This post was co-written by Katherine Warren
Thanks to the triumph of public health and medical interventions, the average American woman today will live to be nearly 81 years old -- that's 33 years longer, on average, than they did a century ago. According to the U.S. Census Bureau, there are currently more than 70,000 American centenarians, people who have lived to be more than 100, and four out of five of them are women. However, women, who live an average of five years longer than do men, face an increased burden of age-related disease in America as well as inequities in the health care system. The good news is that thanks to our investments in research over the past century and a new national focus on women's health since the 1990s, we now are harvesting treatment and prevention advances that can improve women's health today and tomorrow.
Consider this: in the year 1900, the average life expectancy for women was 48 years and the major killers then were infectious diseases like tuberculosis and smallpox as well as complications from childbirth. One hundred years later, now in 2011, the leading causes of death for women in the United States have shifted to chronic diseases including cardiovascular illnesses, cancer, diabetes, and chronic pulmonary disease. Many of these illnesses are preventable. Smoking, a health-damaging behavior in which about one in six American women 18 years or older engages, is the number one preventable cause of death in America.i Since 1950, the United States has seen a 600-percent increase in women's death rates from lung cancer, primarily caused by cigarette smokingii. 14 percent of women over the age of 18 years have had 5 or more drinks in one day at least once in the past year,iii and alcohol is linked to an increased risk for liver disease, cancer, cardiovascular illness, stroke and dementia including 5,771 alcohol-induced deaths among women in 2007.iv, v Moreover, the 65 percent of women in the U.S. who are overweight or obese are at greater risk for cardiovascular disease, cancer, diabetes and stroke. In fact, new studies show that obesity may have a greater impact on women compared to men in terms of health-related quality of life, which includes physical health, mobility, cognitive skills, and emotional health.vi There are also significant disparities in mortality and health outcomes for low-income women and women of color. vii
While genetic factors play an important role in the development of some diseases, developing and implementing strategies to reduce health damaging behaviors and rectify health disparities -- perhaps more than any miracle medication that could be discovered -- has the potential to reduce annual deaths in the U.S. by half as well as dramatically cut health care costs and disability. After all, 75 percent of the $2.6 trillion health care budget in America is associated with these preventable lifestyle factors.
Listed below are some key ingredients of a prescription for a healthier future:
Find a doctor with whom you feel comfortable and get routine check ups. Enter into a partnership with your doctor for your health. If you have doubts about a physician's recommendations, get a second opinion. Make sure you obtain regular screening exams (cholesterol, blood pressure, pap smears, mammograms, and colonoscopies depending on your age). Early detection and regular preventive care reduce the risk of disease and disability and save lives and billions of dollars in health care costs for our nation.
Keep vaccinations up to date. Adults need immunizations too! Consult with your doctor about which immunizations you need at what age and remember to get a flu shot annually. For more information, click here.
Know and keep a record of your family health history. Some diseases run in families. Talk with your relatives to get information. Share this knowledge with your doctor. Learn about the signs and symptoms of these illnesses so that you can detect them early.
Stamp out smoking. If you don't smoke, please never start. If you do smoke, make a plan to stop and see it through. Smoking is the leading cause of preventable death in America and is linked to increased risk of heart disease, cancer, stroke, emphysema, and other chronic illnesses as well as premature wrinkling, and low birth weight babies. There are behavioral strategies, apps, support groups, and medications that can help. Second hand smoke also significantly impairs the health of those who are in contact with smokers. 90% of adult women smokers began as teenagers, so talk, early and often with girls you know, about prevention.
