Women and Heart Disease

My grandmother was in the hospital two weeks ago due to a variety of health concerns that had left her on the verge of collapse.  She’s okay now (thanks to everyone who has been supportive through this!), but my family learned from her doctors that she has likely suffered a minor heart attack sometime in the past weeks.

We were shocked to hear this.  Heart attack?  There had been no signs-- no chest tightening, no irregular heartbeat, no arm pain, nothing.  

That is when the doctor informed us that women actually experience different heart attack symptoms than men.  A heart attack in a man presents itself in the ways enumerated above.  Women, however, are more likely to experience shortness of breath, extreme fatigue, nausea, vomiting, and dizziness as symptoms of their heart attacks.  My grandma had experienced several of these symptoms recently, but had no idea of their deeper significance.  And she's not alone-- heart attacks in women are often misdiagnosed and it is not unusual for a woman to be sent home when presenting her symptoms.  The symptoms we are taught to look for often do not appear in women at all.  In fact, 43% of women do not ever experience the primary tell-tale sign, chest pains, during a heart attack, even though many emergency room doctors still consider this the primary symptom.

This has huge implications for women's health.  Without knowing something is wrong (assuming she survives an initital undiagnosed heart attack), a woman will delay crucial treatment and lifestyle changes necessary to prevent her heart disease from progressing.  As heart disease is the number one killer of women, the importance of this cannot be underestimated.

For many years, the medical establishment didn’t believe women could even experience heart disease, because cases and symptoms were never observed or recorded.   Even after this realization, research continued to be conducted only on male subjects and women's treatment was systemically delivered less aggressively than treatment for male patients.  Unsurprisingly, women showed a much higher incidence of mortality from heart disease.  It is only within the last 10 years that the scientific community finally acknowledged and began steps to remedy the gender bias in heart disease research and treatment.

Yet, women still have a higher mortality rate from heart disease due to the lingering effects of this gender bias.  While enormous steps have been taken to close the disparity, our culture still assumes a male patient and perspective on this issue.  We need to escape this mindset if we are going to fix this problem.  It's common sense: we must research and acknowledge the unique needs, lifestyles, and biochemistry of women if we are to provide the best life outcomes for women.  

An important first step is simply to spread awareness.  I was not aware of the ways that heart attack symptoms present differently in women, and I'm sure that I am not alone.  This needs to be common knowledge, so please spread this information to the women (and men) in your life!  Let's start talking.

Breast Regards: The "I (heart) Boobies" Bracelet Ban

In 2010, Eastern Area Middle School in Pennsylvania suspended several middle school students for wearing the "I (heart) boobies" breast-cancer fundraising bracelets.  The students then did what any self-respecting tween with money will do-- took the school district to court, claiming the ban on the trendy wrist-wear violated their freedom of speech.  While the federal judge ruled in their favor last year, the school district appealed to the federal circuit court, which recently determined it will hear the case in front of the full 14-judge court.  

As a former teacher of young teens (which Science has proven to be the most annoying age EVER), I empathize with the teachers and administrators at this school.  There is nothing like delivering a beautifully poetic and painstakingly-rehearsed lesson on the pythagorean theorem, only to be interrupted by a cacophony of giggles and snorts of "haha BOOBS!"  Yet, at the same time, it is difficult to tell a teenager who is supporting their mother, sister, aunt, etc. who has battled cancer that their particular form of support may be inappropriate for the classroom.  

Regardless of this quandary, which will soon be settled in the federal courts, the situation gives us an opportunity to examine a very problematic media campaign.

The Keep A Breast Foundation, a breast cancer awareness nonprofit in California, introduced the "I (heart) boobies" rubber bracelets in 2004 as part of a strategy to involve younger generations in the fight against breast cancer.  With their bright colors and semi-risque phraseology, the bracelets made breast cancer fun and sexy (because what's sexier than a debilitating disease?). Since then, the bracelets have become a fashion craze among teens and tweens across the country.  

But at what cost?

While the campaign has successfully reached a previously untapped demographic, it is popular only because it sexualizes a very serious disease and objectifies women’s bodies.

Think of it this way: the bracelets do not say “I (heart) women.”  The message is not that women are awesome, that we should concern ourselves with saving women's lives.  No, the message is that boobs are awesome, that we should worry about saving boobs.   It reduces women's complex lives down to a highly sexualized body part.  Consequently, the breast-cancer-battleground shifts from promoting women's health to protecting men's desire to look at, play with, and otherwise enjoy breasts.

If the end goal of breast cancer awareness, education, and research is to improve the health and well-being of women, then this type of outreach is counterintuitive.  Sex may sell, but the cost-- reinforcing a system of male gaze and privilege-- is simply too high.

Framing the Issue: The Impact of the Affordable Care Act on Domestic Violence Discourse and Services

Finally acknowledging the causal links between lack of preventative care, poor health outcomes, and soaring healthcare costs, the Women’s Preventative Care Amendment of the Affordable Care Act went into effect last week.  As of August 1st, 2012 insurance companies must provide for several essential women’s services free of charge, including annual woman-care visits, gestational diabetes screenings, STI and HIV counseling, breastfeeding support, HPV DNA testing, and, that holy grail, contraception.  

As we joyously bid adieu to copays, we cannot underestimate the revolutionary significance of these provisions.  For the first time in this country, women’s mental, reproductive, and sexual health are being recognized as essential components of the overall health and well-being of women and their families.  

One among the mandated services has especially caught my attention for this reason: screening and counseling for domestic violence.