August 2002: What Will It Take to Improve the Health of Mothers?

Ursula Snyder, PhD


August 14, 2002


It's not difficult to list fundamental elements that are required for good health beyond a "normal" genetic makeup and an undetermined amount of good luck: habitation in a clean and safe environment, proper nutrition, regular exercise, enough sleep on a regular basis, emotional/social support, and meaningful/manageable work. Barring genetic defects and trauma, the conditions for much of the illnesses that affect women are precisely the opposing conditions for good health: habitation in a polluted and unsafe environment, poor nutrition, sedentary lifestyle, sleep deprivation, lack of emotional/social support, and demeaning/overly demanding work. These negative conditions are intensified and often provoked by poverty.

This morning in Medscape's "Today's Women's Health News," a review of a study published in the American Journal of Public Health shows the devastating effects that women in poor health have on the health of their children.[1] This particular study, by Dr. Robert S. Kahn, of Children's Hospital Medical Center in Cincinnati, Ohio, and his colleagues, found that maternal poor physical health and smoking had strong associations with children's physical health and behavior problems. The study also showed that maternal depressive symptoms were associated with children's delayed language and behavior problems at 3 years of age. Moreover, the study linked low income in the 12 months before delivery (P < .001) to the measured outcomes. However, even after adjustment for income, education, ethnicity, age, marital status, and child birthweight, maternal reports of ill health were associated with up to 7.1 times higher risk of poor health in their children.

As Editor of Medscape Women's Health, it is my job and opportunity to provide clinicians who treat women with the best clinical and research information available to me on all aspects of women's health -- from laboratory bench to hospital bedside to government policy changes and laws that affect the practice of medicine and women's health. When I read about such studies as the one conducted by Kahn and his colleagues, I ask myself whether Medscape Women's Health has the particular information that would be useful to clinicians and that addresses the issues raised. Obviously, they cross many disciplines. In this case, clinicians coming to Medscape Women's Health can indeed draw from the expertise of clinicians representing all of the medical specialties relevant to the issues in Kahn's study. For example, one can visit the Medscape's "Resource Centers" on pregnancy, growth and development, depression, and smoking. In this latter Resource Center, one of the features is a "Journal Scan" summary from Medscape Nursing that discusses a recent review, "Maternal Smoking During Pregnancy and Severe Antisocial Behavior in Offspring." The Asthma Resource Center is also relevant. One could also visit the section on economic class in the Resource Center on health diversity, which includes an article from the indexed, peer-reviewed Medscape Women's Health eJournalTM by Dr. Roseanna H. Means titled, "A Primary Care Approach to Treating Women Without Homes" and a report, "Socioeconomic Status of Women With Diabetes --- United States, 2000" from the Centers for Disease Control and Prevention. This study showed that, overall, women with diabetes were approximately twice as likely to have an annual household income < $25,000 as women without diabetes.

Seventy percent of the 1.3 billion people living in poverty on this planet are female. More and more, medical scientists are concluding their research on the health of women with published statements indicating that the implementation of strategies to seriously combat ill health in women and to prevent ill health and growth and development problems in children will also require the implementation of strategies to reduce poverty.

Poverty is a medical/political issue. Along with an ever growing number of health professionals and medical scientists, I believe that solutions to many of the medical problems of women and children will necessarily involve the political dimension.

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