WBGH survey shows growth in women’s health
Osteoporosis, family violence are underserved
In a survey that questioned more than 200 large companies (5,000 employees to more than 300,000 employees), the Washington (DC) Business Group on Health (WBGH) found that more and more employers are offering programs to respond to the health care needs of female employees.
Overall, the survey revealed that American corporations provide a wide range of health services that benefit women, particularly through their HMOs. It further shows that compared to traditional health care plans, point of service (POS), preferred provider organizations (PPOs) and HMO plans provide the most coverage for women’s preventive health needs.
A closer look at the responses reveals that breast cancer screening and prenatal care are the most frequently offered women’s health services (more than 80% of managed health care plans; more than 50% of fee-for-service plans), while the least commonly covered tests among all health plans were for depression, family violence, and osteoporosis (about one-third of managed care and fee-for-service plans, and less than 5% of free-standing programs cover bone density tests).
(For a further breakdown of the survey findings, see charts, p. 137.)
No big surprises
The survey held no major surprises for women’s health experts. "If I could have guessed, I would have said that companies are not focusing enough on mental health and osteoporosis," says Jodi Fuller, MA, women’s health manager for the Federal National Mortgage Association (FNMA) in Washington, DC.
Veronica Goff, MS, a director of the WBGH, agrees but notes that this was not necessarily the purpose of the survey. "Our whole purpose is to promote knowledge of and commitment to women’s health issues," she says. "We know that compared with men, women have more chronic and acute illnesses and require more physicians’ visits."
Fuller concurs. "The health needs of women are very different from men. Yet most research until recently, for example, on heart disease, has been done only on men. The sexes react differently to different disease processes, and research on women is just being done now."
A business necessity
The new business reality makes it imperative that employers address women’s health issues, says Goff. "If you look at the general trends in the working population, women are probably 50% of the work force, and there are certain types of illnesses that strike women more often. We can do a much better job than in the past in targeting resources, and women’s health is one of those areas we can address."
What is an effective women’s health program? "The ideal program accompanies women through their life span," says Fuller. "This includes sexual health, healthy pregnancy, breast health, prevention of cancer and heart disease, mental health, healthy lifestyles, violence prevention, and healthy aging."
"Ideally, if we can bring about a change wherein the health plan creates a whole spectrum from prevention through chronic care, large and small companies would benefit," adds Goff.
The FNMA’s efforts in the area of women’s health could serve as a positive role model for other companies to emulate. To begin with, the company actually created a position of women’s health manager.
"We already had a manager of health services," notes Fuller. "On top of that, Fannie Mae [FNMA] had made a special commitment to making women’s health a top priority."
Part of that commitment entails addressing one of the most underserved areas in women’s health: osteoporosis. What th e FNMA learned may convince other companies to follow suit.
In what Fuller calls "a field study," she has gleaned some important information. "We found that women at a younger age had lower bone masses than we thought they should," she notes. "If that’s true in the larger population, we might be underestimating the risks later on. Older women have a higher risk of osteoporosis, but if they start addressing the risk factors prior to menopause, it may prevent or minimize further bone loss."
For example, adolescents need to be reminded to drink milk and exercise. "Where I am, we have working women who can impact those girls as their mothers, so both of them can modify their risk profile and we know osteoporosis is preventable," says Fuller.
Just raising awareness has been beneficial, she notes. "We found that with the employees who received a bone density screening, they were the ones to bring up osteoporosis to their physicians."
Still a long way to go
For more widespread change to occur, traditional thought processes must shift, says Goff. "In the past, some mental health issues, such as family violence, were not really seen as employer issues," she notes. "Now, we’re hearing more and more about domestic violence, and we must begin to consider the costs to the company not the least of which are the health care costs involved." Employers should also look at the indirect costs that result from failure to recognize and treat certain mental health conditions, such as depression.
"Only a select group of companies address women’s health in its totality," says Fuller. "Instead of just saying, Well, we provide mammographies and prenatal care,’ what about the concept of total health of one’s mind, body, and spirit? Employers have a social responsibility to address these issues."
[Editor’s Note: The WBGH has published its survey on women’s health programs, along with five case studies of innovative corporate programs, in a publication called "Corporate Strategies for Women’s Health." Also available from the WBGH is "The Corporate Checklist for Women’s Health," which provides steps for implementing women’s health programs and policies through a range of corporate functions. The checklist also includes mini case studies of five corporate programs. To request one or both of these publications, contact: Washington Business Group on Health, 777 North Capitol Street, NE, Washington, DC 20002. Telephone: (202) 408-9320. Fax: (202) 408-9332.]
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