2000s: CDC/ATSDR Contributions to Women’s Health

Below is a sample of contributions CDC and ATSDR have made in women's health during the 2000s.

2009

CDC designed The Right to Know Campaign to increase awareness of breast cancer among women with physical disabilities and encourage these women to get screened.

The new 2009 Breastfeeding Report Card provides information for each state on key breastfeeding indicators, showing where each state has been successful and where more work is needed to improve breastfeeding practices.

This new report, A Public Health Focus on Infertility Prevention, Detection, and Management, examines the issue of infertility in the United States. The article, published in Fertility and Sterility, presents information on the efforts of a CDC-wide working group that found considerable gaps and opportunities in surveillance, research, communication, and policy development on infertility.

Published interim H1N1 Flu guidance for clinicians and pregnant and breastfeeding women.

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2008

Published Guiding Principles for Development of ACIP Recommendations for Vaccination During Pregnancy and Breastfeeding, which provides guidance to help standardize procedures for policy formulation and presentation of the rationale and recommendations for vaccination of pregnant and breastfeeding women. These principles will be applied to future Advisory Committee on Immunization Practices vaccine statements and routine updates of existing statements in which vaccination of pregnant and breastfeeding women is considered.

Published a report on the first national Maternity Practices in Infant Nutrition and Care (mPINC) Survey. In 2007, CDC conducted this survey to characterize maternity practices related to breastfeeding. The report summarizes results of that survey, which indicated that 1) a substantial proportion of facilities used maternity practices that are not evidence-based and are known to interfere with breastfeeding and 2) states in the southern United States generally have lower mPINC scores, including certain states previously determined to have the lowest 6-month breastfeeding rates. These results highlights the need for U.S. hospitals and birth centers to implement changes in maternity practices that support breastfeeding.

Launched the African American Women and Mass Media Pilot Campaign, which uses radio and print media to make more women aware of the importance of getting mammograms to find breast cancer early. The campaign also seeks to increase the use of the National Breast and Cervical Cancer Early Detection Program screening services among African American women aged 40-64. The campaign is being piloted in Savannah and Macon, Georgia.

Published, in collaboration with the Agency for Healthcare Research and Quality, Women with Diabetes: Quality of Health Care, 2004-2005 . This report uses national data sets to show gaps in knowledge about quality of care among women with diagnosed diabetes. The report examines the quality of health care in the United States for women with and without diagnosed diabetes, using the most scientifically based measures and national data sources available. It presents 15 measures of health care quality showing the use of services in several areas: access to care, general well-being, evidence-based diabetes-specific preventive care, cardiovascular disease-specific preventive care, cancer-specific care, immunizations, and dental care.

Released findings of an STD study that estimates that one in four (26 percent) young women between the ages of 14 and 19 in the United States (3.2 million teenage girls) is infected with at least one of the most common sexually transmitted diseases (human papillomavirus, chlamydia, herpes simplex virus type 2, and trichomoniasis). The study is the first to examine the combined national prevalence of common STDs among adolescent women in the United States.

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2007

Developed The Reproductive Health Assessment Toolkit (RHA) for Conflict-Affected Women, which provides user-friendly tools to quantitatively assess the reproductive health needs of conflict-affected women aged 15–49 years. The RHA Toolkit enables field staff to collect data to inform program planning, monitoring, evaluation, and advocacy. It promotes using the collected data to enhance services and improve the reproductive health of women and their families.

Developed, in collaboration with the American College of Obstetricians and Gynecologists, the Drinking and Reproductive Health: A Fetal Alcohol Spectrum Disorders Prevention Tool Kit . The primary component in the tool kit is a CD-ROM that aims to teach women’s health care providers how to screen and advise all of their patients of reproductive age about risky drinking and the use of effective contraception among patients who continue to engage in risky drinking. It also addresses drinking during pregnancy.

Published the Purchaser's Guide to Clinical Preventive Services: Moving Science into Coverage, an important resource on preventive services. Developed in collaboration with the National Business Group on Health, the guide provides large employers with the information they need to select, define, and implement preventive medical benefits such as colorectal cancer screening and tobacco use treatment. It includes Life Course Charts on preventive preconception, prenatal, and postpartum care; preventive care for children and adolescents; and preventive care for adults. It also includes clinical preventive service information on 46 conditions and topics, including breast and cervical cancer, contraceptive use, depression, healthy pregnancy, obesity, osteoporosis, sexually transmitted diseases, and tobacco use treatment.

