I. Introduction

This work reviews the situation of women’s focusing on New York City based largely on data from publications produced in the last three years. However, not many publications comprehensively addressing the situation of women’s health have been produced in the last three years. Thus, overall data from the United States federal agencies and groups were used on the assumption that the United States federal data are largely applicable to the situation of New York City. Nevertheless, New York City publications were also used because at least three sourcebooks on women’s health in New York City were accessed close to the deadline of this report.

In developing the basic recommendations forwarded by this work, this work identified the basic health vulnerabilities of women (focusing on New York City), reviewed women’s capacities to pay for health services, and looked into some of the multi-sector initiatives that have been emerging in New York City. The work attempted to comprehensively look into all these to the extent that data are available and attempted to identify the routes through which women’s health can advanced both in New York City and in the United States. The book of Watkins et al. (2002) was helpful for public health frameworks but, primarily, this work took the basic procedure of identifying some of the more pressing health problem problems confronted by the women of New York and the women of the United States in general, the obstacles or constraints affecting the resolution of women’s health problems, and the current initiatives being undertaken to address the problem as the bases for this work’s set of recommendations.

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II. Socioeconomics and Demographics
The United States 2010 Census recorded 308.7 million people in the United States. Women compose 50.8% of the United States population in which more than one third or 36.5% of the women belong to the 18 to 44 years old age group (U.S. Census Bureau, 2011b). Around 24% of the women population is in the 18 years old and below age bracket while about 17.5% of the women are in the 5 to 17 years old age group (U.S. Census Bureau, 2011b).
The 2010 census noted that the U.S. “population grew at a faster rate in the older ages than in the younger ages” (U.S. Census Bureau, 2011b, p. 2). The median age for women is not immediately available but for the entire U.S. population it was 29.5 years old in 1960, 28.1 years old in 1970, 30.0 years old in 1980, 32.9 years old in 1990, 35.3 years old in 2000, and 37.2 years old in 2010 (U.S. Census Bureau, 2011c). It is likely valid to believe that an ageing population also applies to the women in the U.S.

In general, women outnumber men starting at around 35 years old but boys or men outnumber girls or women below 35 years old (U.S. Census Bureau, 2011b). Nevertheless, for every 100 females there were 96.7 of the opposite gender in 2010 in the United States (U.S. Census Bureau, 2011c).

III. Health Data and Vulnerabilities of Women in the United States
Before focusing on the health situation of women in New York City, it appears best to review the 2010 publication of the Human Resources and Services Administration on the health situation of women. It appears logical to believe that the federal data on the health situation of women in general are largely applicable to the situation of women in New York City. Although this work also utilized some of the publications of New York City in the last three years, the federal publications on the overall situation of women appears also useful in the formulation of recommendations that can advance the health situation of the women of New York. Because the health concerns are numerous, we focus on health concerns or health data that appear to be most important in developing a set of policy recommendations in advancing women’s health in general and, particularly, for the women of New York City.
Figure 1 below indicates that although the life expectancy at birth of women has been increasing from 1970 to 2007, there seems to be a wide margin of disparity between the life expectancy at birth of black females with the life expectancy of birth of white females. Although genetic factors are possible, what appears more likely is that black women have less access to health services. Thus, the shorter life expectancy at birth of black women compared to white women.
Figure 1. Life expectancy at birth, 1970-2007

Source: HRSA, 2010, p. 28

Source: HRSA, 2010, p. 29
Figure 2. Leading causes of cancer deaths among women

Source: HRSA, 2010, p. 32

As shown by Figure 2 above, at the federal level and probably true as well for New York, lung and bronchial cancers appear to be the top cancer killer for women. This can be related to smoking and pollution and is something that must be investigated in the immediate months or years to come.
Figure 3. Females compared with males in the US with diabetes, 2005-2008

Source: HRSA, 2010, p. 34

Figure 3 indicates that women are more resilient to diabetes in younger years but are less so compared to men at 75 years and older. This implies that among women, health education may start to give more attention to diabetes for women 75 years or older.
Figure 5. New cases of HIV reported, 2008

Source: HRSA, 2010, p. 40

Figure 5 indicates the new cases of HIV that are likely to be found among black women compared to other races of women. Figure 5 suggests that education work on HIV may have to focus on certain communities to be more effective. Meanwhile, Figure 6 contributes an important insight: we must focus on the age group from 15-29 years old in combating sexually transmitted diseases among women and young women.
Figure 6. Rates of Chlamydia and gonorrhea among women in the U.S.

Source: HRSA, 2010, p. 41

Figure 7. HSV-1 and HSV-2 infection among women 18 and older

Source: HRSA, 2010, p. 41

Figure 7 indicate the there are racial groups that are more vulnerable to the Herpes Simplex Virus. However, we must investigate HSV’s possible correlation with poverty even if racial resilience is also possible.
Figure 8. Males versus females with severe headaches/migraines, 20008

Source: HRSA, 2010, p. 46

Figure 8 indicates that U.S. women, in general, are more vulnerable to severe headaches and migraines than men. This represents a difference on what the emphasis can be in women’s versus men’s health.

