Shift work increases diabetes in women
Posted by on December 16, 2011 - 6:09am

Women who worked a rotating night shift had an increased risk of type 2 diabetes that was not completely explained by an increase in body mass index (BMI), according to results of a prospective study of women who were enrolled in the Nurses' Health Studies.  Nurses who had 1 to 10 years of night shift work  saw a 5% excess risk for type 2 diabetes compared to women who did minimal to no night shift work. That risk climbed to 40% after a decade of shift work, according to Frank Hu, MD, PhD, from Brigham and Women's Hospital/Harvard School of Medicine in Boston, and colleagues.

Excess risk rocketed to almost 60% for those who had put in 20 years or more, the group reported. Other studies have suggested that rotating night shift work is associated with an increased risk for obesity and metabolic syndrome, both of which are conditions related to type 2 diabetes, they wrote.

Hu's group examined the relationship between the duration of rotating night shift work and the risk of type 2 diabetes in U.S. women who participated in Nurses' Health Studies (NHS) I and II. They also looked at whether greater weight gain was linked to duration of shift work.

Collectively, NHS I and II enrolled nearly 240,000 women. For this study, the women who completed the NHS questionnaire in 1988 or 1989 served as the baseline for this particular study. Participants were excluded if they had diabetes, heart disease, stroke, or cancer at baseline. Follow-up took place at 18 to 20 years.

Rotating night shifts were defined as working at least three nights a month in addition to days and evenings in that same month. The control group consisted of women who did not report a history of rotating night shift work.  In both cohorts, women who spent more years in night shift work were older, more likely to have a higher BMI, and be smokers.

In a secondary analysis, they found that night shift work was also associated with an elevated risk for obesity and excessive weight gain during the follow-up period.   They suggested that, beyond BMI, a reason for the link between shift work and type 2 diabetes may be "chronic misalignment between the endogenous circadian timing system and the behavior cycles." This misalignment has been pegged as a reason for metabolic and cardiovascular disorders, including increases in glucose and insulin, they wrote.

In an accompanying commentary, Mika Kivimäki, PhD, from University College London, and colleagues said the study "probably represents the most accurate estimate of shift work-type 2 diabetes association available to date, suggesting this effect is comparable in size to that of work stress in coronary heart disease and larger than the effect of work stress on type 2 diabetes."

They suggested that in an increasingly "24/7" society, efforts need to be made to prevent type 2 diabetes among shift workers by promoting healthy lifestyle and weight control. Also, prediabetic and diabetic employees need to be identified early and treated accordingly.
Source reference:
Hu FB, et al  PLoS Medicine 2011; 8(12).

 

Broken heart syndrome higher in women and we are not talking about romance!
Posted by on December 14, 2011 - 6:05am

Women were nine times more likely to develop takotsubo cardiomyopathy (TTC), or "broken heart syndrome," than men, and older women more likely than younger, researchers found.

In a database that included 6,178 women, those older than 55 were 4.6 times more likely to develop the condition than younger women, reported Abhishek Deshmukh, MD, a cardiology fellow at the University of Arkansas.

Although it's been known that women have a higher rate of TTC than men, those data come from small studies or single-center studies.  Deshmukh's study was a  significantly larger sample and it confirmed a sharp jump in women over 55 and older.  He surmised that a hormonal component could be responsible since researchers did not see a difference in TTC rate in men related to age.

For the study, the investigators combed the Nationwide Inpatient Sample, the largest hospitalization database from the U.S.   They calculated the overall frequency of TTC to be 5.2 per 100,000 women and 0.6 per 100,000 men.

Typically, patients with TTC present with symptoms of an MI. EKG and enzymes will be positive for an myocardial infarction (heart attack) , but there will be no coronary stenosis (blockage),  Deshmukh said. Once MI is ruled out, clinicians can test for TTC.   In TTC, the left ventricle at the apex will dilate.  In Japanese, “tako-tsubo” means “fishing pot for trapping octopus,” and the left ventricle of a patient diagnosed with this condition resembles that shape. Treatment is consistent with that for congestive heart failure including beta blockers and ACE inhibitors.

It's difficult to predict who will develop TTC, which usually occurs after extreme stress such as the death of a spouse, but positive stresses -- such as winning the lottery -- can also trigger the condition.

However, researchers are examining characteristics of the left ventricle at the onset of TTC. Apparently, there are a number of ventricular variants involved in the disease. "The hope is that with the identification of these characteristics, we can predict who is at risk," Deshmukh said.   He emphasized that recovery from TTC is uneventful and generally assured.

