1990s: CDC/ATSDR Contributions to Women’s Health

Below is a sample of contributions CDC and ATSDR have made in women's health during the 1990s.

1999

Established the National Sexual Violence Resource Center (NSVRC), a comprehensive collection and distribution center for information, statistics, and resources related to sexual violence.

Conducted the Complementary and Alternative Menopausal Practices Survey (CAMPS) in collaboration with the National Institutes of Health. This survey was conducted to evaluate the knowledge, attitudes, beliefs, and practices of women and their health care providers with regard to menopause and conditions related to menopause, and to include assessment of environmental influences such as pharmacological, behavioral, and alternative therapies and practices.

Published Surveillance for Injuries and Violence among Older Adults. Rates of fall-related and hip fracture hospitalizations increased from 1988-1996. Hospitalization rates for hip fractures increased significantly for women while the rates for men remained stable. Hip fracture hospitalization rates were highest for white women.

Published health data of women by state, race/ethnicity, and age on CD-ROM using new table-viewing called Beyond 20/20™ from the Healthy Women: State Trends in Health and Mortality project. Users were given the flexibility to design tables and graphics that best suit their needs. The site continually updates data.

Produced an in-depth report comparing maternal and child health in the Russian Federation and in the United States.

Funded a multi-agency, 3-year study with the Centers for Medicaid and Medicare Services (CMS) to address the public health need to increase immunization for influenza and pneumococcal disease at long-term care facilities (LTCF) using Standing Orders Programs (SOP). SOP allows authorization of facility staff to administer vaccination according to an approved protocol without a physician’s examination or written order. The findings from this study have led to change in CMS’s regulations/interpretive guidelines to allow for the use of SOP in all CMS-certified LTCF and to monitor coverage. This will lead to an increase in immunization coverage in the LTCF of residents, of whom a large portion are women.

Published Ten Great Public Health Achievements in the 20th Century, which included a focus on family planning and healthier mothers and babies. Achievements in other public health topics were also described, including heart disease and stroke, which are leading causes of death among women in the United States.

Co-sponsored The Changing Face of Women's Health exhibit, the first national exhibit dedicated to women's health. The exhibit began it's tour to different cities around the United States in 1999.

Awarded $9 million to community coalitions in 18 states through the Racial and Ethnic Approaches to Community Health (REACH 2010) initiative to help address racial and ethnic disparities in six health priority areas: infant mortality, improvements in breast and cervical cancer screening and management, cardiovascular disease, diabetes, improvements in child and/or adult immunization levels, and HIV/AIDS.

Organized the National Folic Acid Campaign, along with the March of Dimes and the National Council on Folic Acid, to promote the use of folic acid to prevent the serious birth defects spina bifida and anencephaly.

Released The Effects of Workplace Hazards on Female Reproductive Health that identifies possible and probable workplace hazards and their effects.

Developed and published Intimate Partner Violence Surveillance: Uniform Definitions and Recommended Data Elements to improve consistency and quality of estimates.

Developed the National Arthritis Action Plan: A Public Health Strategy with the Arthritis Foundation and the Association of State and Territorial Health Officials. This report proposed a national coordinated effort for reducing the occurrence of arthritis and its accompanying disability.

Co-sponsored the National Conference on Violence and Reproductive Health: Science, Prevention and Action, the first national conference of its kind. A diverse group of representatives within the reproductive health and violence prevention fields assembled to continue the study of direct and indirect links between violence against women and women's reproductive health.

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1998

Reported findings that showed that ovarian cancer is more likely to be hereditary in Jewish women than in non-Jewish women.

Developed an on-going national anti-smoking campaign with celebrities speaking about smoking. Musicians BoyzIIMen and model Christy Turlington were among the celebrities to urge everyone to either quit smoking or not to smoke at all.

Issued Women: Work and Health, the first comprehensive report on the health and well-being of America's working women. The report profiled key statistics for the more than 60 million women who are part of the American labor force, using data from the Departments of Health and Human Services, Labor, and Commerce. The report found that women die from work-related injuries at a substantially lower rate than men. Industries with highest fatality rates are the same for both men and women: mining, agriculture, construction, and transportation. The number of workplace homicides is higher among men than women, but proportionately they are greater among women, accounting for almost half of women's job-related fatalities.

