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Survey: Cost Concerns Cause Women to Forgo Medical Care

More than a quarter of women ages 64 and under delayed or chose not to seek medical care in 2004 because they couldn't afford it, according to a national study released Thursday.

For uninsured women, that figure soared to 67 percent, according to the Kaiser Family Foundation, which sponsored the study. The comprehensive findings—touching on myriad topics such as health insurance coverage and access, use of prescription drugs and concerns about quality of care—are detailed in the report.

Based on phone interviews with 2,766 women ages 18 and older, the study also found that 17 percent of women with private health insurance postponed or decided not to get medical treatment they thought they needed in the past year because of cost concerns.

In addition, the study found 20 percent of all women reported they did not fill prescription drugs in the past year because of the expense. One in seven women also reported skipping or taking smaller doses of prescription drugs in the past year to make their supplies last longer.

As a followup to a similar study conducted in 2001, the report identified a lack of communication between women and doctors on topics such as smoking, alcohol use and calcium intake, with individual percentages hovering at 33, 20, and 43, respectively.

While 28 percent of women ages 18 to 44 said they had talked to their doctor about sexually transmitted diseases, 31 percent in that age group said they had broached the topic of HIV/AIDS.

Despite the lack of doctor-patient counseling about health risks and lifestyle issues, 53 percent of women said they turned to health care providers first when they needed information on a particular health issue.

Carolyn Clancy, director of the Agency for Healthcare Research and Quality and part of a panel discussing the survey's findings, said women needed to be more proactive about speaking with their doctors and should get into the habit of putting together a checklist before their appointments.

"You need to prepare in the same way as if you were going to the car mechanic," Clancy said.

Alina Salganicoff, vice president and director of Women's Health Policy at the Kaiser Family Foundation who was also on the panel, agreed. "Women need to realize they are partners in their health," she said.

The study also revealed that mammography rates reported by women ages 40 to 64 fell slightly, from 73 percent in 2001 to 69 percent in 2004.

"This is an issue we thought we'd be beyond," said another panelist, Paula Johnson, chief of the Division of Women's Health at Brigham and Women's Hospital in Boston. With fewer and fewer radiologists wanting to do mammograms, she added, the entire field is in crisis.

Screening rates for pap smears and blood pressure for women ages 18 to 64 have also fallen slightly since 2001, the study indicated. While 81 percent of women in that age group in 2001 reported having pap smears in the past two years, only 76 percent did so in 2004.

The study also found that a mere 38 percent of women ages 50 and older said they had a colon cancer screening test in the past two years; 37 percent of women ages 45 and older, meanwhile, reported they had an osteoporosis test in the past two years. Screening tests are an essential tool for early detection and prevention of many diseases, according to the Kaiser Family Foundation.

The report also highlighted the prevalence of anxiety or depression among women, with 23 percent of the respondents reporting they have been diagnosed with depression or anxiety by a physician in the past five years.

"This really has to be seen as an epidemic in our society right now," said panelist Susan Starr Sered, senior research associate at Suffolk University's Center for Women's Health and Human Rights.

Johnson, who is also director of the Connors Center for Women's Health and Biology, added that depression was projected to become the second leading cause of death and disability by 2020.

Starr Sered, author of numerous books on women's issues, drew a link between mental health and another finding of the survey—that certain chronic conditions such as obesity and diabetes rose in the non-elderly population between 2001 and 2004.

"If you live in chronic pain, your mental health suffers," she said.

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