IV. Women’s Capacity to Pay for Health Services
Figures 9, 10, and 11 indicate that a large percentage of working women continue to have no access to health insurance services. At the same time, the figures, particularly figures 9 and 10, indicate that a large percentage of women above 65 have incomes below the poverty level and should be considered at risk as far as medical attention is concerned.
Figure 9. Women aged 18 and older and source of health care

Source: HRSA, 2010, p. 61

Figure 10. Women 65 years and older receiving retirement income

Source: HRSA, 2010, p. 55

Figure 11. Women 65 years and poverty status, 2008

Source: HRSA, 2010, p. 56

V. Focus on New York
The health programs for women at the federal level need not be so different from the health programs for women in New York City. However, the areas to prioritize may have to be the poverty areas of New York City because of their poor access to health services. The poverty areas of New York City are identified in Figure 12.
Figure 12. Poverty areas in New Your City

Source: New York City, 2007, p. 12

Identifying the neighborhoods in New York City where the poverty rates are highest is also important because based on the data of the New York City Department of Health and Hygiene (2011, p. 12), although teen-age pregnancy has been steadily decreasing in New York City from 2000 to 2009, those with the highest poverty rates in the neighborhood of New York City have the highest teen pregnancy rate per thousand females.
In 2009, for example, New York City neighborhood with a poverty rate of 20% or higher has a pregnancy rate per 1,000 females of 98.5 compared to only 65.5 in neighborhoods of poverty rates 10.0% to 19.9%, and only 38.1 for neighborhood with poverty rates of 0.0% to 9.9%. The poverty rate data is important because we can immediately identify which type of women to focus on for health services as well identify the areas in which teen pregnancy would be likely highest and simultaneously confronted with more severe risks to the lives and health of women.
The latest official figures on the health of women of New York City are not immediately available. However, a March 2005 document on the health of women in New York City is available at the New York City Department of Health and Mental Hygiene. One of the distressing data in the document indicates that “women in the poorest neighborhoods have a life expectancy 5 years shorter than those who live in the highest income neighborhoods” (NYC Department of Health and Mental Hygiene, 2005, p. 1). The document also said that “Hispanic women and women with low incomes are less likely than other to have health care coverage” (NYC Department of Health and Mental Hygiene, 2005, p. 1). The document also noted that “AIDS mortality is 7 times higher for black women than white women” (NYC Department of Health and Mental Hygiene, 2005, p. 1). The document emphasized that “Black women are more than twice as likely to die of pregnancy-related complications” ((NYC Department of Health and Mental Hygiene, 2005, p. 1).

VI. Alliance for Women’s Health in New York City
In New York City a New York Alliance for Women’s Health is operating. The organization is composed of some 55 organizations based in New York City. It is an organization active in lobby work for women’s health. In November 2009, for example, it has expressed its opposition to Stupak-Pitts amendment on the House “health reform” package. It is highly likely that the alliance of 55 strong organizations can be tapped for promoting women’s health in New York City.
In addition to the New York Alliance for Women’s Health, another organization that can be relied on is the National Women’s Health Alliance that is based in West 57th Street. The organization covers a wider area than New York City but is an organization can be relied on for advancing health consciousness among women and the advancement of health policies that can be advantageous to women.

VII. Recommendations

Based on the foregoing, the recommendations that this study submits are the following.

First, focus enough concern on the lengthening the life expectancy at birth of black women as federal studies show that the life expectancy at birth of black females is about 4 years shorter with that of white females.
Second, continue to focus on cancers, especially lung and bronchial cancers as important cause of deaths for women. Lung and bronchial cancers may be related to smoking and this implies that public health education on smoking (and probably pollution) should be among the top priority concerns of education for health.

Third, pay attention to racial differences in vulnerability to HIV and adjust the emphasis of education work on HIV accordingly.

Fourth, consider the racial differences in vulnerability to Herpes Simplex Virus and its possible correlation with poverty.
Fifth, provide an emphasis on severe migraines and headaches among women as women are more vulnerable to the two conditions than men.
Sixth, tap alliances and organizations advocating women’s health for health education work among women, identifying women greatly at risk for health, and advancing policies beneficial for women’s health.
Finally or seventh, give an adequate focus to teen pregnancy in New York City and a manner that puts emphasis on reaching out to communities of New York City in which poverty rates are highest.
These recommendations do not exhaust of course the recommendations that can be advanced to promote women’s health in New York City. We can treat these as talking points as we collaborate with women’s groups in the city to refine these recommendations as well as add a lot more in the interest of advancing women’s health in New York City.

References

  • HRSA. (2010, September). Women’s Health USA. United States Department of Health and Human Services Health Resources and Services Administration: Human Resources and Services Administration.
    New York Alliance for Women’s Health. (2009, November 17). Letter to Honorable Harry Reid, Senate Majority Leader, Hart Senate Office Building, Washington, United States of America.
    New York City. (2007). New York City community health atlas. New York City: GIS Center, Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene.
    NYC Department of Health and Mental Hygiene. (2005). The health of women in New York City. New York City: New York City Department of Health and Mental Hygiene 2005.
    NYC Department of Health and Mental Hygiene. (2011). Teen pregnancy in New York City: 2000-2009. New York City: New York City Department of Health and Mental Hygiene.
    U.S. Census Bureau. (2011a). Interactive population map. Available in: http://2010.census.gov/2010census/popmap/ (accessed 19 September 2011).
    U.S. Census Bureau. (2011b). Age and sex composition: 2010. Available in: http://www.census.gov/prod/cen2010/briefs/c2010br-03.pdf (accessed 19 September 2011).
    U.S. Census Bureau. (2011c). Age and sex composition: 2010. 2010 Census Briefs, Issued May.
    Watkins, D., Edwards, J., and Gastrell, P. (2002). Community health nursing: Frameworks for practice. 2nd ed. Edinburgh: Bailliere Tindall.
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