Released Smoking during Pregnancy, 1990-96, which showed that although the overall rate of smoking during pregnancy dropped 26 percent between 1990 and 1996, smoking by teens increased. A follow-up report, Smoking during Pregnancy in the 1990s, was released in 2001.

Published first edition of Guidelines for Vaccinating Pregnant Women. These guidelines were based on recommendations of the Advisory Committee on Immunization Practices (ACIP).

Began work with international health organizations and ministries of health to assess the burden of reproductive health disease in stabilized refugee settings and to estimate and evaluate pregnancy outcomes.

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1997

Published Work with Video Display Terminals and the Risk of Reduced Birthweight and Preterm Birth, which resulted from a landmark study to determine whether working with video display terminals (VDTs) was associated with adverse pregnancy outcomes. No excess risks for miscarriage, low birth weight, or pre-term birth were found among women who used VDTs.

Published Smoking Behavior of Recent Mothers, 18-44 Years of Age, Before and After Pregnancy. The study found that women who were smoking prior to pregnancy continued to smoke, although some cut down on the number of cigarettes.

Established the WISEWOMAN (Well-Integrated Screening and Evaluation for Women) program in Massachusetts, Arizona, and North Carolina to provide additional services to participants in the National Breast and Cervical Cancer Early Detection program. These services included screening for heart disease factors, dietary and physical activity interventions for women with abnormal screening results, and referral and follow-up as appropriate. CDC currently funds WISEWOMAN demonstration projects in 12 states, tribes, and territories.

Published Physical Activity, Functional Limitations, and the Risk of Fall-Related Fractures in Community-Dwelling Elderly. The results of this study suggested that vigorous physical activity may reduce the risk of fractures among elderly persons without physical limitations but may increase fracture risk among those with limitations.

Published the first Assisted Reproductive Technology Success Rates report that gave consumers and potential assisted reproductive technology (ART) users an idea of a woman's average chance of having a pregnancy and a live birth by using ART.

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1996

Issued Health, United States, 1995 Chartbook, which included a special report women's health status, health care resources, and utilization and health care expenditures.

Established the Rape Prevention and Education Grant Program. The purpose of this program was to award grants to states and territories to be used for rape prevention and education programs conducted by rape crisis centers, State sexual assault coalitions, and other public and private nonprofit entities. Currently all 50 states, the District of Columbia, and 8 territories receive funding.

Partially funded Understanding Violence against Women, a report published by the National Research Council’s Panel on Research on Violence Against Women.

Unveiled, with partners, the National Occupational Research Agenda (NORA), a framework to guide occupational safety and health research into the next decade for the entire occupational safety and health community. The NORA process resulted in a remarkable consensus about the top 21 research priorities, one of which is reproductive health research.

Released Physical Activity and Health: A Report of the Surgeon General that reported that physical activity does not need to be strenuous to achieve health benefits to reduce the risk of heart disease, diabetes, high blood pressure, and colon cancer.

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1995

Conducted the 1995 National Survey of Family Growth, which has led to many reports and articles on women's health topics, including trends in contraception and infertility, trends in surgical sterilization from 1965-1995, trends in breastfeeding, trends and differences in teenage sexual activity, trends and differences in patterns of marriage and cohabitation, and the influences of community environments on women's health outcomes.

Published Prevalence and Impact of Arthritis among Women- United States, 1989-1991 , which documented the importance of arthritis and other rheumatic conditions as the leading cause of morbidity and activity limitation for women.

Co-sponsored, with The National Institute of Justice, the National Violence against Women Survey survey from November 1995 to May 1996.

Established the Community Coalition Partnership Programs for the Prevention of Teen Pregnancy. Thirteen communities in eleven states were funded for the prevention of initial and repeat teen pregnancies.

Conducted the community prevention component of the National Institutes of Health's Women’s Health Initiative through the Prevention Research Centers program.

