Recipients of AcademyHealth’s Presidential Scholarship for New Health Services Researchers were invited to blog about select sessions during the 2012 Annual Research Meeting. The following session summary is written by Sean M. Phelan, Ph.D., M.P.H., Department of Family Medicine and Community Health, University of Minnesota - Twin Cities. The Annual Research Meeting featured a special session that was organized to highlight sex and gender disparities in health and health care, and to discuss strategies to raise awareness about gender inequity and eliminate barriers to high quality health care for women. Presenters included Drs. Arlene Bierman, Paula Adina Johnson, Sarah Hudson Scholle, and Elizabeth Yano, and the session was chaired by Carolyn Clancy, director of AHRQ. Though little of the session was devoted to disparities between LGBT and heterosexual individuals, Dr. Clancy reported disturbing rates of discrimination in health care. In one study, 19 percent of LGBT, 22 percent of male-to-female transgendered, and 19 percent of female-to-male transgendered reported being denied health care services. Also, 28 percent of transgendered people reported avoiding or delaying care. Dr. Clancy highlighted some key areas where improvement is need for women’s health, including cancer screening, quality of diabetes care, and immediacy of cardiac care. Dr. Johnson reported on some of the challenges and successes of the Massachusetts health care bill. Successes include covering 98.1 percent of state residents, increasing access to care, and reducing insurance premiums. Disparities persist, however, and coverage rates—though high overall—vary greatly by region. The Health Disparities Council was formed to evaluate and address disparities. The Council, however, did not prioritize gender disparities, and thus, information is scarce. Dr. Adina Johnson stressed the need to regularly and systematically collect and report stratified data in order to understand health and health care through a gendered lens. The need to collect and report information stratified by gender was a common theme for several of the presenters. Dr. Hudson Scholle made the case that there is much effort to quantify women’s health, but very little effort made in stratified reporting to uncover gender disparities, and as a result, gender disparities are not a large part of the national agenda. She asserted that stratified disease rates and gender disparities should be reported in many studies, and among various subgroups. She presented findings from a study of individuals with schizophrenia which identified gender disparities in cholesterol testing and diabetes monitoring. Dr. Bierman presented information from the Ontario Women’s Health Equity Report (POWER), which presented findings stratified by several characteristics, allowing for comparisons between subgroups and making possible the identification of disparities not otherwise evident. These data have contributed to her conclusions that the social determinants of health affect women and men differently, and that gender inequity is much more than a difference in health care access. The POWER report is available on the study’s website, and contains a wealth of information about gender and other disparities in health and health care, as well as a road map of strategies to reduce these inequities. Dr. Yano reported on the status of women’s health and gender disparities in the VA. Overall, the VA outperforms other health care systems on several quality metrics; however, the growing number of women seeking care at VA facilities is presenting new challenges and opportunities for the VA to fulfill its mission. Women currently make up 15 percent of active duty personnel, and large proportions of women who served in Iraq or Afghanistan are now seeking care at VA facilities. In order to serve this growing population of women veterans, 54 percent of VA hospitals have women’s clinics, which have improved rates of cervical and cancer screening, and rates of reported access, continuity of care, and care coordination. Gender disparities persist in lipids control, diabetes process measures, depression screening, influenza and pneumococcal vaccination, and colorectal cancer screening. As part of a program to reduce gender disparities and improve care, each VA region (VISN) chooses a disparity to focus on, and develops an intervention and implementation strategy, and must measure and show evidence of reduction in the disparity. Overall, the session identified several gender disparities, but also found key gaps in gender stratified reporting that impairs our ability to assess disparities and hinders the development of interventions to reduce disparities and improve women’s health.  

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