Eat smart. Eating a balanced diet rich in fruits, vegetables, fiber, whole grains, vitamins, folate and calcium and that is low in saturated fats and salt is a critical ingredient in the recipe for a healthier future. Limit your fat intake to 30 percent of daily calories. Also try to incorporate lean meats and other sources of protein that are low in fat, like tofu and legumes. Portion control is a key element! Visit nutrition.gov and choosemyplate.gov for more information. Eating smart will help you to maintain a healthy weight and reduce the risk of stroke, type 2 diabetes, coronary heart disease certain cancers, gout, and a range of other health concerns.viii
Exercise regularly. Physical activity is one of the most important steps you can take towards a healthier future. If you are not currently exercising, start slowly and build up. Aim for at least 30 minutes at least five days a week of moderate-intensity aerobic exercise, or 1 hour and 15 minutes per week of high-intensity aerobic exercise. Cross train to avoid injury. Also remember to strength train all of your major muscle groups at least twice a week, and don't forget to stretch! Weight-bearing exercise can stave off osteoporosis, which affects 10 million Americans, 80 percent of whom are women. A new study has shown that one hour of physical activity every day is a cornerstone of keeping women from putting on extra pounds as they age. Pick activities you like -- join your local bike share, practice yoga, use the stairs instead of the elevator, take a power walk instead of a power lunch. Try a pedometer and aim for 10,000 steps a day! Visit fitness.gov to learn more.
Exercise your mind as well. Turn off the T.V. and pick up a crossword puzzle! Playing Sudoku, doing memory puzzles, joining a book club, or learning a new language or skill are great ways to keep your mind sharp and engaged. Choosing fun and meaningful activities also makes life more enjoyable and keeps your mind active as you age.ix
Get enough sleep. Most adults need 7 to 8 hours of sleep per night. Women are twice as likely as men to have difficulties falling asleep or staying asleep. This is a particular problem during pregnancy. Getting a good night's rest leaves you refreshed, alert and ready to tackle the day's challenges. Adequate sleep can also help to reduce stress and give your body a chance to heal from illness and injury. To take advantage of these benefits, establish a regular bedtime routine, avoid caffeine, alcohol, heavy meals, and exercise right before getting into bed, and turn off the computer and other electronic devices which can contribute to insomnia. Create a dark, quiet, and comfortable environment in which to fall asleep. If you continue to experience insomnia for more than 2 weeks, have persistent snoring, restless legs while sleeping, or other disturbances, talk to your doctor.
Limit alcohol intake. If you drink, do so responsibly and only in moderation. While one glass a day of red wine might help prevent heart disease, remember that serious health issues are associated with its use including car crashes, alcohol abuse, increased risk of liver disease and some cancers. For women, more than 1 drink a day is associated with an increased risk of breast cancer.x Avoid alcohol entirely if you are pregnant. Never drink and drive. And drugs? Don't, unless they are prescribed for you and then be sure to take them for the recommended period of time.
Get regular skin exams. Melanoma, a serious form of skin cancer, is on the rise in young women, aged 15 to 39. Perform self-exams looking for growths with irregular shapes and colors. Have your skin checked annually. Put prevention into practice -- use sunscreens and bathe in the shade. While adequate vitamin D from the sun has been shown to have important health benefits, taking a supplement to get sufficient amounts may be necessary for some people.
Be safe. Be safe in your home, in your workplace, on your bike, in your car, outdoors and in your sexual practices. Wear a helmet, use your seat belt, wear sunscreen, check your smoke alarms and install a carbon monoxide detector in your home. Have a family plan in case of a natural disaster or emergency. In your personal life, protect yourself from sexually transmitted infections (STIs) including HIV/AIDS as well as unintended pregnancy.
Find your own stress buster. Find time in the day that's just for you. Take a walk, read a book, practice yoga. Make sure you have time to engage in the activities in life that bring you joy and satisfaction.
Be connected. Having strong connections to others can improve your health and longevity. It's also more fun and easier to engage in healthy behaviors if others join you. Many studies have shown that women in particular gain long term health benefits from relationships in ways that are as powerful as a healthy diet and getting enough sleep. These benefits extend to givers and receivers of support. A lack of connections, on the other hand, is associated with increased mortality by as much as 50 percent, depression, and a decline in cognitive function later in life. It's the quality of relationships that makes the difference, so visit with your friends and family regularly, reach out to make new contacts, and enjoy developing meaningful connections.
