Back to Table of Contents | February 2005

Pulse

Defining Excellence

The University of Minnesota begins a journey toward improving the health of the state’s female population.

United Nations Secretary General Kofi Annan once said, “When women are fully involved, families are healthier. They are better fed. Income, savings, and reinvestment go up. And what is true of families is true of communities and eventually of whole countries.”

Nancy Raymond, M.D., director of the University of Minnesota’s National Center for Excellence in Women’s Health, has posted that statement on the center’s Web site and applies it as a mantra of sorts. “Basically, the best way to make a healthy world is through healthy women,” says Raymond, who is also an associate professor of psychiatry.

The belief that the world’s health is so closely tied to the health of women was what prompted Raymond and her colleague Anne Taylor, M.D., a University of Minnesota cardiologist, to lead the effort to get the institution recognized as a leader in women’s health, particularly in regard to clinical care, education of health care professionals, research, and community outreach.

The U.S. Department of Health and Human Services’ Office of Women’s Health granted the designation in September 2003, making the University of Minnesota one of 23 such sites around the country. (Harvard University, UCLA, the University of Wisconsin, and Boston University are among the others that have received the designation.)

The designation—and the funding that goes with it—has allowed the university to create an organization that coordinates work that’s already being done on women’s health issues throughout campus. According to Raymond, the university will receive $150,000 a year in financial support from the Office of Women’s Health for up to four years through September 2007. The University of Minnesota’s Academic Health Center will provide matching funds.

Some of the work being done by faculty affiliated with the center includes:

— Studies by Taylor and her colleague, Toni Bransford, M.D., of why African American women younger than 55 years of age suffer higher morbidity and mortality rates than African American men and Caucasian women in the same age group.
— Raymond’s examination of the differences in metabolism between women who do and don’t have eating disorders.
— Associate professor of psychiatry Scott Crow, M.D.’s study of the effectiveness of different types of treatments for eating disorders (eg, cognitive behavioral therapy versus drug therapy with self-help manuals).
— A study by Doug Yee, M.D., who heads up the breast cancer program at the University of Minnesota Cancer Center, to determine whether exercise can help reduce estradiol and insulin growth factor, two hormones that have been associated with increased breast cancer risk.
—A survey to determine which factors, if any, make it difficult to retain women faculty at the medical school, where representation of women in full professorship positions remains low. “We think the more women there are in advanced positions in medical schools, the more emphasis there will be on making sure that adequate research and teaching takes place with regard to the unique aspects of diseases—heart disease, stroke, and diabetes, for example—in women,” Raymond says.
—Disseminating heart-health educational materials to health care professionals around the state. “Particular emphasis is being paid to rural areas—for example, training rural health professionals about how the symptoms and signs of heart disease in women are different from those in men,” explains Raymond.
—Organizing training for law enforcement officers, immigration attorneys, prosecutors, and health care professionals on the problem of human trafficking and slavery in Minnesota.
—Conducting focus groups among Latina women, West African immigrant women, women from rural parts of northern and western Minnesota, Asian women, and American Indian women about what kind of health information they want. Outreach director Melissa Avery says they’ll develop educational materials for each of these audiences based on the results. “Providing women with information that they want by a method they prefer will help them promote their own health,” she says.

Raymond believes the National Center of Excellence designation will help broaden expertise at the university and ensure that issues surrounding women’s health get more attention.

“Reproduction and the genitals are not the only things that make women different than men; their hearts are different, their brains are different, they respond differently to treatment and present symptoms differently than men,” she says. “Certainly, with the center, there will be growing awareness of these facts—and with it, growing interest in finding answers to the many questions that remain.” —Jeanne Mettner

The Subtle Symptoms

Most women don’t go to the emergency department when they experience head, neck, back, and jaw pain—common symptoms of a heart attack.

According to a study by the American College of Emergency Physicians, 47 percent of women said they would call their doctor if they experienced such symptoms and only 35 percent would call 911 or go to the nearest emergency department.

Of the 1,000 women age 35 and older who were surveyed,

• 66 percent said they would take aspirin or ibuprofen if experiencing such symptoms;
• 59 percent said they would lay down and rest;
• 46 percent said they would wait 24 hours to see if the symptoms went away.

Chest pain is the second leading cause of emergency department visits. However, women often experience less common, more subtle warnings such as flu-like symptoms, feelings of breathlessness, unexplained fatigue, feelings of anxiety, and weakness or dizziness when having a heart attack.

Minnesota: Where the women are strong...and live long

The National Women's Law Center examined 34 indicators of health status among women and ranked states for each. (Table)