevent women from receiving screening tests. These included financial barriers (a lack of money and not having health insurance coverage) as well as having inadequate information.37 While not having health insurance coverage was the most common barrier, it was not the only one. The study found that nearly one in four women with health insurance did not obtain preventive services. Other reasons cited by women as barriers to obtaining care were a lack of time and a lack of awareness that preventive services were covered by insurance plans.37 In Utah, most but not all women with health insurance are receiving recommended preventive services. Available figures from three HMOs in Utah indicate that approximately 68 percent of women enrollees age 52 through 64 received a mammogram in the preceding two year period and that about 71 percent of women enrollees age 21 through 64 had a Pap smear in the preceding three year period.s Recommendations The "Women's Health in Utah" report raises important questions, some of which can only be answered with additional study. Several of the most important issues highlighted by the report and this article have been identified by the Utah Department of Health as priority issues that will receive ongoing or new attention. (Table 2) The "Women's Health in Utah" report recommends several ways in which the public and private health sectors can work together to address women's health issues. One example is the collaboration of the Utah Department of Health with providers and health plan managers to examine the variability in Utah's cesarean section rates with the intent to improve health care delivery.38 Another is promoting the collection of more gender-specific data and ensuring that gender-specific analyses of those data are performed. In the words of Martha Romans, director of the Jacob's Institute of Women's Health, "Despite the recent increased attention to women's health, the need for sound data about women's health experiences has never been greater. Efforts to allocate limited resources in the health care delivery system and to institute health care reform underscore the necessity for data on the unique health needs of women, lest they be overlooked by policy makers and reformers. "31 The prevention and treatment of diseases that are unique to or more common among women are already receiving increased attention at the national level.39 The National Institutes of Health (NIH) established the Office of Research on Women's Health in Utah's Health: An Annual Review 1996 |