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WISEWOMAN:
Improving the Health of Uninsured Women

At A Glance
200
4

This report is also available in Portable Document Format (PDF-2007K). Learn more about PDFs.

Photo collage of women of different ages and races


"I knew I needed to make some changes in my life, or I would follow in the footsteps of my mother’s poor health. The WISEWOMAN program at the Women’s Health Network identified my health problems, and I began to make changes to better myself."

Verna DeAngelis
Massachusetts WISEWOMAN participant and
Women's Health Support Group champion


Increased Health Risks For Uninsured Women

The WISEWOMAN logo

In 1999, about 1 of every 10 U.S. women aged 40–64 years was uninsured. Uninsured women are more likely to be of minority racial and ethnic groups, to have less education, and to be poorer than insured women. Their ability to pay for health care is limited. Uninsured women may be especially vulnerable to cardiovascular disease and other chronic diseases, because they are more likely than insured women to smoke cigarettes and to be overweight, and are less likely to engage in physical activity and to be aware of their cholesterol levels.

Among women aged 40 years or older, 71% of those who are insured report having had a mammogram in the previous year, compared with only 46% of uninsured women. Uninsured U.S. adults are also less likely to be screened for high blood pressure and high cholesterol and to be advised to lose weight and quit smoking.

Cardiovascular Disease: The Leading Cause of Death Among Women

Although heart disease and stroke are commonly believed to affect men primarily, more than half of all people who die of heart disease and stroke are women. Among women, heart disease is the leading cause of death and is often not diagnosed until it has progressed to an advanced stage. Addressing risk factors such as high cholesterol, high blood pressure, obesity, sedentary lifestyle, and smoking greatly reduces women’s risk for illness and death from heart disease. However, screening, intervention, and treatment services for these risk factors are often beyond the reach of uninsured women.

WISEWOMEN Participants with Hypertension,
High Cholesterol, and Diabetes
January 2000 - June 2003

Graph depicting WISEWOMEN Participants with Hypertension, High Cholesterol, and Diabetes January 2000 - June 2003

Source: WISEWOMAN Program, CDC

[A text version of this chart is also available.]

Percentage of U.S. Adults Who Had No
Health Insurance, by Race/Ethnicity, 2002

Graph depicting the percentage of U.S. Adults Who Had No Health Insurance, by Race/Ethnicity, 2002

Source: U.S. Bureau of the Census. Health insurance coverage in the United States: 2002. Current Population Reports. September 2003:7. Available at http://www.census.gov/prod/2003pubs/p60-223.pdf.


[A text version of this chart is also available.]

CDC’s Leadership in Promoting Healthy Lifestyles

WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation) is a CDC-funded program that helps women in need gain access to screening and lifestyle interventions that can reduce their risk for heart disease and other chronic diseases. Eligible women are 40–64 years old and have little or no health insurance. Many are from racial and ethnic minority populations.

WISEWOMAN is the result of 1993 legislation that allows for expansion of the services offered through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Through the NBCCEDP, CDC helps states, territories, and tribal organizations provide potentially life-saving screening for breast and cervical cancers to low-income and uninsured women.

In 1995, CDC used a portion of NBCCEDP funding to launch WISEWOMAN demonstration projects in Massachusetts, North Carolina, and Arizona. The primary goal of these WISEWOMAN projects was to offer uninsured women screenings and interventions for obesity, sedentary behavior, poor dietary habits, high blood pressure, high cholesterol, and smoking. Some projects also screened women for diabetes or osteoporosis. Interventions were directed at changing behavioral risk factors for chronic diseases, especially physical inactivity and unhealthy diets. Each project tested different interventions to determine which ones worked best for their populations. Specific interventions included structured counseling, physical activity classes, nutrition classes, and walking groups. WISEWOMAN staff provided referrals when treatment was needed.

In their first year, the three WISEWOMAN projects demonstrated that offering screening tests for chronic disease risk factors to women in the NBCCEDP was feasible and well accepted by providers and participants. Early studies of the effectiveness of selected WISEWOMAN interventions found that participants reported reducing the fat in their diets and becoming more physically active.