Know your health care plan. Choose a health care plan that is right for you and your family. The recently passed health care reform legislation, The Patient Protection and Affordable Care Act is fixing many discriminatory policies that existed for women in the U.S. health care system. Women are much less likely to have jobs with health coverage than are men and to lose their coverage if divorced or widowed. This means women have the most to gain from the new health care law with its state-based insurance exchanges that go into effect in 2014. Insurers can no longer deny coverage to women who have a pre-existing health condition or who have been victims of domestic abuse.xi Before passage of the legislation, 80 percent of individual health plans did not provide maternity care. Women could pay up to 50 percent more than their male counterparts for the same health insurance, a practice that will be illegal starting in 2014.xii Young women up to the age of 26 can now be covered on their parents' health insurance. Also, preventive services including pap smears and mammograms depending on your age will be included in all new health plans without co-pays or a deductible. If you are reaching the age of 65, register for Medicare at least 3 months before your birthday. And to learn more about how the new health care law benefits women, click here.
Be a savvy health consumer. Read as much as you can and use trustworthy Internet sites (see list below) for reliable health information. Be informed, follow the recommendations in this prescription, and share it with others. Knowledge is power when it comes to your health and the health of your family, workplace and community. Though advancements in women's health have come a long way in recent years, much more still needs to be done. You can help ensure further progress. Write or email your local, state and federal representatives to express your opinions on how to improve health in your neighborhood and in our nation.
Over the past two decades, important actions have been taken to make women's health a national priority. Now let's build on this success by working together to ensure a healthier future for women in the years ahead.
Rear Admiral Susan Blumenthal, M.D. (ret.) is the Public Health Editor of the Huffington Post. She serves as Director of the Health and Medicine Program at the Center for the Study of the Presidency and Congress in Washington, D.C., a Clinical Professor at Georgetown and Tufts University Schools of Medicine, and Chair of the Global Health Program at the Meridian International Center. She served for more than 20 years in health leadership positions in the Federal government in the Administrations of four U.S. Presidents, including as Assistant Surgeon General of the United States, the first Deputy Assistant Secretary of Women's Health, as a White House Advisor on Health, and as Chief of the Behavioral Medicine and Basic Prevention Research Branch at the National Institutes of Health. Dr. Blumenthal has received numerous awards including honorary doctorates and has been decorated with the highest medals of the U.S. Public Health Service for her pioneering leadership and significant contributions to advancing health in the United States and worldwide and was the recipient of the 2009 Health Leader of the Year Award from the Commissioned Officers Association. Admiral Blumenthal has been named by the National Library of Medicine, The New York Times and the Medical Herald as one of the most influential women in medicine and as a Rock Star of Science by the Geoffrey Beene Foundation.
Katherine Warren, an undergraduate at Harvard University, serves as a Health Policy Fellow at the Center for the Study of the Presidency and Congress and is the founding Co-Director of the Akili Initiative, an online student think tank for global health.
Recommended Websites for More Information:
iCenters for Disease Control and Prevention. Inhaling Tobacco Smoke Causes Immediate Harm. December 9, 2010. Electronic document, retrieved December 14, 2010.
iiOffice of the Surgeon General (2001). Women and Smoking: A Report of the Surgeon General. U.S. Department of Health & Human Services. Available from http://www.surgeongeneral.gov/library/womenandtobacco/
ivCenters for Disease Control and Prevention. Fact Sheets: Alcohol Use and Health. July 20, 2010. Electronic document, retrieved December 14, 2010.
vCDC (2010). Deaths: Final Data for 2007. National Vital Statistics Report 58(19):
viTanya GK, et al. (2011). Race and gender associations between obesity and nine health-related quality-of-life measures. Quality of Life Research 20(5): 665-674.
viiMurray, C. J. L. et al. (2006). Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States. PLoS Medicine, 3(9):260.
viiiFDA. Dietary Guidelines for Americans, 2011.
ixScarmeas, N. & Stern, Y. (2004). Cognitive Reserve: Implications for Diagnosis and Prevention of Alzheimer's Disease. Current Neurology and Neuroscience Reports 4(5): 374-380.
xAllen NE, Beral V, Casabonne D, Kan SW, Reeves AB, and Green J. (2009) Moderate Alcohol Intake and Cancer Incidence in Women. JNCI Natl Cancer Inst 101(5): 296-305.
xiSebelius, K. (2011). Health care law helps women. Journal Sentinel. May 12, 2011. Available from http://www.jsonline.com/news/opinion/121736898.html