A comprehensive new report on the state of U.S. women, using widely accepted health-status indicators, paints a dismal picture of the overall health and well-being of American women.

Overall, the U.S. received an “unsatisfactory” grade in the report’s rating system. No state was rated “satisfactory;” 42 states were rated “unsatisfactory” and eight states received failing grades: Pennsylvania, Illinois, Indiana, Oklahoma, South Carolina, Arkansas, Louisiana and Mississippi as well as the District of Columbia.

The report, called “Making the Grade on Women’s Health: A National and State-by-State Report Card,” said the health and well-being of America’s women are seriously undermined by state and national health policies that fail to provide adequate insurance coverage, full access to care and proper preventive measures.

The report cited the lack of proper mental health care, reproductive health care and the treatment of victims of violence, the prevention of violence, as well as numerous other short-comings.

The 10 top-ranked states: Hawaii, followed by Vermont, Massachusetts, Minnesota, Colorado, Connecticut, Washington, Utah and New Hampshire. Kansas and South Dakota tied for 10th place.

The 10 lowest-ranking states: Texas, Tennessee, Oklahoma, West Virginia, South Carolina, Arkansas, Kentucky, Alabama, Louisiana and Mississippi.

Different indicators were used in rankings, so that the 10 lowest ranking states are not the same as the failing status.

The reports authors hope that women’s health advocates and policy makers will use the report card to create and strengthen policies that will improve women’s health.

Nation has not focused on improving women’s health

Prepared by the National Women’s Law Center, the University of Pennsylvania School of Medicine’s FOCUS on Health & Leadership for Women and the Lewin Group, a health policy consulting firm, the report card concluded:

“The nation has not focused consistently and comprehensively on improving women’s overall health and well-being.” It called for redoubled efforts to earn “As” for policy and performance in women’s health care.

The report was prompted by the need for a common set of health status indicators for women, said Sharon Levin, senior counsel for the National Women’s Law Center. “It’s really critical that we avoid making health policy in a vacuum,” she said.

Levin said many people believed they knew about women’s health, but little analysis of available information existed or of the information that needs to be gathered.

“We were actually quite disappointed to see the results,” Levin said. “It just goes to show public officials have let women down in this country and we have a lot of work to do.”

Reproductive care, mental health and violence need attention

Specifically, the report card found that:

  • Too many women–nearly one in seven–lack health insurance coverage.
  • State and national health policy makers have not done enough to provide women access to health care and health care providers. Nearly one in 10 Americans lives where there are few or no health care providers.
  • Women’s health suffers because reproductive health, mental health and the violence women confront are not given sufficient attention. Fewer than half the states require private insurers to cover Pap smears and cervical cancer screening, for example.
  • States pay too little attention to prevention. No state has met national goals for increasing physical activity, reducing obesity and improving diet.
  • And, there is a mixed picture of key health conditions, diseases and causes of death affecting women. Satisfactory progress has been made on reducing heart disease, lung cancer, breast cancer and AIDS. But the report gave failing grades to the national efforts to reduce diabetes, stroke, osteoporosis, unintended pregnancies and maternal mortality.

In setting up the report card, the authors decided that the best grade that could be given was “satisfactory” because most benchmarks reflect desirable progress rather than measures of where women’s health should ultimately be. States received “unsatisfactory” if they came within 10 percent of the benchmark and “fail” if they fell short by an even greater margin.

Dr. Michelle Berlin, co-director of the University of Pennsylvania’s FOCUS on Health & Leadership for Women at the School of Medicine, said she found particularly alarming that no state met all 25 health status indicators and that every state missed 10 of the benchmarks.

Only one out of the basic 25 indicators was met by every state–the percentage of women age 50 and over who have mammograms.

Every state failed in ten major areas

The report card showed that every state is failing to make satisfactory progress on indicators involving women without health care insurance, women who receive first-trimester prenatal care, leisure-time physical activity, women who are overweight, women who eat five fruits and vegetables a day, women who have high blood pressure, women with diabetes, overall life expectancy, women living in poverty and suffering because of the wage gap.

Some report card health indicators also showed striking differences among the states. For example, 7.5 percent of Hawaiian women are uninsured, while 28 percent of Texas women have no health insurance, a four-fold difference. Similarly, life expectancy ranged from 81.3 years for Hawaiian women to 76.9 years for women in Louisiana.

The authors also concluded that more research into women’s health, better data collection and data systems and a sharper focus on emerging issues affecting women’s health and well-being are needed.

“The absence of sustained research, or even adequate data collection in such key areas as violence, mental health and unintended pregnancies has a severe negative effect on women’s health,” the authors wrote.

The report card is being distributed to policy makers and women’s health advocates as part of a major public education campaign to improve women’s health.

In compiling the report, the authors reviewed more than 70 public policies that affect women’s health and the data for 32 indicators of women’s health status.

Funded by Bristol-Myers Squibb Foundation, the Open Society Institute and the Jessie Ball duPont Fund, the report is expected to be published annually.

In conclusion, the authors said: “This first report card shines a light on the challenges to the nation and the states to improve women’s health. It is time for the nation and the states to take the steps necessary to earn an ‘A’ for effort and an “A” for results for all women.”

Note: Women’s Enews will follow up with additional news items based on the report’s findings.

Melinda Voss has a master’s degree in public health. A former reporter for The Des Moines Register, she freelances and teaches journalism at the University of Minnesota.