This study was presented at an American Heart Association meeting and the findings still need to be published in a peer reviewed journal.

Mammography: Sometimes science tells us what we don't want to hear
Posted by on December 12, 2011 - 6:08am

While mammograms certainly play an important role in the early detection of breast cancer (and women have responded to this selling point), when weighed against other issues related to quality of life, this benefit  becomes the question of debate among the scientific community.  While researchers have ways to measure quality of life via quality-adjusted life years (QALYS), how do women measure quality of life?  Some recent research done in the UK has caught my attention that found:    after 10 years of mammograms, a woman may get more harm than good from the screening.    When false positive diagnoses and unnecessary surgeries were taken into account, the quality-adjusted life years (QALYs) gained were significantly reduced, James Raftery, PhD, of the University of Southampton, and colleagues reported online in the British Medical Journal.

"Inclusion of the harms from false-positive results and unnecessary surgery reduced the benefits of screening by about half, with negative net QALYs in the early years after the introduction of screening," they wrote.   In 1986, the Forrest report led to breast screening in the U.K., suggesting it would reduce the death rate from breast cancer by almost a third, and with few harms and at low cost.  Since then, a number of harms associated with screening have been acknowledged, particularly false positives and overdiagnosis of cancers that would never have caused symptoms. Also, a recent Cochrane review noted that mortality reductions may be smaller than initially expected, the researchers said.

They looked at data from eight trials involving 100,000 women from the U.K., ages 50 and up, who had breast screening and found that taking the effects of those harms into account reduced the estimate of net cumulative QALYs gained after 20 years by more than half, from 3,301 to 1,536.  And when they changed the reduction in mortality from that suggested by the Forrest study to that suggested by the recent Cochrane review, the net QALYs after twenty years fell even more. .

So how does this finding relate to the everyday woman who, responsibility, has her annual mammogram and feels good about it?    Who finds a small cancer before it is felt?   How do these feelings weigh against the possibility of going through a biopsy (and finding it negative--to her relief).      On the negative side, what if having ten mammograms over the years actually creates a cancer?   These ideas and concepts are hard to understand for the layperson.

Means of reducing the harms from screening might include less frequent screens, particularly for younger women, the researchers said.  Maybe they are right.   Another solution is finding 100% safe ways to detect breast cancer at an early stage.

It is refreshing that Raftery and colleagues recognized this dilemma and wrote that more research is needed on the extent of unnecessary treatment and its impact on quality of life.  Maybe women are not that upset about these procedures vs. missing a cancer.     Further study should also focus on identifying patients who stand to benefit most from surgery, they added.

"From a public perspective, the meaning and implications of overdiagnosis and overtreatment need to be much better explained and communicated to any woman considering screening," they concluded.

So, reader, what do YOU think?

Stress and the Holidays
Posted by on December 10, 2011 - 12:27pm

Handling holiday stress is the focus of this month's e-newsletter from the Institute for Women's Health Research and can be accessed by clicking HERE.   It addresses why stress is handled differently in men and women.

We also thought the following tips on e-shopping might be helpful!.

Now that black Friday is over, many of you have likely decided to do the rest  of your shopping on-line.   Here are some tips to help you avoid problems when shopping from home.

Coupon and Promotion Codes. Search for coupon and promotion codes to be sure you get all discounts the e-tailer currently offers. To find current codes, perform a search for the e-tailer’s name along with the words ‘promotion code’ or ‘coupon’. After applying the coupon code double check your total price to ensure the discount was applied properly. Also check "Deal of the Day" websites, where retailers offer deep discounts on merchandise and services.

Payment Methods. The way you pay matters! You get the most protection with a credit card; debit cards are more risky. Virtual wallets such as PayPal are convenient but have disadvantages, too. Single use credit card numbers are another option – ask your credit card provider if they offer this feature.

Shipping and Handling. Shipping and handling can put a big dent in a shopping budget. Look for sites that offer free or discounted shipping rates. Make sure you understand all conditions placed on free shipping offers and that you’ll get your merchandise in time if you choose that option. The law affords you rights surrounding time-frames for shipping your purchase.

Return Policies. Understand the e-tailer’s return policy. Do they offer a special, extended return policy for the holiday season? What documentation needs to accompany a return? If you purchase online, and the e-tailer also has a brick and mortar site can you return to the store? Do you need a return authorization number or an “RA” to return an item? Will the e-tailer pay for return shipping of the item or do you have to cover that cost? Will you have to pay a re-stocking fee?

