Thursday, October 5, 2017

Calling All Wonder Women—The US Health System Needs Strong Leaders, Healthy Mothers

Legend has it that the creation of Wonder Woman—the super hero and pop culture icon who has saved us from imminent doom since World War II—was inspired by real-life women's health activists from the early twentieth century. These were women who bucked convention and championed causes like reproductive rights and suffrage. Women who saw opportunities for collective action where others saw insurmountable obstacles. Women who refused to be relegated to second-class status and instead became the driving force for creating a more just, inclusive world.

We have come a long way since the days of Margaret Sanger and Susan B. Anthony, but not far enough. The US health system offers a window into our uneven progress. Women in the United States have dismal population health outcomes compared with those in peer nations, particularly when it comes to pregnancy outcomes.

Women lack leadership opportunities and, at times, basic respect. While women comprise about 80 percent of the health care workforce, according to Rock Health's State of Women in Healthcare: 2015 report, it notes that only 27 percent of board members in Truven Health Analytics' 100 Top (US) Hospitals are female. And less than 10 percent of CEOs at those 100 Top Hospitals are women, says a 2016 Rock Health research blog post. Some of the regressive women's health–related policies proposed during recent reform debates—such as optional coverage for maternity care—were developed with scant female representation and sound straight out of Sanger's era (the early twentieth century).

Given these headwinds, we could become disillusioned. Or, we could channel our inner Wonder Woman to fight injustice. Over the past twenty-five–plus years, we at the Jewish Healthcare Foundation (JHF) have partnered with many heroines while leading campaigns to detect and prevent breast cancer, improve women's heart health, and prevent cancer through advocating for HPV vaccination.

We're taking that work to the next level by establishing the Women's Health Activist Movement Global (WHAMglobal), which forms networks of advocates in women's health to improve health care delivery and outcomes, equity, and leadership.

Launched in late 2016 and supported by the JHF and the Heinz Family Foundation, WHAMglobal aims to spark local, national, and international advocacy for women's health, health care quality and safety, health professions workforce development, and pay equity within the field. I founded WHAMglobal, the members of which include mothers, daughters, caregivers, and patients who are now aligned to build upon the momentum created by January 2017's marches with strategy and programming.

WHAMglobal is focused on uncovering and advancing "Big Ideas"—those that creatively tackle urgent women's health issues, unite communities around a shared goal, and hold the promise of being expanded to other communities. Here in Pittsburgh, Pennsylvania, we recently unleashed the creativity of our nonprofit sector through a Big Idea Challenge, which featured twenty nonprofit organizations developing and pitching their best plan to advance women's health in the region for the chance to win a $10,000 award and the support of the WHAMglobal network. The Big Idea Challenge provided inspiration for a broader effort to improve maternal health education, advocacy, and outcomes in western Pennsylvania and beyond.

Pregnancy should be one of the happiest times in a person's life. For too many families in the United States, it's a time filled with heartache. The United States has the worst maternal mortality rate among developed countries, and its rate is not even close to rates in similar countries. About twenty-six mothers in the United States die for every 100,000 live births, according to a study in the Lancet. The next-highest maternal death rate among peer countries is the United Kingdom, at nine per 100,000 live births. And while maternal death rates are declining elsewhere, rates in the United States keep climbing. There are numerous reasons for this, but the CDC Foundation estimates that about 60 percent of these deaths could be prevented.

One in seven women in the United States grapple with the symptoms of postpartum depression.

Our Big Idea Challenge winner, the Latino Community Center, is focused on improving maternal health outcomes for Pittsburgh's growing Latin American community. Its team plans to support mothers by offering prenatal and perinatal classes, promoting breastfeeding, establishing postpartum support groups, developing culturally competent communications materials, and training community health workers (CHWs). The CHWs will help pregnant women and new mothers navigate the health system and connect to vital community and social services.

By partnering with and learning from the Latino Community Center's efforts, WHAMglobal will develop a larger, maternal health–focused CHW program that features curricula, training programs, and career tracks collaboratively developed by multiple agencies and organizations.

Around the world, CHWs are valued members of care teams who help keep mothers well. The United States, by contrast, lags behind in terms of CHW training, certification, and reimbursement. WHAMglobal aims to change that. For starters, we will develop a best practices guide on using CHWs to improve maternal health and will collaborate with other other local community partners serving immigrant and refugee populations to implement their own CHW programs. These efforts are part of a recent $500,000 grant that the JHF made to build the WHAMglobal network.

We're not stopping there. WHAMglobal is recruiting advisory committee members with the clinical, cultural, and policy skills to improve women's health and foster development of a CHW model. We're reaching out to women's health leaders from around the United States and globe, including the Women of Impact and the International Women's Forum, to share learnings and address our unacceptably high maternal mortality rate. We are, in short, unlocking the Wonder Woman–like qualities that we all possess to fight injustices in the health system.

The advancements made over the years in women's health and equity are not irreversible, and are not complete.

If you want someone to protect your rights, don't look to the silver screen—look in the mirror and join us.



from Health Affairs BlogHealth Affairs Blog http://ift.tt/2y406iK

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