Increasing the Reach of WISEWOMAN

WISEWOMAN has gradually expanded the number of demonstration projects. In 2003, CDC supported 14 projects in 13 states to provide screening and interventions to underserved women. From January 2000 through June 2003, more than 15,000 women aged 40–64 participated in the WISEWOMAN program. Women enrolling in WISEWOMAN during this period had a high prevalence of risk factors for heart disease and stroke: 72% were either overweight or obese, 28% smoked, 25% had high blood pressure, and 23% had high cholesterol.

 



CDC also funds studies at Prevention Research Centers to develop effective interventions that reduce risk factors for cardiovascular disease and other chronic diseases among women in need. In fiscal year 2004, CDC received $14 million to fund WISEWOMAN projects.

CDC's WISEWOMAN Demonstration Projects, Fiscal Year

 2003Map of CDC's WISEWOMAN Demonstration Projects, Fiscal Year

[A text version of this map is also available.]

WISEWOMAN: Fostering Community Partnerships to Improve Women's Health

Community partnerships help strengthen WISEWOMAN projects. By pooling resources and sharing lessons learned, WISEWOMAN programs and their partners can offer underserved women aged 40–64 an array of health services they otherwise would not receive. In addition to offering screening, WISEWOMAN goes a critical step further by ensuring access to quality education and skill-building opportunities for all women and by promoting support groups to help women change and maintain healthy behaviors, as the following examples illustrate.

Promoting Physical Activity Through Community Partnerships

The Healthwise program in Winston-Salem, North Carolina, funded by the Kate B. Reynolds Charitable Trust and the WISEWOMAN program, provides health education, counseling, and referrals to WISEWOMAN clients. Aspart of their counseling, clients are encouraged to become more physically active. Most clients are referred to exercise classes or walking groups sponsored by Healthwise. However, patients with physical limitations or schedule conflicts need additional options. WISEWOMAN, Healthwise and the YWCA program began a partnership that provides WISEWOMAN participants with YWCA scholarships to encourage participation in physical activity appropriate for their health needs during convenient evening and weekend hours. The partnership also encourages women who are unaware of WISEWOMAN to enroll and become physically active at a price they can afford. As women seek to achieve their health goals, WISEWOMAN offers ongoing support and motivation and fosters a supportive environment among participants. Through access to Healthwise and the YWCA, WISEWOMAN clients have had opportunities to become more physically active, lose weight, increase their stamina, and better control their blood pressure and cholesterol levels.

Massachusetts Women Help Each Other Through Support Group

Social support and peer-led groups can be important in helping women change and maintain healthy behaviors. In response to a request from women in rural Ware, Massachusetts, for a support group to help them adopt healthier lifestyles, the state’s Women’s Health Network created the Women’s Health Support Group. WISEWOMAN is one program that provides services to women eligible for the Women’s Health Network.

Photo of women exercising in a swimming poolSupport group members — who have weight problems or high blood pressure, cholesterol, or blood sugar levels — are referred to the WISEWOMAN program, while WISEWOMAN participants who want additional support are also referred to the support group. Each month group meetings provide health tips and help in managing blood pressure, blood sugar, and cholesterol levels. Meetings also offer hands-on activities such as swapping and tasting recipes and cooking healthy meals. The support group makes sure thatthe interests of the participating women drive the group’s agenda. Together, WISEWOMAN and the Women’s Health Support Group are helping to ensure that underserved women in Ware get the care and support they need to adopt healthy lifestyles.

Future Directions

CDC’s WISEWOMAN program is unique because it approaches the health of women holistically. WISEWOMAN is strengthening its ability to address the multiple health needs of women by partnering with CDC’s Office on Smoking and Health, Division of Diabetes Translation, Division of Cancer Prevention and Control, and Division of Adult and Community Health. This crosscutting, collaborative program will continue to develop and test culturally appropriate interventions to promote the general health of uninsured women. CDC is evaluating the WISEWOMAN projects to learn which interventions work best and will begin promoting these best practices in 2005.

 
For more information or additional copies of this document, please contact the

Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention
and Health Promotion
Mail Stop K–46
4770 Buford Highway, NE
Atlanta, GA 30341-3717
(770) 488-5820
Fax (770) 488-6000

ccdinfo@cdc.gov
http://www.cdc.gov/wisewoman

 

 




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This page last reviewed August 10, 2004

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