Although they comprise approximately half of the population in the United States, women are woefully underrepresented in state legislatures and noticeably absent from the policy-making process that determines access to important women's health policies.
But when women are present, the political agenda changes.
According to a 2001 report, Women State Legislators: Past, Present and Future, issued by the Center for American Women and Politics (CAWP) at Rutgers University, the presence of women legislators brings increased attention to women's issues and prompts members of both genders to consider legislation favorable to women, racial and ethnic groups, and the disadvantaged. The report also concluded that both Democratic and Republican women are more likely than their male counterparts to support liberal and moderate positions on a variety of issues, such as harsher penalties for hate crimes and legally recognized civil unions for gay and lesbian couples.
"When women legislators come to the table, you see issues raised that men don't generally think about," says Susan Crosby, Deputy Executive Director of Women in Government, a bipartisan educational association for elected women in state government (personal communication, December 12, 2003) "Women come to the table primarily with 2 agenda items -- education and health. Men just don't think about their safety when walking down a dark street, or they don't think about who is going to care for their aging parents. But women do."
Crosby knows firsthand the importance of women legislators and the impact they can make in setting favorable policies for women. She served for 12 years in the Indiana House, 6 years as the deputy speaker of the House. "I'm convinced that having more women legislators will result in more favorable legislation for women."
But to shape the policy agenda, women have to first get to the table, a hurdle in and of itself. Although women currently represent 22% of the elected state lawmakers (up from 10% in 1979), no state boasts 50% representation. Washington comes the closest with 37% in 2003, and in only 5 others -- California, Colorado, Maryland, Oregon, and Vermont -- do women legislators comprise over 30%.
But if women bring women's issues to the policy table, then is the reverse true? Will their absence hinder important women's issues such as access to healthcare? Possibly. According to the CAWP report, women legislators, regardless of party affiliation, will favor increased access to women's health services more often than men within their party. For example, more women than men favor allowing minors to obtain a legal abortion without parental consent, and fewer women would like to see the Supreme Court overturn Roe v. Wade.
"Having women legislators keeps the pressure on women's health issues," says Crosby. "In the last 10 years there's been more gender-specific research just for women, and we're here to remind the business industry, the pharmaceutical industry, and the research community that women's health policy should not be made body part by body part. To address women's health needs as a society, we need a comprehensive approach."
Women health policy leaders have known for some time that serious gaps in service delivery and access to care exist. As reported in The Kaiser Family Foundation in its 2003 benchmark report, Women's Access to Care: A State-Level Analysis of Key Health Policies, women's health policies have been enacted by states in a piecemeal fashion, resulting in disparate levels of healthcare across the country.
Will electing more women legislators help close these gaps? That's hard to say. No one knows for sure if having more women legislators will improve women's health policy and actually improve women's health, and little research has been done to explore the connection. Of the top 10 states with the highest women's health status in 2001, only 4 were among the top 10 states with the greatest percentage of women legislators (Colorado, Connecticut, Vermont, and Washington).
According to Crosby, however, other forces may override the presence of women legislators. "We've seen some enormous budget problems in the last few years, and I'm afraid that we will see some unintended consequences of these actions regardless of who is elected."
But, she adds, efforts to recruit women into elected positions should continue. "We should actively promote and encourage women to participate in our democratic process on both sides of the aisle," says Crosby. "If we're going to have a true democracy, then we need an open debate among people that reflect our population. And 50% of our population are women."
Medscape Ob/Gyn. 2003;8(2) © 2003 Medscape
Cite this: Election 2004: Will Electing More Women State Legislators Advance Women's Health Policy? - Medscape - Dec 31, 2003.