Launched the One Test. Two Lives. campaign which focuses on ensuring that all women are tested for HIV early in their pregnancy. One Test. Two Lives. provides quick access to a variety of resources for providers and patients to help encourage universal voluntary prenatal testing for HIV.

Developed, in collaboration with Medscape™ from WebMD™, an online continuing medical education program called Follow Up of Abnormal Clinical and Imaging Findings of the Breast: Five Self-Study Modules for Primary Care Clinicians. The five self-directed, interactive training modules are designed to educate clinicians on providing appropriate and timely care to women with early signs of breast cancer, and to train physicians on the latest evidence, protocols, and guidelines around detecting breast cancer.

Launched the Pre-Teen Vaccine Campaign, which is aimed at educating parents and healthcare providers of 11 and 12 year-olds about the routine vaccines recommended for this age group. These vaccines include the HPV vaccine for girls, the Meningococcal vaccine (MCV4), and the Tetanus-diphtheria-acellular pertussis (Tdap) vaccine. The campaign includes media outreach, a website with information about each vaccine, and educational flyers and posters.

Launched, in collaboration with the Department of Health and Human Services’ Office on Women’s Health, the Inside Knowledge Campaign to raise awareness about five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar. Inside Knowledge is an initiative that supports the Gynecologic Cancer Education and Awareness Act of 2005, or Johanna’s Law.

Hosted The Changing Face of Women's Health Exhibit for the second time at CDC in Atlanta. The interactive exhibit began its U.S. tour in 1999.

Published Use of Mammograms among Women Aged 40 Years and Over- United States, 2000-2005. The report describes findings that indicate a decreasing trend in self-reported use of mammograms among women aged 40 years and over during 2000-2005.

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2006

Launched the Chronic Fatigue Syndrome Awareness Campaign, the first national public awareness campaign on chronic fatigue syndrome (CFS). CFS occurs four times more frequently in women than in men.

The Advisory Committee on Immunization Practices (ACIP) recommended that human papillomavirus (HPV) vaccination be routinely given to girls when they are 11-12 years old to help prevent cervical cancer.

Launched the Choose Respect Initiative to help adolescents form healthy relationships to prevent dating abuse before it starts.

Launched a new women's health website, which included information on what's new, health tips, facts and stats, programs, publications, and more.

Developed and published Recommendations to Improve Preconception Health and Health Care- United States with public and private partners to help improve the health of women and couples before conception of a first or subsequent pregnancy.

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2005

Published Fertility, Family Planning, and Reproductive Health of U.S. Women. The report presented national estimates of fertility, family planning, and reproductive health indicators among females 14-44 years old from the National Survey of Family Growth.

Published the CDC Guide to Breastfeeding Interventions . All major types of interventions known to have been implemented or thought to promote and support breastfeeding are discussed, including maternity care practices, workplace support, peer support, educating mothers, professional support, media, and social marketing.

Published Summarizing the First 12 Years of Partnerships and Progress against Breast and Cervical Cancer: National Report, 1991-2002 . The report included information on the National Breast and Cervical Cancer Early Detection Program and outcomes for women it served.

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2004

Published Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2002 . The report presented national estimates among males and females 15-19 years old from the National Survey of Family Growth.

Published Use of Contraception and Use of Family Planning Services in the United States, 1982-2002 . The data from the National Survey of Family Growth showed that the leading method of contraception in the United States in 2002 was the oral contraceptive pill, followed by female sterilization and condom.

Published SARS during Pregnancy- United States. Two of eight persons with laboratory-confirmed severe acute respiratory syndrome-associated coronavirus infection in the United States during 2003 were pregnant women.

Published Report on the Universal Data Collection (UDC) Program, May 1998 through December 2002 . The report included data on females with von Willebrand disease.

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2003

Launched a web page on work and reproductive health, which included information on the effects of occupational exposures on women's and men's reproductive health.

Published Costs of Intimate Partner Violence against Women in the United States. The health-related costs of rape, physical assault, stalking, and homicide by intimate partners exceed $5.8 billion each year. Of this total, nearly $4.1 billion are for direct medical and mental health care services; productivity losses account for nearly $1.8 billion.

