Sunday, February 29, 2004

Women's Health in the Spotlight
Julie Gerberding, New American Hero

Dr. Gerberding photo from CDC websiteMost people had never heard of Dr. Gerberding or the CDC until the SARS epidemic got everyone's attention.  Then every news outlet wanted to hear everything she had to say.  Dr. Gerberding seems to have found that she can put this media attention to good use.  Indeed, with SARS, Mad Cow, the ricin scare, and Avian Bird Flu, and the omnipresent fear of bioterrorism, the pubic wants to know and needs to know what Dr. Gerberding has to say. 

Now that the SARS/Mad Cow/ricin/Avian flu headlines are receding from memory, she is back with some important public health pronouncements.  She is talking openly about one of the sad chapters in medical history, that of the inadequate attention paid to women's health.  Now that about 50% of medical students are female, that is changing.  There is still a long way to go, and Dr. Gerberding is playing a big role.  For example, yesterday's NYT contained an article on the problems that infectious disease cause during gestation and delivery.  These are problems with huge humanitarian and financial impacts.  They are especially tragic because so many are preventable with good pre- and postnatal care. 

To address these issues, the CDC sponsored the International Conference on Women and Infectious Diseases in Atlanta GA on February 27th and 28th.  This is being held in conjunction with the International Conference on Emerging Infectious Diseases.  In May, the CDC will co-sponsor the 2004 National Sexual Violence Prevention Conference. 

The NYT article is drawn from the ICWID conference.  We will have to wait until May to hear what she has to say at the  NSVPC.   The CDC has, in the meantime, put out a report  on the economic impact of what they call Intimate Partner Violence.  This consists mainly of men being violent toward wives or girlfriends.  As we shall see, the economic impact is very great indeed.  The report indicates that their overall cost estimate does not include may costs, such as legal and criminal justice related costs.  It also includes only costs stemming from violence toward adult women.   They did not feel able to gather reliable information regarding victims under the age of 18. 

February 28, 2004
Action Urged on Diseases With Dangers for Women

ATLANTA, Feb. 27 — New diagnostic tests and better information programs are urgently needed to improve the control of a number of infectious diseases that affect women and newborns, a top federal health official said here on Friday.

Sexually transmitted diseases and certain other common infections affect women disproportionately, compared with men, and can be dangerous, particularly in pregnancy, said the official, Dr. Julie L. Gerberding. Dr. Gerberding is director of the Centers for Disease Control and Prevention here.

Cultural, economic and social factors also have a critical role in the disparities between men and women. Women often serve as the brokers for their families' health care "but are last in line to address their own health problems for lack of time," Dr. Gerberding said at the opening of a two-day international meeting on women and infectious diseases.

A lack of scientific knowledge and the failure to apply what is known also increases the burden of such illnesses on women, she said.

The centers, the World Health Organization and the American Society for Microbiology are sponsoring the meeting to renew efforts to decrease infection death rates among women and newborns.

"Women disproportionately suffer the burden of poverty, are the victims of widespread and persistent discrimination in all areas of life and put their lives at risk every time they become pregnant," Dr. Gerberding said.

She added that although the problem of women and infection was more complicated than gender alone, it offered "some unique aspects."

One is that certain diseases can cause more serious illness and lead to more severe complications among pregnant women. Another is that women are at least four times more vulnerable to infection from H.I.V. and other sexually transmitted diseases.

For example, 60 percent to 70 percent of the women who are infected with gonorrhea or chlamydia may be unaware of it. Delayed diagnosis and treatment can lead to chronic pain, stillbirth, infertility and even death.

April 28, 2003
Contact: CDC Injury Media Relations:

CDC Reports the Health-Related Costs of Intimate Partner Violence Against Women Exceeds $5.8 billion each year in the United States

The health-related costs of rape, physical assault, stalking, and homicide by intimate partners exceed $5.8 billion each year. Of this total, nearly $4.1 billion are for direct medical and mental health care services and productivity losses account for nearly $1.8 billion, according to a report by the Centers for Disease Control and Prevention (CDC). The report is being released today in conjunction with the CDC Injury Center’s national conference, “Safety in Numbers.”

“Violence against women harms more than its direct victim. It also harms the children, the abuser and the entire health of all our families and communities. For the health of our country, it is critical that we stop this cycle now,” Health and Human Services Secretary Tommy G. Thompson stated. “Just last week, the Department hosted a meeting of the National Advisory Committee on Violence Against Women and shared the many Department programs that are making a profound difference, providing the support and healing they need to rebuild their lives.”

CDC Director Dr. Julie Gerberding added, “Violent acts against women don’t end with visits to the emergency room. They are a major public health problem that we are committed to preventing. Intimate partner violence costs women and their families a high-price financially, physically and emotionally. We must continue to do all we can to prevent the pain, anguish and health problems that result from intimate partner violence.”

The report estimates the incidence, prevalence and health-related costs of non-fatal and fatal Intimate Partner Violence (IPV) against women. It also identifies future research needs and highlights CDC priorities for IPV prevention research. IPV is defined as violence committed by a spouse, ex-spouse, current or former boyfriend or girlfriend.

“CDC is actively involved in ongoing efforts to prevent violence against women,” said Sue Binder, M.D., CDC Injury Center Director.“ This report provides information that is crucial in helping communities demonstrate the impact violence against women has on society.”

CDC researchers examined the data from the 1995 National Violence Against Women Survey for the incidents of IPV, the costs, how health care was used, and how much work-related time was lost for women who were assaulted by intimate partners. This report reflects the most current and reliable data that is available on IPV and its related health costs.

Because of the data limitations, the costs presented in the report likely underestimate the economic burden of IPV in the United States. The report points out that these cost figures are not comprehensive, excluding such important costs as those related to the legal and justice systems. Therefore, the costs should not be used for analyzing benefit-cost ratios for IPV prevention programs. However, the report may be useful in calculating the health-related cost savings from reducing IPV and associated injuries and for evaluating the impact of IPV on specific sub-sectors of the economy, such as consumption of medical resources.

To help reduce IPV, CDC is currently:

  • Developing a guide to identify promising prevention programs and interventions for batterers
  • Funding programs to support rape prevention and education efforts in all 50 states, the District of Columbia and eight territories, providing for education in communities about the extent of sexual assault and the development of programs to prevent it. 
  • Funding 14 state Domestic Violence Coalitions to develop and implement community coordinated responses. This initiative coordinates services and mobilizes communities to respond to and prevent domestic violence. 
  • Funding projects to help monitor and track intimate partner violence in five states. The goal is to help reduce IPV through the collection of timely and credible data that are useful for planning, implementing and evaluating prevention programs.

The full report on the Costs of Intimate Partner Violence Against Women in the United States is available online at: http://www.cdc.gov/ncipc/pub-res/ipv_cost/ipv.htm.

For more information on intimate partner violence visit the CDC’s website at: http://www.cdc.gov/ncipc.

Notice that the report was based upon data from 1995.  It is almost certain that the costs are much higher now.  The incidence of domestic violence increases with increasing unemployment and general financial stress.  Also, the costs of health care, and of health insurance, have increased considerably since 1995.  It is important to recognize the fact that IPV has a significant impact on all of us. 

Efforts to reduce the frequency of perinatal infectious disease, and the incidence of domestic violence, deserve greater attention among health care providers and among policy makers.  Dr. Julie L. Gerberding, M.D., M.P.H.,  is hereby nominated as a New American Hero.