Vanderbilt's Katherine Hartmann, M.D., Ph.D., spoke at Tuesday's event marking the release of the 2009 Tennessee Women's Health Report Card. (photo by Anne Rayner)
Report card grades health status of Tennessee women
When it comes to grading women’s health in Tennessee, there’s good news and bad news.
Some of the bad news — more than one-third of women 18 and older in Tennessee are getting no leisure physical activity, and nearly one-third are obese with a Body Mass Index (BMI) of greater than 30.
The good news — much of what needs fixing is fixable, with small investments in personal change.
The 2009 Tennessee Women’s Health Report Card, released this week, provides a comprehensive picture of the health status of the state’s 3.1 million women. The report card gives grades of A-F, looking at a five-year span of data about reproductive health, sexually transmitted infections, leading causes of death, modifiable risk behaviors, preventive health practices and barriers to health.
Grades were based primarily on comparison to national Healthy People 2010 goals, a broad-based U.S. Health and Human Services (HHS) initiative.
A collaborative effort of the Vanderbilt Institute for Medicine and Public Health, the Vanderbilt Institute for Clinical and Translational Research, Meharry Medical College, East Tennessee State University and the Tennessee Department of Health, the Report Card highlights areas that need attention, especially in supporting lifestyle changes to prevent long-term health consequences.
Some of the areas of concern:
• The proportion of women with each of the following diseases has increased: diabetes, hypertension and high cholesterol.
• Lung cancer rates continue to rise, and more than one in five women smoke cigarettes.
• Sexually transmitted infections continue to be a problem, with the highest risk among minority women.
At Tuesday's event, Jeff Balser, M.D., Ph.D., right, talks with Michael Warren, M.D., medical director of the Governor's Office of Children's Care Coordination, and Veronica Gunn, M.D., chief medical officer of the Tennessee Department of Health. (photo by Anne Rayner)
The Report Card also highlights areas of continued improvement and new successes:
• More than 75 percent of women over the age of 40 have received a mammogram in the last two years.
• While Tennessee has one of the highest infant mortality rates, risk is decreasing among all groups.
• Deaths caused by diabetes have decreased substantially.
• Hip fractures among women over 65 have declined steadily.
“There is always media focus on bad numbers – strokes are up; hypertension is up; heart attacks are up,” said Katherine Hartmann, M.D., Ph.D., associate professor of Obstetrics and Gynecology and deputy director of the Vanderbilt Institute for Medicine and Public Health.
“But we don’t want to beat people up. It’s not a guiltfest. We want to get the word out that relatively modest changes in levels of activity and in how you eat, and in things like participating in smoking cessation, are small investments in your health that can make a difference.”
Hartmann said she believes the most surprising grades on the Report Card are in the sexually transmitted infections category, mostly F’s.
“But this can be some of the trickiest data on report cards, because it’s not always possible to know if there is an increased spread of STIs or if it’s simply improvement in detection efforts,” Hartmann said.
“Clearly the news is bad, but we have a strong indication that the numbers are related to stronger vigilance and screening, not a worsening trend.”
Information generated by the Report Card will serve many needs.
“Understanding disparities in health status is a high priority as we work to improve health equity,” said Tennessee Health Commissioner Susan Cooper, M.S.N., R.N. “Physical and social determinants impact women's health. Reports like this can be a useful tool for identifying areas of need and opportunities for improvement.”
Although many of the grades are disappointing, there is room for hope, according to one of the Report Card’s authors.
“I don’t think we’d graduate with this Report Card,” said Valerie Montgomery Rice, M.D., professor of Obstetrics and Gynecology, senior vice president for Health Affairs and dean of the Meharry School of Medicine. “I think we’d barely pass. But I believe we can and will get promoted.”
Plans are to repeat the Report Card every two years. The group hopes to also produce report cards in child health, prevention and men’s health.
“Our message is ‘this is serious news,’” Hartmann said. “We can wring our hands about that and think the task is too large, or at every level, from the individual person through the health care system through the policymakers, we can start to figure out what the basic first steps are. Then we just need to take the next step. And the next.”
Attending Tuesday’s announcement, held at the Nashville Public Library, were several representatives from Vanderbilt including Hartmann and Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine.
To view the complete 2009 Tennessee Women’s Health Report Card, go to www.medicineandpublichealth.vanderbilt.edu.