Problems with the purchase. One of the most common online purchasing problems is products that don't arrive in time. Even if the company is unable to ship as promised, it must provide you adequate notice promptly and give you a revised delivery date. You must be allowed to agree to the delay or cancel the order and get a refund. If you're not happy about a transaction, you should complain to the retailer using the address or phone number you kept from your transaction receipts. If you don’t receive the merchandise you ordered, file a dispute with your credit card company.

 

Breaking News: FDA ruling on emergency contraception overruled
Posted by on December 7, 2011 - 3:00pm

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today overruled federal drug regulators to block wider access to the emergency contraceptive known as Plan B.
A panel of scientists at the Food and Drug Administration (FDA) determined that Plan B should be made available without a prescription to women of all ages, according to a statement from FDA Commissioner Margaret Hamburg. Hamburg agreed with their decision, but Sebelius intervened to block over-the-counter access.

Many women's professional health organizations have advocated  that drugs for reproductive purposes should not be treated differently than drugs for other medical purposes and many are concerned that politics played a role in this case.   Congressional Republicans have been vocal about their opposition to expanding access to emergency contraception.  This action by Dr. Sibelius raised concerns that scientific experts charged with making access determinations about this drug have been stripped of their ability to make that decision.  If you wish to express yourself on  this current action, you can call  202-401-5781 or 202-205-5445.

The statements by FDA Commissioner and the Secretary of Health and Human Services are provided below for your review:

Statement from FDA Commissioner Margaret Hamburg, M.D. on Plan B One-Step

The U.S. Food and Drug Administration (FDA) has been carefully evaluating for over a decade whether emergency contraceptives containing levonorgestrel, such as Plan B One-Step, are safe and effective for nonprescription use to reduce the chance of pregnancy after unprotected sexual intercourse.

Plan B One-Step is a single-dose pill (1.5 mg levonorgestrel tablet) which is effective in decreasing the chance of pregnancy if taken within 3 days after unprotected sexual intercourse.  The product contains higher levels of a hormone found in some types of daily use oral hormonal contraceptive pills and works in a similar way to birth control pills.

Plan B One-Step was originally approved in July 2009 for use without a prescription for females age 17 and older and as a prescription-only option for females younger than age 17.  In February 2011, Teva Women’s Health Inc. submitted a supplemental application seeking to remove the prescription-only status for females younger than age 17 and to make Plan B One-Step nonprescription for all females of child-bearing potential.

The Center for Drug Evaluation and Research (CDER) completed its review of the Plan B One-Step application and laid out its scientific determination. CDER carefully considered whether younger females were able to understand how to use Plan B One-Step.  Based on the information submitted to the agency, CDER determined that the product was safe and effective in adolescent females, that adolescent females understood the product was not for routine use, and that the product would not protect them against sexually transmitted diseases. Additionally, the data supported a finding that adolescent females could use Plan B One-Step properly without the intervention of a healthcare provider.

It is our responsibility at FDA to approve drugs that are safe and effective for their intended use based on the scientific evidence.  The review process used by CDER to analyze the data applied a risk/benefit assessment consistent with its standard drug review process.  Our decision-making reflects a body of scientific findings, input from external scientific advisory committees, and data contained in the application that included studies designed specifically to address the regulatory standards for nonprescription drugs.  CDER experts, including obstetrician/gynecologists and pediatricians, reviewed the totality of the data and agreed that it met the regulatory standard for a nonprescription drug and that Plan B One-Step should be approved for all females of child-bearing potential.

I reviewed and thoughtfully considered the data, clinical information, and analysis provided by CDER, and I agree with the Center that there is adequate and reasonable, well-supported, and science-based evidence that Plan B One-Step is safe and effective and should be approved for nonprescription use for all females of child-bearing potential.

However, this morning I received a memorandum from the Secretary of Health and Human Services invoking her authority under the Federal Food, Drug, and Cosmetic Act to execute its provisions and stating that she does not agree with the Agency’s decision to allow the marketing of Plan B One-Step nonprescription for all females of child-bearing potential.   Because of her disagreement with FDA’s determination, the Secretary has directed me to issue a complete response letter, which means that the supplement for nonprescription use in females under the age of 17 is not approved.  Following Secretary Sebelius’s direction, FDA sent the complete response letter to Teva today.  Plan B One-Step will remain on the market and will remain available for all ages, but a prescription will continue to be required for females under the age of 17.

