March is Women’s History Month and April is National Women’s Health and Safety Month, which makes this an ideal time to reflect on the improvements that have occurred in women’s health care while sharing tips and suggestions that can help keep women healthy.
Men and women have different health needs that need to be addressed at differing stages in women’s lives. Poverty, issues related to violence and other socio-economic concerns always have factored heavily in women’s health. The average life expectancy for an American woman in 1900 was 48.3 years. Women only made up 18 percent of the paid labor force until World War II when they were introduced to jobs traditionally held by men. By 1950, women represented 30 percent of the paid labor force and by the late 1990s, nearly half of the labor force was female.
Until the middle of the 20th century, health care for women mainly was based on reproductive-health issues. The maternal mortality rate was six to nine deaths per 1,000 live births, and approximately 90 percent of deliveries took place at home. Most births were unattended or assisted by midwives who often were poorly trained. The majority of maternal deaths were associated with poor obstetrical practices, such as a lack of basic hygiene, the overuse of surgical interventions (forcep deliveries, episiotomies and cesarean deliveries) and a lack of training for health-care providers. An estimated 40 percent of maternal deaths were caused by birth-related infections. In 1900, 30 percent of infants in America’s major cities died before their first birthdays.
Infectious diseases were leading causes of death for women, men and children. Many of the deaths that occurred in the early 20th century now are considered preventable. Preventive-health practices in the 20th century — hand washing, sterilization of medical equipment, proper ventilation, safe food storage and preparation, and access to a safe water supply — played a big role in reducing the number of deaths that used to be considered “the norm.” Immunization was a key preventive-health practice responsible for this decline.
Today we know that many conditions that cause high mortality rates among U.S. women can be prevented or controlled if women have access to health-care services. About one-third of women older than 65 have heart disease, and many have problems with hypertension. Nearly two-thirds of women between 60 and 69 have low bone density, which dramatically increases their risk of breaking bones in a fall. Women today can avoid many of the problems women years ago didn’t know how to prevent. Good health is not something women can take for granted. We have to eat healthy diets, stay physically active, avoid tobacco and second-hand smoke, limit alcohol and keep our weight within a normal range.
Other ways women can prevent disease and problematic health issues is by scheduling routine screenings, which catch diseases in their early stages when they can be treated or cured. The following are tests that every woman should know about and schedule:
• All women should undergo pap tests for cervical cancer about three years after they become sexually active or when they are 21 years old. Screening should be done every year with the regular pap test or every two years using the newer liquid-based pap test.
• Clinical breast exams should be scheduled every three years for women in their 20s and 30s in addition to monthly breast self-exams. Women older than 40 should continue to do monthly self breast exams and have a clinical breast exam every year.
• Mammograms should be scheduled every year beginning at age 40.
• Blood pressure test for hypertension should begin at age 21. Have your blood pressure checked every one to two years.
• Diabetes testing should be done every three years beginning at age 45.
• Women should begin testing their blood cholesterol at age 20 with testing repeated every five years.
• Bone mineral density exam/bone mass measurements should be done at age 40 if you are at increased risk for osteoporosis or low bone density.
• While recommendations vary, the American Thyroid Association recommends having a thyroid test once every five years starting at age 35.
• Colorectal cancer screening are recommended for women age 50 years or older.
• Dental exams, regular checkups and professional teeth cleanings can detect oral-health problems and should be done on a regular basis.
• Examine your skin once a month for changes, such as moles that change color, shape or size, and ask your health-care professional how often you should have your skin examined.
• Keep your immunizations up to date.
Above all else, just take care of yourself. Life is too short to waste even one day feeling overburdened.

Ratcliffe is a consultant to the Coastal Health District. You can call her at 876-6399.