Released A Public Health Action Plan to Prevent Heart Disease and Stroke . Developed with collaboration from major national partners, the plan was a strategy for achieving national goals for preventing heart disease and stroke—leading causes of death for both women and men—over the next two decades, through 2020 and beyond.

Received funding from the Avon Foundation for the CDC Foundation to award grants for mobile mammography screening programs to eight community organizations. These grant awards allowed community organizations to reach underserved women, such as the uninsured or those living in geographically remote areas, and offered breast and cervical cancer screening services. The AVON Foundation provided $4.1 million dollar gift to fund this initiative, called the AVON/CDC Foundation Mobile Access Program.

Published the first Atlas of Stroke Mortality: Racial, Ethnic and Geographic Disparities in the United States, which provided an extensive series of national and state maps that showed local disparities in stroke death rates for the five largest racial/ethnic groups in the United States. For both women and men, stroke is the third leading cause of death in the United States, preceded by heart disease and cancer.

Launched the Diethylstilbestrol (DES) Campaign to help inform individuals that there may be health problems associated with DES exposure in women who were prescribed DES while pregnant from 1938-1971 as well as their daughters and sons.

Produced Sexual Violence Prevention: Building Leadership and Commitment to Underserved Communities, a web cast providing educational information to help participants identify strategies that can help prevent sexual violence in underserved communities.

Published Ethylene Oxide and Breast Cancer Incidence in a Cohort Study of 7576 Women. The study was conducted among women workers exposed to ethylene oxide (EtO), a direct alkylating agent that induces mammary tumors in mice. An increased risk of breast cancer was found to be associated with high cumulative EtO exposure.

Developed and published An Occupational Reproductive Research Agenda for the Third Millennium to guide research in the area of reproductive health. The agenda identified causative agents, mechanisms by which they act, potential target populations, and opportunities to intervene and protect the reproductive health of workers.

Published Use of Hormone Replacement Therapy (HRT) among Postmenopausal Women in the United States, 1988-1994, data from the National Health and Nutrition Examination Survey that showed patterns of HRT use in the United States and factors associated with HRT use. Although much has been written about the risk and benefits of HRT, much less documents its actual use in the United States.

Launched A National Agenda for Action: The National Public Health Initiative on Diabetes and Women's Health, which was an action plan on diabetes and women's health. The plan called for expanding community-based health education programs, promoting risk assessment, supporting quality care and self-management for diabetes and its complications, and encouraging research into the factors that influence diabetes and women's health. Diabetes has increased to epidemic proportions in the United States. Diagnosed diabetes (including gestational diabetes) among women has increased almost 50 percent during the past decade. The prevalence of type 2 diabetes is at least two-to-four times higher in Black, Hispanic, American Indian, Asian, and Pacific Island women than in whites.

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2002

Funded a multi-agency, three-year study (1999-2002) with the Centers for Medicaid and Medicare Services (CMS) to address the public health need to increase immunization for influenza and pneumococcal diseases at long-term care facilities (LTCF) using Standing Orders Programs (SOP). SOPs allow authorization of facility staff to administer vaccination according to an approved protocol without a physician’s examination or written order. The findings from this study have led to a change in CMS’s regulations/interpretive guidelines to allow for the use of SOP in all CMS certified LTCF and to monitor coverage. This will lead to an increase in immunization coverage in the LTCF of residents, a large portion of which are women.

Awarded more than $3.8 million to 14 state domestic violence coalitions to help develop and coordinate activities to prevent domestic violence in communities across the country. The Domestic Violence Prevention Enhancement and Leadership Through Alliances (DELTA) program supported state domestic violence coalitions to provide prevention-focused technical assistance, training, and funding to local communities.

Increased efforts to bring attention to fetal alcohol syndrome (FAS) and how it is preventable. The targeted FAS Media Campaign is one strategy to enhance current prevention efforts related to FAS and other prenatal alcohol-related effects.

Published Prevalence of Overweight and Obesity among Adults- United States, 1999-2000, which reported that obesity continued to increase dramatically during the late 1990s for Americans of all ages, with nearly one-third of all adults now classified as obese. The findings showed more adult women were obese (33 percent) than men (28 percent), with the problem greatest among non-Hispanic black women (50 percent) compared with Mexican-American women (40 percent) and non-Hispanic white women (30 percent).