A Statement by U.S. Department of Health and Human Services Secretary Kathleen Sebelius

Plan B One-Step is an emergency contraceptive, sometimes referred to as the “morning after pill.” Plan B One-Step is currently labeled over the counter to women ages 17 years and older, but is sold behind the pharmacy counter. It is available by prescription only to women 16 years and younger. My decision does not change any current availability of the drug for all women.

In February 2011, Teva Women’s Health Inc. submitted to the FDA a supplemental new drug application for Plan B One-Step. This application sought to make Plan B One-Step available over the counter for all girls of reproductive age. The science has confirmed the drug to be safe and effective with appropriate use. However, the switch from prescription to over the counter for this product requires that we have enough evidence to show that those who use this medicine can understand the label and use the product appropriately. I do not believe that Teva’s application met that standard. The label comprehension and actual use studies did not contain data for all ages for which this product would be available for use.

FDA has recommended approval of this application in its Summary Review for Regulatory Action on Plan B One-Step. After careful consideration of the FDA Summary Review, I have concluded that the data, submitted by Teva, do not conclusively establish that Plan B One-Step should be made available over the counter for all girls of reproductive age.

The average age of the onset of menstruation for girls in the United States is 12.4 years. However, about ten percent of girls are physically capable of bearing children by 11.1 years of age. It is common knowledge that there are significant cognitive and behavioral differences between older adolescent girls and the youngest girls of reproductive age. If the application were approved, the product would be available, without prescription, for all girls of reproductive age.

The Secretary of the Department of Health and Human Services is responsible, acting through the FDA Commissioner, for executing the Federal Food, Drug, and Cosmetic Act. Today’s action reflects my conclusion that the data provided as part of the actual use study and the label comprehension study are not sufficient to support making Plan B One-Step available to all girls 16 and younger, without talking to a health care professional. Plan B One-Step will still be available over the counter to women ages 17 and older.

Because I do not believe enough data were presented to support the application to make Plan B One-Step available over the counter for all girls of reproductive age, I have directed FDA to issue a complete response letter denying the supplemental new drug application (SNDA) by Teva Women’s Health, Inc..

 

FDA removes HCG weight loss products from market
Posted by on December 6, 2011 - 12:17pm

The Food and Drug Administration (FDA)  and the Federal Trade Commission said over-the-counter weight loss products containing human chorionic gonadotropin (HCG) are fraudulent and illegal, and the agencies have told seven manufacturers to stop selling them.  They have become a popular but fraudulent fad.

"There is no substantial evidence HCG increases weight loss beyond that resulting from the recommended caloric restriction," said Elizabeth Miller, acting director of the FDA's fraud unit for OTC products.

The manufacturers' recommended diet while taking HCG is as low as 500 calories, low enough to create a risk of malnutrition, electrolyte imbalance, cardiac arrhythmias, and gallstone formation, Miller said.   Almost anyone who limits their diet to 500 calories will loose weight without ANY supplements, making the supplement useless.

The warning letters sent to manufacturers of the products note that HCG has not received FDA approval for any weight loss indication. The substance is approved as an injectable drug for certain forms of female infertility and is therefore clearly subject to FDA regulation.

HCG weight-loss products are typically sold over the Internet, often promoted with unsolicited "spam" emails, with such claims as "Lose 26 pounds in 26 days" and "Resets your metabolism."

The companies have 15 days to inform the FDA of the steps they have taken to correct the violations. Theoretically, the firms could seek FDA approval for the weight-loss claims, but the agencies expect that they will simply stop selling the products.  If not, the FDA will take action.   Many of these products are labeled as homeopathic remedies, but they are illegal whether the word "homeopathic" is used or not, said Richard Cleland, assistant director of the FTC's advertising practices division.   If the product is marketed or meets federal standards to qualify as a drug, but is not FDA-approved, it cannot be sold legally, Cleland said.

The seven companies receiving the warning letters, in addition to HCG Diet Direct, included Nutri Fusion Systems, Natural Medical Supply (doing business as HCG Complete Diet), HCG Platinum, Theoriginalhcgdrops.com, and HCG-miracleweightloss.com.

Coffee benefit seen in endometrial cancer
Posted by on December 5, 2011 - 7:42am

Women who drank at least four cups of coffee daily had a 25% lower risk of endometrial cancer as compared with women who consumed less, data from a large prospective cohort study showed.