Supported the American College of Surgeons (ACOS) to define appropriate follow-up measures for women with abnormal breast exams. This landmark document served as the basis for follow-up protocol for all National Breast and Cervical Cancer Early Detection Program providers and others interested in understanding the appropriate follow-up measures.

Collaborated with Beijing Medical University to evaluate the effectiveness of folic acid taken before and during early pregnancy, to prevent spina bifida and anencephaly, two common and severe birth defects.

Published the Report to Congress on Out-of-Wedlock Childbearing, which summarized trends in nonmarital childbearing and identified potential causes, antecedents, and remedial resources.

Developed a population-based survey program for the Indian Health Service to study Fetal Alcohol Syndrome to determine its extent and the effectiveness of community-based prevention programs.

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1994

Established the CDC/ATSDR Office of Women's Health to provide leadership and focus for CDC's efforts to promote and improve the health of women.

Published the first recommendations for the prevention of perinatal transmission of the human immunodeficiency virus (HIV).

Established a working definition of Chronic Fatigue Syndrome (CFS) and emphasized the importance of having researchers better define CFSin published studies.

Published a report, Health Insurance and Cancer Screening among Women, which found that women over the age of 50 who are enrolled in health maintenance organizations (HMO) are more likely to receive cancer-screening procedures than women with fee-for-service coverage. The report also showed that screening levels for Pap testing, mammography, and clinical breast examination were 11 to 18 percentage points lower for women aged 65 years and over than for women aged 50 to 64 years, despite the higher risk of disease among older women.

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1993

Funded the American Medical Women’s Association (AMWA) to develop a training kit on breast and cervical cancer education for primary care physicians. The kit provides an extensive overview of breast and cervical cancer issues.

Reported that the female condom is an effective method to reduce the risk for transmission of HIV infection.

Partnered with Avon Products, Inc., YWCA of the USA, and National Alliance for Breast Cancer Organization (NABCO) to provide screening services for early detection of breast and cervical cancer to reach uninsured and underinsured women. This was a unique partnership for breast and cervical cancer early detection screening services between a public, non-profit organization, a federal agency, and the private sector.

Identified Chlamydia trachomatis, a bacterial agent causing a sexually transmitted disease (STD), as the leading cause of infertility among women. CDC, in collaboration with the Office of Population Affairs of the Public Health Service, launched a national public health program for women to prevent infertility due to treatable STDs.

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1992

Published Recommendations for the Use of Folic Acid to Reduce the Number of Cases of Spina Bifida and Other Neural Tube Defects. CDC, in conjunction with the March of Dimes and the National Council on Folic Acid, recommends that daily consumption of 400 mcg of synthetic folic acid can prevent neural tube defects.

Initiated the Women's Contraceptive and Reproductive Experiences (CARE) study to investigate whether oral contraceptives act as a protective factor or risk factor in breast cancer development. This is the follow-up study to the Contraceptive and Steroid Hormone (CASH) study that began in 1982.

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1991

Conducted the first meta-analysis showing that estrogen replacement therapy increased the risk of breast cancer by about 30 percent after five years of use, a finding that was confirmed in later studies.

Published new research, which examined risk factors for preterm delivery, especially in minorities. The mortality rate for black infants was twice that of white infants, and the gap continues.

Demonstrated the effectiveness of a newly developed hepatitis B vaccine. Recommendations were developed to eliminate transmission of hepatitis B from mothers to newborns and to encourage routine immunization of infants.

Published Criteria for a Recommended Standard: Occupational Exposure to Ethylene Glycol Monomethyl Ether, Ethylene Glycol Monoethyl Ether, and Their Acetates. This document specified recommended exposure limits to certain industrial solvents based on studies that demonstrated dose-related malformations and other reproductive effects in several species of animals exposed at or below the Occupational Safety and Health Administration permissible exposure limits.

Began the HIV Epidemiology Research (HER) study, a prospective study of HIV infection on the physical, emotional, and social health of American women, to identify intervention components that may improve the lives of HIV-infected women.

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1990

Began the National Breast and Cervical Cancer Early Detection Program to provide free or low-cost mammograms, Pap tests, and follow-up services to low-income women for the early detection and control of breast and cervical cancers.

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