STATEMENT
by Wanda K. Jones
Dr. P.H., Deputy Assistant Secretary, Women's Health, United States Department of Health and Human Services

It is a pleasure and honor to be part of this important roundtable.

In the U.S., we are pleased that women's health is now on the national agenda and our experiences may be helpful though I know we have much to learn. As American writer Judith Stern says, "Experience is a comb life gives you after you lose your hair." I hope by sharing some of our progress here, we can help you avoid at least some hair loss!

Why Women's Health?

Achieving "health for all women in the 21st century" means having to acknowledge that the face of the average woman is changing around the world. A recent report from UNESCO reminds us that in 1950, life expectancy across the globe was 47…now it stands at 66, including emerging market economies. It is true that ten million children in the world will never see their fifth birthday. Yet it is equally true that better public health and nutrition have raised longevity even in many relatively poor countries.

In 50 years, when the United Nations celebrates its 100th birthday in the middle of the 21st century…20 percent of the world population will be over the age of 65, compared with one percent 100 years ago. In the United States, in just 30 years, one in four women will be over the age of 65!

And the fastest growing segment will be adults living past 80, including more and more people living past 100. This has profound social, cultural and health implications. More and more of this aging population will be women living on their own, either through divorce or widowhood. Are we ready? For example:

Will longevity gains create a larger disabled population? How will we pay for the medical services needed for older citizens? Will housing arrangements change to accommodate multiple generations of family members? Will formal education end around the age of 22? Will we restructure universities to bring back students in mid-life? Will businesses adapt to maintain a productive work life for many years past the standard retirement age of 65? In America, our national landscape is blooming in myriad shades: by the year 2030, one in five American women will be of Hispanic heritage, one in eleven will be Asian, and the number of African Americans, and Native Americans (almost 1 in 100) will grow steadily. In fact, by the year 2050, non-Hispanic white women like me will represent barely half of the adult female population in America.

Status of Women's Health

So it is clear that our nation and the world face the challenge of meeting the health needs of an increasingly older, more diverse and more female population. Geographic borders are blurred by the changing faces of women around the world, and by the technologies that help us reach each other more easily than ever.

Killers

For lack of time, I won't do much more than list the major killers of women in this country. Heart disease followed by the cancers: lung, breast and colorectal cancer in particular. But it's not just what kills us, it's how we live our lives.

Women who have had a live birth

Over 80 percent of U.S women have had a child by the age of 44, underscoring the fact that childbearing and childrearing remain major factors in women's health and are not to be discounted in their role in an older woman's health risks or her ability to attend to her own needs.

Unintended Live Births

Despite contraceptive technologies available to us, too many pregnancies are unintended…approximately 20% of women over 35 giving birth report that their pregnancy was unintended. This is not just a teen problem, and it reflects problems in lack of choices and lack of use of appropriate methods.

HIV/AIDS

I don't have to tell this group what a devastating problem HIV/AIDS is, even in this country, particularly for African American and Hispanic women.

Violence

More than 2.5 million U.S women are victims of violence each year and nearly 2/3 of them are attacked by someone they know.

Chronic Diseases

And the bonus years of life bring chronic conditions: osteoporosis, arthritis, diabetes and autoimmune diseases; not to mention the effects of surviving heart disease or breast cancer. We know we can prevent or at least delay these conditions - prevention has to be our investment if we expect to extend life and quality of life in the next century. Public Health Services Office of Women's Health Activities

Again, for lack of time, I can't give you in great detail what we're doing in the United States, but let me say our efforts are consistent with those of the Department of Health and Human Services - eliminating racial and ethnic disparities in health. We support culturally sensitive educational and communications initiatives that encourage personal responsibility. Centers of Excellence

We fund National Centers of Excellence in women's health, some of which were selected for their excellence in serving the health needs of minority women.

Girl Power!

We have a Girl Power! Campaign which is designed to give girls, ages 9 to 14, the tools to practice healthy behaviors to last them a lifetime.

Minority Women

Special outreach efforts target minority women.

HIV/AIDS

We support a Collaborative Work Group of Women…to bring public and private groups together.

Violence

We fund the National Domestic Violence Hotline (1-800-799-SAFE) to help women.

Since its inception 3 years ago, the hotline has received almost 300,000 calls, the majority from women and men who had never before reached out for assistance. This response underscores the need for more outreach.

My office staffs the National Advisory Council on Violence against Women, which is embarking on a process of establishing a national agenda that increases the focus on prevention. The Department of Justice and HHS led by Attorney General Janet Reno and Secretary Donna Shalala are committed to eliminating VAW, and have undertaken a variety of efforts for women, for batterers, and, in recognizing the cycle of violence, for children. The Council is working toward a national agenda to end the scourge of domestic violence.

NWHIC

But we have not stopped there… we now have the tools of the information age. You have seen our web page displayed downstairs, but the National Women's Health Information Center has a toll-free phone line and a website that serve as a national clearinghouse for both federal and private sector information on women's health.

The center acts as a "one-stop shopping" gateway for any and all women's health issues and links to all federal agencies and publications on women's health and to hundreds of government-screened private sector sites.

Health Insurance

Around the world, nations struggle with the problem of how to pay for the health care of their citizens. Some have national health insurance. In the United States, we have not yet been able to do that. Sixteen percent of American women have no health insurance, and those who do often have limited coverage. That may be our biggest challenge as we face a new century.

Closing

In closing, let me quote anthropologist Margaret Mead. She said, "A small group of thoughtful people could change the world. Indeed, it's the only thing that ever has."

I know that I am in a room filled with thoughtful people who have the power to make changes in the world. I wish you well as you change the world, today, tomorrow, and for all time.

Thank you.