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Census 2000 counted 140 million females, 51% of the U.S. population, of whom 40 million are members of racial or ethnic minority groups20. By 2050, it is projected that just under half of females in the United States will be members of racial or ethnic minority groups21. The ratio of males to females is highest at birth, when male infants outnumber female infants, and gradually declines with age due to higher male mortality rates. Among Americans 85 and older, women outnumber men by more than 2 to 122. Poverty disproportionately affects women; almost 13 million women lived in households with income below the Federal poverty level in 200123.
Women in the United States have a life expectancy 5 years longer than men and lower age-adjusted death rates than men for 13 of the 15 leading causes of death24. However, women are more likely than men to report having arthritis, asthma, autoimmune diseases, and depression23. Overall, many women's health needs are inadequately addressed25. Among women, racial and ethnic differences in mortality and health status are observed. Black women have higher death rates than white women due to heart disease, cancer, and stroke while Hispanic, API, and AI/AN women have lower death rates due to these conditions23. Black and Hispanic women are also more likely to report fair or poor overall health and having diabetes. Poor or near poor women are more likely to report fair or poor overall health; limitations of activity; and having anxiety or depression, arthritis, asthma, diabetes, hypertension, obesity, and osteoporosis26.
In general, gender differences in quality of care are small. However, significant gender differences in cardiovascular care have been demonstrated. Among women, racial, ethnic, and socioeconomic differences in quality of care exist. Racial and ethnic differences are noted in receipt of cardiovascular procedures, cancer screening, and management of fibroids27. Socioeconomic differences are noted in receipt of Pap tests and mammograms28. Women are more likely to obtain preventive services than men23. Among women, racial, ethnic, and socioeconomic differences in access to care are observed. Black women are more likely than white women to report forgoing needed physician care; and Hispanic women are more likely than non-Hispanic white women to report lack of health insurance and coverage for dental and vision care, not having a regular health care provider, not seeing a specialist when needed, and problems communicating with physicians29. Poor and near poor women are more likely than high income women to report lack of health insurance, dissatisfaction with their health plan when insured, and not having a usual source of care28.
Many measures of relevance to women are tracked in the NHDR. Findings presented here seek to highlight conditions and topics of particular importance to quality of and access to health care for women including:
- Heart disease
- Maternity care
- Usual source of care