Published Chronic Obstructive Pulmonary Disease Surveillance- United States, 1971-2000 which reported that, for the first time, the number of women dying from Chronic Obstructive Pulmonary Disease (COPD) surpassed the number of men dying from it (59,936 versus 59,118). The report presented national data regarding objectively determined COPD; COPD-associated activity and functional limitations; self-reported COPD prevalence, COPD physician office and hospital outpatient department visits, COPD hospitalizations, and COPD deaths; and COPD emergency department visits.

Published Hysterectomy Surveillance- United States, 1994–1999, which reported that an estimated 3,525,237 hysterectomies were performed among U.S. women aged >15 years, and the overall hysterectomy rate for U.S. female, civilian residents was 5.5 per 1,000 women. Approximately 600,000 hysterectomies were performed annually in the United States, and approximately 20 million U.S. women had had a hysterectomy.

Published more results from the Collaborative Review of Sterilization (CREST) study. The study reported that few of the women who undergo tubal sterilization or whose husbands undergo vasectomy later go on to regret either procedure. The study was conducted by CDC and funded by the National Institute of Child Health and Human Development, NIH.

Published Oral Contraceptives and the Risk of Breast Cancer. Women who took oral contraceptives at some point in their lives were no more likely to develop breast cancer between the ages of 35 and 64 than were other women the same age, according to findings from the National Institute of Child Health and Human Development (NICHD) Women's Contraceptive and Reproductive Experiences Study (Women's CARE). The analysis was conducted by CDC, NICHD, and other research institutions to determine whether current or former contraceptive use during the reproductive years increases breast cancer risk. The women studied were members of the first generation of American women to use oral contraceptives.

Reported on the changing trends in obstetric procedures in the United States from 1990-2000. The overall rate of obstetric procedures had not changed, but the mix of obstetric procedures performed had continued to change during that period.

Published Trends in Deaths from Systemic Lupus Erythematosus (SLE)- United States, 1979-1998. This report indicated that marked age-, sex-, and race-specific disparities exist in SLE death rates and that death rates have increased by approximately 70% during the study period among black women aged 45 to 64 years.

Developed and published Sexual Violence Surveillance: Uniform Definitions and Recommended Data Elements to improve consistency and quality of estimates.

Developed the CDC Injury Research Agenda to guide research in seven key areas of injury prevention and control, including intimate partner violence and sexual violence.

Supported the development and release of the World Report on Violence and Health. The goals of the report were to raise awareness about the problem of violence globally, to make the case that violence is preventable, and to highlight the crucial role that public health has to play in addressing its causes and consequences.

Held the CDC/ATSDR Advancing the Health of Women: Prevention, Practice, and Policy conference in Atlanta, Georgia. In this 2 ½ day conference, general and concurrent sessions were held to provide opportunities to expand participants' knowledge on women's health issues and increase their effectiveness in helping women live healthier lives.

Produced A Community Toolkit for Reducing Tobacco Use among Women, a toolkit to help lead girls and women toward the ultimate goal of happy, healthy, and smoke-free lives.

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2001

Funded and collaborated, along with the American College of Obstetricians and Gynecologists (ACOG), the Immunization Action Coalition to publish Vaccinate Women. This publication educates obstetrician/gynecologists about the importance of vaccination and urges them to become vaccination providers. Each issue is distributed to 35,000 ACOG members, obstetrician/gynecologist residents, and other women’s health specialists.

Established the Violence Against Women Electronic Network (VAWnet). Today, VAWnet provides support for the development, implementation, and maintenance of effective violence against women intervention and prevention efforts at the national, state, and local levels through electronic communication and information dissemination.

Published a review of women's use of health care.

Co-sponsored the National Bone Health Campaign, "Powerful Bones, Powerful Girls." This on-going campaign's goal is to promote bone health in girls 9 to 12 years old so they can reduce their risk of osteoporosis by developing healthy habits now.

Created an environmental health research laboratory to help improve the diagnosis for and care of people with osteoporosis. Bone markers are currently used to measure bone development and show whether treatment for osteoporosis is working. CDC’s research laboratory has helped to improve this testing and standardize how the test is done by doing laboratory studies to determine test accuracy; translating research findings into guidelines; and creating reference materials for clinicians, health care providers, and assay manufacturers.