The apparent benefit was limited to regular coffee, as consumption of decaffeinated coffee was associated with only a trend toward an inverse relationship with endometrial cancer risk, as reported online in Cancer Epidemiology, Biomarkers & Prevention.  Tea consumption was not associated with the risk of endometrial cancer in this study.

"Our findings provide prospective evidence with the potential beneficial role of four or more cups of coffee per day against endometrial cancer risk," Youjin Je, MS, of Harvard School of Public Health in Boston, and co-authors wrote.   "However, recommendations about high coffee consumption should be made with caution. Because our population is relatively health conscious and thus may tend not to add substantial sugar and cream, the results of risk reduction with four cups of coffee per day may not be generalizable to coffee drinkers who typically add sugar or cream to coffee."

In theory, coffee consumption might influence endometrial cancer risk via caffeine's effects on the female hormonal milieu. Studies have shown that coffee or caffeine intake influenced levels of sex hormone binding globulin, free estradiol, C-peptide, and adiponectin, the authors wrote in their introduction.

Epidemiologic studies have demonstrated an inverse association between coffee consumption and endometrial cancer risk, but most of the data was collected retrospectively. Moreover, few studies attempted to control for caffeine intake or coffee components that might influence endometrial cancer risk.

The prospective Nurses' Health Study (NHS) provided a dataset with characteristics that could address limitations of previous investigations of coffee consumption and endometrial cancer, the authors continued. Initiated in 1976, the NHS accumulated data on 121,700 female nurses who were ages 30 to 55 at enrollment.

Je and colleagues analyzed data on a subgroup of 67,470 Nurses' Health Study (NHS) participants who completed an initial food frequency questionnaire in 1980 and six follow-up questionnaires until 2002. In a complicated analysis, the inverse association no longer remained significant for other variables except for the comparison of four or more cups of coffee daily versus less than one cup daily.

Analysis of the type of coffee consumed showed that women who drank four or more cups of caffeinated coffee daily had higher reduction in relative risk than women who drank less than one cup daily. Increasing consumption of decaffeinated coffee was associated with a nonsignificant reduction in the relative risk of endometrial cancer.

"Unmeasured factors associated with coffee drinking habit may also have influenced our results. However, the factors are more likely to be related to unhealthy lifestyles rather than healthy lifestyles, which make the observed association more inverse after adjusting for the factors."

The study was supported by the National Institutes of Health.

Primary source: Cancer Epidemiology, Biomarkers & Prevention

Today's teens will die younger of heart disease--girls fair worse!
Posted by on December 3, 2011 - 7:58am

A new study that takes a complete snapshot of adolescent cardiovascular health in the United States reveals a dismal picture of teens likely to die of heart disease at a younger age than adults do today, reports Northwestern Medicine research.

“We are all born with ideal cardiovascular health, but right now we are looking at the loss of that health in youth,” said Donald Lloyd-Jones, MD, chair and associate professor of preventive medicine at Northwestern University Feinberg School of Medicine.  “Their future is bleak.”   The effect of this worsening teen health is already being seen in young adults. For the first time, there is an increase in cardiovascular mortality rates in younger adults ages 35 to 44, particularly women, Lloyd-Jones said.

The alarming health profiles of 5,547 children and adolescents, ages 12 to 19, reveal many have high blood sugar levels, are obese or overweight, have a lousy diet, don’t get enough physical activity and even smoke, the new study reports. These youth are a representative sample of 33.1 million U.S. children and adolescents from the 2003 to 2008 National Health and Nutrition Examination Surveys.

“Cardiovascular disease is a lifelong process,” Lloyd-Jones said. “The plaques that kill us in our 40s and 50s start to form in adolescence and young adulthood. These risk factors really matter.”

“After four decades of declining deaths from heart disease, we are starting to lose the battle again,” Lloyd-Jones added.

The American Heart Association (AHA) defines ideal cardiovascular health as having optimum levels of seven well-established cardiovascular risk factors, noted lead study author Christina Shay, who did the research while she was a postdoctoral fellow in preventive medicine at Feinberg. “What was most alarming about the findings of this study is that zero children or adolescents surveyed met the criteria for ideal cardiovascular health,” Shay said. “These data indicate ideal cardiovascular health is being lost as early as, if not earlier than the teenage years.”

