Recent decades have marked significant strides in women’s health, with key advancements in preventive care guidelines, diagnoses, and treatments, as well as in clinical and social research. However, far more progress is needed along multiple dimensions as women continue to face serious health disparities and lack of access to timely and high-quality care.
To learn more about the current state of women’s health — where policies, programs and initiatives have left an impact, and where more progress is still needed — Becker’s Healthcare recently spoke with two directors from Guidehouse: Julia Clark, PhD, and Kaajal Singh, MHA. Dr. Clark and Ms. Singh have decades of experience working with policymakers, providers, payers, patients, state and local agencies, and advocacy organizations.
The Current State of Women’s Health
Women’s health recognizes a holistic view of health — physical, mental and social — at the individual and population levels. Despite the progress of women’s health in the past few decades, such as heightened awareness around and access to preventive screenings, women and adolescent girls continue to face significant health challenges and disparities. Consider the following:
- Adolescent girls are struggling with mental health like never before. As highlighted in recent Centers for Disease Control and Prevention research, adolescent girls are twice as likely to experience poor mental health and suicidal ideation compared to adolescent boys. “There’s a significant difference in the mental health challenges among girls compared to their male counterparts, so the way we talk about the crisis and the subsequent policies to address them need to be in consideration of who is being impacted disproportionately and how,” Dr. Clark said.
- Women are being diagnosed with cancer at younger ages, at higher rates, and in later stages than before.
- Women experience higher rates of some chronic conditions, such as hypertension, asthma, depression and osteoporosis. Ms. Singh noted that amid these higher rates, there has not been a commensurate increase in preventive care.
- Women continue to outlive men by almost six years but are living longer in worse health than men. With more women living with chronic disease, often leading to disability, chronic disease prevention is essential.
Despite these well-established, ongoing women’s health challenges, clinical studies continue to lag in equitable representation. There has been some progress in terms of gender representation, but there are still significant inclusion gaps for women of color and women in historically underserved populations, Dr. Clark said.
These are just a few of the issues that underscore the tremendous disparities that continue to exist in women’s health. “We need to make sure we’re considering the true differences in the populations being impacted,” Dr. Clark said. “The populations that are disproportionately affected need commensurate responses through policy and through grassroots care on the ground and in the home.”
Top-Down Opportunities to Drive Meaningful Change
Opportunities to improve research and health outcomes for women often hinge on governmental policies at the federal level.
One such example includes policies to improve maternal health outcomes in the U.S., which Ms. Singh described as lagging. To help address this, the Centers for Medicare & Medicaid Services (CMS) recently announced a new statewide initiative, the Transforming Maternal Health Model, aimed at working with Medicaid patients who have some of the highest-risk maternal health outcomes. “This model is predicated around improving maternal health outcomes by addressing some of the disparities in a very direct and targeted way,” Ms. Singh said.
The CMS model has three main pillars:
- Looking at non-traditional resources to provide support in all phases of maternal health, including conception, pregnancy and postpartum. This can incorporate resources such as doulas and community health workers.
- Focusing on safety and quality improvement to make healthcare experiences safer for both mothers and babies. This aspect of the model is going to be accompanied by patient safety bundles.
- Whole-person care, as quality maternal care must consider a woman’s physical, mental and social well-being as equal components of overall well-being.
“CMS’s model is a great example of how government policies are working to meet patients where they are; partnering with the states, which are actually in charge of executing; and providing support for pregnant women,” Ms. Singh said. “It’s an effective approach to targeting the right populations and we need to see more interventions like this at broader scale and with sustained funding.”
Meeting Women Where They Are
Efforts to advance women’s health would benefit from initiatives that complement top-down approaches and seek to drive change at the point of delivery. Dr. Clark emphasized mental health issues affecting adolescents, commending the Biden administration’s increased attention and investments in this realm. However, a top-down strategy takes time to play out and has at times resulted in a one-size-fits-all approach, Dr. Clark said.
In contrast, bottom-up strategies meet adolescents where they are. This includes conducting mental health screenings in schools and during primary care visits, as well as involving other trusted adults in communities — who receive lay training — to do mental health screenings.
“Amid the shortage of mental health providers, this type of multi-pronged approach, involving trusted people in communities, is making a difference on a broader scale,” Dr. Clark said.
Other successful interventions include mobile care teams that can administer vaccinations or provide services to women who have just delivered a baby and need postpartum care. Dr. Clark and Ms. Singh also noted successful community-based health programs, particularly for older adults with transportation limitations, that engage people in education and screenings in such locations as churches and senior centers.
A crucial element of any bottom-up initiative, especially those targeting women’s health, is trust. Ms. Singh stressed the importance of focusing on women’s health and trust-building as part of training programs for physicians, nurses, social workers and other members of the healthcare workforce.
“Building trust with women is essential to having them want to seek care and see that care through,” Ms. Singh said. “Women are often the decision makers in their families and coordinate care for themselves and others, including children, aging relatives and significant others. Creating a safe environment where a woman feels represented and respected translates into a more effective working relationship between the woman, her family, and her clinical team, which will help influence positive health outcomes.”
Keys to an Effective Women’s Health Care Model
A 19-time Best in KLAS® winner, Guidehouse is trusted to deliver advisory, digital and managed services to organizations across the healthcare industry, including CMS. The firm’s unique expertise and versatility across the commercial and public sectors has been proven to catalyze transformation and pioneer new directions for the future of healthcare.
To improve women’s health, Dr. Clark and Ms. Singh recommend that leaders reconsider core women’s health practices and build new approaches by:
- Engaging healthcare teams and community organizations in an aligned vision to address women’s health disparities and opportunities.
- Working with providers and federal, state and local health agencies to enhance access to clinical trials and address social drivers of health among women at all stages of life.
- Investing in technology-driven wellness and preventive care strategies, provider education, and community and health plan partnerships.
- Implementing population health initiatives and metrics that complement accountable care models, such as Medicare Advantage, Medicaid managed care organizations and other value-based programs, that strive for high-quality care across the continuum by improving health equity at both the national and local levels.
“Women are foundational to our nation as leaders, economic contributors and caregivers,” said Ms. Singh. “If we ignore the health needs of women and do not create an environment with solutions that are meeting them where they are, we are risking the health and well-being of our foundation as a nation, which is a significant risk to our future.”
“Our team at Guidehouse is incredibly optimistic about the future of healthcare,” Dr. Clark said. “We are privileged to work alongside some of the most committed people across healthcare who are motivated to improve health outcomes, reduce total cost of care and see to the greater well-being of the communities they serve. Buoyed by rapid advancements in technology and incremental gains in policies and programs that directly impact the health of women, our team is truly excited to be leading the conversations and changes required to evolve the future of women’s healthcare to better serve our clients and communities.”