Published the Women's Safety and Health Issues at Work fact sheet. This publication contained information on working women, the hazards they may face, and NIOSH research in areas of particular concern to women.

Established The National Center on Birth Defects and Developmental Disabilities (NCBDDD) which works to improve the health of children and adults by preventing birth defects and developmental disabilities, promoting optimal child development, and promoting health and wellness among children and adults living with disabilities.

Published To Be or Not to Be On Hormone Replacement Therapy: A Workbook, which provides information and guidance to help women decide whether hormone replacement therapy (HRT) is a good choice.

Published the HIV Prevention Strategic Plan to more effectively address HIV infection and AIDS at home and abroad. The document outlined the blueprint for prevention and control.

Issued the National Report on Human Exposure to Environmental Chemicals. The report included data about levels of 27 environmental chemicals in blood and urine samples among participants in the 1999 National Health and Nutrition Examination Survey. Assessment of women's and children's exposure to mercury has been improved through availability of data in the report on levels of mercury in blood samples from women of childbearing age and children aged 1-5 years.

Published Surveillance for Homicide among Intimate Partners- United States, 1981-1998. This report was the first state-by-state analysis of intimate partner homicide.

Published Women and Smoking: A Report of the Surgeon General. This report summarized what is known about smoking among women, including patterns and trends in smoking habits, factors associated with starting to smoke and continuing to smoke, the consequences of smoking on women's health, and interventions for cessation and prevention.

Published U.S. Fall Prevention Programs for Seniors: Selected Programs Using Home Assessment and Modification. This document described 18 outstanding fall prevention programs in 14 states that included home assessment and home modification. The programs described will be used as models by agencies or organizations that want to develop fall prevention programs for older adults.

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2000

Published results from the Collaborative Review of Sterilization (CREST) study on tubal sterilization and menstrual abnormalities. For nearly a half century, there has been some concern that tubal sterilization may result in menstrual abnormalities, such as an increase in menstrual pain and bleeding. Results of this study showed that tubal sterilization is not associated with menstrual problems.

Developed Tool Kit to Prevent Senior Falls to provide health professionals with current technical information and science-based materials about senior falls and fall-related injuries that can be incorporated into new or existing prevention activities.

Funded ten prevention projects on sexual violence and intimate partner violence among racial and ethnic minority populations, which supported the development, implementation, and evaluation of sexual violence and intimate partner violence prevention programs and services targeting minority populations.

Published Reducing Falls and Resulting Hip Fractures among Older Women. Findings showed that age is a risk factor for hip fracture, and women are more likely to be hospitalized for hip fractures. Fall prevention programs using multifaceted approaches that are community based have been shown to be effective.

Published Recommendations Regarding Selected Conditions Affecting Women's Health that focused on four women's health issues: falls and resulting hip fractures; exercise-related injuries; breast and cervical cancer detection; and congenital toxoplasmosis. For each report, prevention recommendations and specific research recommendations were provided.

Published State Laws Relating to Breast Cancer, January 1949 to May 2000 . This summary covered all legislation enacted between January 1949 and May 2000.

To increase access to treatment for women diagnosed through the National Breast and Cervical Cancer Early Detection Program, Congress passed the Breast and Cervical Cancer Prevention and Treatment Act that authorizes states, if they choose, to provide Medicaid coverage for treatment services for women screened by the program and identified with a cancerous condition.

Published Building Data Systems for Monitoring and Responding to Violence Against Women: Recommendations from a Workshop, which provided recommendations regarding public health surveillance and research on violence against women. The report resulted from a workshop co-sponsored by the US Department of Health and Human Services and the US Department of Justice.

Supported and participated in the First International Conference on Women, Heart Disease and Stroke in Victoria, Canada. The conference led to the development of the 2000 Victoria Declaration on Women, Heart Diseases and Stroke: Science and Policy in Action.

Published Women and Heart Disease: An Atlas of Racial and Ethnic Disparities in Mortality in conjunction with the Office for Social Environment and Health research at West Virginia University. The publication provided critical data on geographic, racial, and ethnic inequalities in women's heart disease death rates for the major racial and ethnic groups.

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