Pregnant Women Eschew Meds
A minority of women believe it is safe to take depression medication while they are pregnant, according to a new survey by the Society for Women's Health Research. The survey of 1,000 women was conducted by telephone in October; 500 family and general practitioners and internal medicine specialists were also queried. Only 11% of women said they thought it was safe to take a depression medication during pregnancy, compared with 68% of physicians. Less-educated and lower-income women and African American women were more likely to believe it was unsafe to take a medication. Half of women said it was safe post partum, compared with 97% of physicians. Women falsely believed that depression was a normal part of the postpartum experience and also underestimated their risk for depression at specific life stages involving hormonal transitions, according to the society. In a statement, Sherry Marts, vice president of scientific affairs for the society, said the survey shows a disconnect between physicians' beliefs about depression and women's perceptions. “The health care community needs to do a better job communicating with women about depression,” Ms. Marts said.
HIV Policy Changes Urged
A small change in how the Center for Disease Control and Prevention tracks new HIV/AIDS cases could help capture data on infections in women, especially minorities, more accurately, potentially helping to get infected women into treatment much earlier, according to a coalition advocating the change. The National Women and AIDS Collective (NWAC), along with Sen. Hillary Clinton (D-N.Y.) and Sen. Edward Kennedy (D-Mass.), is asking the CDC to revise the model it uses to capture data on new cases of HIV/AIDS so it records more information on environmental and socioeconomic factors. “Research shows that women of color remain at disproportionate risk of HIV infection even when they aren't engaging in high-risk behavior such as drug use, sex with men who have sex with men, [and] sex work,” The NWAC said in a statement. “As such, a data collection method that takes into account only high-risk behaviors falls far short of addressing the prevention needs of women of color and other populations whose HIV rates are influenced by a range of environmental and socioeconomic factors.” The NWAC, along with the two senators, plans to set up a working group with the CDC to try to enact the changes, a NWAC spokesperson said.
Abstinence Programs Don't Work
There's no strong evidence that any abstinence program delays the initiation of sex, hastens a return to abstinence, or reduces the number of sexual partners, according to a study from the nonpartisan National Campaign to Prevent Teen and Unplanned Pregnancy. “Many of the abstinence programs improved teens' values about abstinence or their intentions to abstain, but these improvements did not always endure and often did not translate into changes in behavior,” said the report, “Emerging Answers 2007.” But two-thirds of programs that support both abstinence and the use of condoms and contraceptives for sexually active teens had positive behavioral effects, according to the report. However, the report said that researchers should not conclude that all abstinence-only programs are ineffective, because fewer than 10 rigorous studies of these programs have been carried out, and studies of two programs provided “modestly encouraging results.” More study is needed before the programs are disseminated widely, the report concluded.
Preventive Coverage Widespread
Almost all health savings account/high-deductible health plans (HSA/HDHPs) offered by the employment-based insurance market provide “first-dollar” coverage for preventive care, regardless of whether the deductible has been met. In a July 2007 survey by America's Health Insurance Plans, 96% of small groups (50 or fewer employees), 99% of large groups (51 or more employees), and 99% of jumbo groups (3,000 or more employees) said they cover preventive care on a first-dollar basis. Conversely, only 59% of individually purchased HSA/HDHPs do so. The 36 companies surveyed had more than 1.7 million HSA/HDHP enrollees (there are 4.5 million nationwide). The preventive care services commonly covered include recommended immunizations and preventive screenings. All plans surveyed covered mammograms, Pap smears, and annual physicals; most covered colonoscopies and prostate cancer screening.
Improvement Through Transparency
Transparency of quality and price information is important or very important for improving the U.S. health care system, according to 77% of 241 health care opinion leaders surveyed in October 2007 by Harris Interactive on behalf of the Commonwealth Fund and Modern Healthcare. Stimulating provider performance-improvement activities was rated as an important or very important goal of transparency by 84% of respondents; 76% also cited encouraging payers to reward quality, and 66% thought helping patients make informed choices was an important or very important goal. More than half (56%) thought that a new public-private national entity should be responsible for setting the standards for measurement and reporting, with 75% saying the costs of such measurement and reporting should be shared by providers, insurers, and the government. Most (88%) felt that adoption of health information technology was an important or very important component of any system of transparency. The online poll surveyed peer-identified leaders and experts in academia, research, health care delivery, business, insurance, government, and labor and advocacy groups.