Focusing on Gender-Specific Medicine
This issue of Clinical Geriatrics focuses on important topics in women’s health. Last month, we published an article that explored screening for depression, an all-too-common problem affecting the older woman. This month we chose three issues also of major significance to the older woman: menopause, osteoporosis, and cardiac disease. While menopause is a natural part of the aging process, it can clearly impact the older woman’s quality of life and deserves proper attention in the physician’s office. Cardiac disease and osteoporosis are best approached through a life-long program of prevention. Even with the best of intentions, however, these problems will likely continue to affect millions of women during their later years of life. Fortunately, there are new ways to effectively treat these problems once they have been identified.
Women represent over half of the U.S. population (151.9 million in 2006). Of women over the age of 18, 14% rate their health as being either fair or poor. Thirteen percent report that they are limited in their usual activities due to one or more chronic health conditions. Eighteen percent currently smoke, 62% are “overweight,” and 33% have hypertension. Women all too commonly are affected with arthritis, diabetes, heart disease, depression, and hypertension. They may be subjects of domestic violence and live in fear of breast cancer and gynecological malignancies.
Each year, women account for over 500 million visits to office-based physicians and over 60 million visits to hospital-based ambulatory care centers. Women account for more than 20 million discharges each year from our nation’s hospitals, with an average length of hospital stay of 4.5 days. Approximately 15% of women report having no health insurance, and 11% report having no routine healthcare. Sixty-seven percent of women over age 40 had a mammogram within the past 2 years, and 78% of women over age 18 had a Pap smear within the past 3 years. The leading causes of death in women are heart disease, cancer, and stroke.
As we continue to debate the status of our national healthcare, we must not forget the importance of gender-specific health concerns and continue to bring this to the forefront of our healthcare mandate. We clearly recognize the importance of screening for and, when necessary, treating women for breast and gynecological cancers, but certain diseases, including Alzheimer’s disease and osteoporosis among many others, are also more common in women. Heart disease, long recognized as being a problem of older men, is now the leading cause of death in women; the rate of heart disease in women is rising rapidly and is a problem in need of serious consideration.
We hope that you will find our “Women’s Health” issue of value in your practice, and, as always, we welcome your comments.
Dr. Gambert is Professor of Medicine and Associate Chair for Clinical Program Development, Co-Director, Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Director, Geriatric Medicine, University of Maryland Medical Center and R Adams Cowley Shock Trauma Center, and Professor of Medicine, Division of Gerontology and Geriatric Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.