The study used measurements from the American Heart Association’s (AHA)  2020 Strategic Impact Goals for monitoring cardiovascular health in adolescents and children. Among the findings:

Terrible Diets:   All the 12-to-19-year-olds had terrible diets, which, surprisingly, were even worse than those of adults, Lloyd-Jones said. None of their diets met all five criteria for being healthy. Their diets were high in sodium and sugar-sweetened beverages and didn’t include enough fruits, vegetables, fiber, or lean protein.“They are eating too much pizza and not enough whole foods prepared inside the home, which is why their sodium is so high and fruit and vegetable content is so low,” Lloyd-Jones said.

High Blood Sugar:   More than 30 percent of boys and more than 40 percent of girls have elevated blood sugar, putting them at high risk for developing type 2 diabetes.

Overweight or Obese:   Thirty-five percent of boys and girls are overweight or obese.   “These are startling rates of overweight and obesity, and we know it worsens with age,” Lloyd-Jones said. “They are off to a bad start.”

Low Physical Activity:   Approximately 38 percent of girls had an ideal physical activity level compared to 52 percent of boys.

High Cholesterol:
Girls’ cholesterol levels were worse than boys’. Only 65 percent of girls met the ideal level compared to 73 percent of boys.

Still Smoking:   Almost 25 percent of teens had smoked within the past month of being surveyed.

Blood Pressure:    Most boys and girls (92.9 percent and 93.4 percent, respectively) had an ideal level of blood pressure.    The problem won’t be easy to fix. “We are much more sedentary and get less physical activity in our daily lives,” Lloyd-Jones said. “We eat more processed food, and we get less sleep. It’s a cultural phenomenon, and the many pressures on our health are moving in a bad direction. This is a big societal problem we must address.”

Source:  Northwestern NewsCenter

Impact of HIV/AIDS on Women
Posted by on December 1, 2011 - 1:12am

Today, World AIDS Day, is a good time to reflect on how this disease effects women since it's discovery in 1981.  HIV incidence among women increased gradually until the late 1980s, declined during the early 1990s, and has remained relatively stable since, at approximately a quarter of new infections (23% in 2009).  According to the Center for Disease Control (CDC), more than 290,000 women are living with HIV/AIDS in the US.

Women of color are particularly affected.   Black women accounted for two thirds (64%) of new AIDS diagnoses among women in 2009 and also accounted for the largest share of new HIV infections among women in 2009 (57%).   On the positive side, perinatal HIV transmission, from an HIV infected mother to her baby, has declined significantly in the U.S., largely due to treatments which can prevent mother-to-child transmission.

Globally the news is more dire.   Women represent about half of ALL people living with HIV worldwide, and more than half (59%) in sub-Saharan Africa.   Gender inequalities, differential access to services, and sexual violence increase women's vulnerability to HIV, and women, especially younger women, are biologically and anatomically  more susceptible to HIV.   In Southern Africa, young women are up to 5 times more likely to become infected with HIV than their male counterparts.

An important concern is the fact that young people ages 13-29 account for 39% of new infections in the US and 42% of new cases globally---the largest share of any age group.

Source:   Henry J. Kaiser Family Foundation

Maggie Daley recognized the importance of women's health
Posted by on November 30, 2011 - 2:08pm

As the City of Chicago and the nation mourns the death of former first lady of Chicago, Maggie Daley, I reflect on a lesser known aspect of  this remarkable woman.  Yes, she is well known for her strong support of the city's school children and the importance of bringing the Arts into their lives.   She was also a supporter of breast cancer causes even before she faced her own diagnosis and she participated in many of the events sponsored by the Y-ME National Breast Cancer Organization, founded and based in Chicago.

But not everyone knows that in 1993, she spearheaded the development of a Task Force on Women's Health that resulted in the June 1994 release of an "Urban Women's Health Agenda" in partnership with the Chicago Department of Health.  I was privileged to be a member of this Task Force along with an amazing diverse group of women who advocated for better health for ALL women in Chicago.  Today, I looked through a copy of that report and realized how visionary it was.  The report's themes are still important and include:

  • Improving women's health means improving girls' self esteem
  • Health policy must consider community based institutions and families
  • Health care must integrate at the systemic and community level
  • More women should be encouraged and supported to enter health careers
  • The role of violence as a health determinant must be addressed
  • Research studies must include more women and look for sex differences
  • Primary care is critical to promoting healthy behaviors.

The comprehensive approach to improved healthcare for all that is found in this report is worth visiting as we struggle with the current health care debate.   Maggie was always about people and she recognized how diverse we are as a city and a nation.     Let's remember this as we continue to seek a better health care system.

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