Weekly Newsletter

FRIDAY, July 13 (HealthDay News) -- Twenty percent of American women had no health insurance in 2010, up from 15 percent in 2000, a new report reveals.

In addition to the nearly 19 million uninsured women, another 17 million women were underinsured in 2010, according to the report, released Friday by the Commonwealth Fund. The fund is a private foundation that seeks to promote improved health care, especially for low-income people, the uninsured, minority Americans, children and the elderly.

The report also compared insurance coverage for U.S. women to women in 10 other industrialized countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom, all of which have universal health coverage.

While uninsured women in the United States were likely to have problems paying medical bills and getting health care, many insured American women also face these problems, compared with women in other countries, the study found.

Other highlights of the report include:

• U.S. women had problems paying medical bills at double the rate of women in any other country studied.
• In the United States, 26 percent of women had medical bill problems, compared with 13 percent in Australia, 12 percent in France, and 4 percent in Germany.
• 39 percent of American women spent $1,000 or more in out-of-pocket medical costs during 2009-2010, compared with 24 percent of women in Switzerland, 1 percent in Sweden, and 0 percent in the United Kingdom.
• 43 percent of U.S. women went without recommended care, didn't see a doctor when they were sick, or didn't fill prescriptions because of cost, compared with 28 percent in Germany and Australia, 8 percent in the Netherlands, and 7 percent in the United Kingdom.
• Only 52 percent of American women were sure they could afford health care if they became seriously ill, compared with 91 percent of women in the United Kingdom, 77 percent in the Netherlands and 76 percent in Switzerland.

For uninsured women the problems were worse, according to the report, titled "Oceans Apart: The Higher Health Costs of Women in the U.S. Compared to Other Nations, and How Reform Is Helping."

• 51 percent of uninsured U.S. women had a problem paying medical bills.
• 77 percent went without needed health care due to costs, more than double the rates of women in other countries.

The report also found insurance differences in the United States among states.

For example, 30 percent of women in Texas were uninsured, compared with 5 percent in Massachusetts, which has a universal health insurance law similar to the Affordable Care Act, the controversial health-reform legislation signed into law in 2010 by President Barack Obama.

Many of these problems will be solved when the Affordable Care Act is fully implemented, the study authors said.

"With the Supreme Court upholding the constitutionality of the Affordable Care Act, the nation is moving forward on ensuring access to high-quality care for all Americans," Karen Davis, president of the Commonwealth Fund, said during a Thursday news conference.

Once the Affordable Care Act is fully implemented in 2014, the rate of uninsured women will drop from 20 percent to 8 percent, the study authors contended.

Under the Act, women can already get preventive care with no co-pay or deductible for services such as screenings for cervical, breast and colon cancer, cholesterol checks, and osteoporosis and chlamydia screenings. And insurance companies cannot deny coverage because of a preexisting condition, the study authors added.

The law will also prevent insurance companies from charging women higher premiums because of their gender or health.

Dr. Bradley Flansbaum, director of Hospitalist Services at Lenox Hill Hospital in New York City, said "the Affordable Care Act fills in the gaps for women's services."

There are disparities in women's health care in coverage and premium costs, he noted.

"It's almost considered that having an extra X chromosome is considered a disability," Flansbaum said. "The Affordable Care Act levels the playing field."

Because not all states are going to increase Medicaid benefits as outlined in the law, there will still be gaps in coverage for women on Medicaid in some states, he added.

The new report is not without critics.

They include Greg Scandlen, director of the Health Benefits Group Inc., which offers health insurance and life insurance to individuals and groups. "This report is a wonderful example of how you can prove anything if you cherry-pick the data carefully enough," he said.

Women aren't disadvantaged when it comes to health insurance, Scandlen said, adding, "In fact, women are far more likely to be covered than are men at nearly every age."

There are sex-based differences in all insurance markets, Scandlen said. "Women pay more for health insurance than men because they consume far more services than men. In the life and auto insurance markets, women pay far less than men because they drive safer and live longer," he said.

By looking at health care in other countries, Scandlen said, the report didn't take into account long wait times for care and the rationing of care in other nations.

"The Affordable Care Act may very well remove price obstacles to care, although that remains to be seen," he said. "But if it floods the system with new patients without increasing the supply of providers, it may result in less actual care for everyone."

More information

For more on the Affordable Care Act, visit HealthCare.gov.

FRIDAY, July 13 (HealthDay News) -- Chemicals in beauty and personal care products may boost women's risk of diabetes, a new study suggests, although the authors cautioned that the finding is far from conclusive.

Researchers found that elevated concentrations of chemicals called phthalates in women's bodies are associated with an increased chance of developing diabetes. Phthalates are hormone-disrupting chemicals commonly used in products such as soaps, nail polishes, hair sprays, perfumes and moisturizers.

The chemicals are also used in a number of other consumer products, such as electronics, toys and adhesives.

In this study, researchers analyzed concentrations of phthalates in the urine of 2,350 women from across the United States. They found that women with the highest levels of mono-benzyl phthalate and mono-isobutyl phthalate were nearly twice as likely to develop diabetes as those with the lowest levels of the two chemicals.

Women with higher-than-average levels of mono-(3-carboxypropyl) phthalate had about a 60 percent increased risk of diabetes, and those with moderately high levels of the chemicals mono-n-butyl phthalate and di-2-ethylhexyl phthalate had about a 70 percent increased risk of diabetes.

The study, published online July 13 in the journal Environmental Health Perspectives, was led by Tamarra James-Todd, a researcher in the division of women's health at Brigham and Women's Hospital, in Boston.

"This is an important first step in exploring the connection between phthalates and diabetes," James-Todd said in a hospital news release. "We know that in addition to being present in personal care products, phthalates also exist in certain types of medical devices and medication that is used to treat diabetes and this could also explain the higher level of phthalates in diabetic women. So overall, more research is needed."

The researchers also cautioned that the women in the study "self-reported" their diabetes, a less than ideal method of conducting research. And while the study found a potential connection between phthalates and diabetes in women, it did not prove a cause-and-effect relationship.

More information

The U.S. Food and Drug Administration has more about phthalates and cosmetic products.

WEDNESDAY, July 11 (HealthDay News) -- Menopausal women who lose weight eating a low-fat diet rich in fruits and vegetables could reduce or eliminate their hot flashes and night sweats, a large new study suggests.

One reason the researchers looked at weight loss as a way of dealing with menopausal symptoms was because of long-standing research linking hormone-replacement therapy to heart disease and breast cancer.

"We wanted to see if this could be an alternative to hormone therapy," said lead researcher Candyce Kroenke, a research scientist at Kaiser Permanente's Northern California Division of Research in Oakland.

"Indeed, women who lost weight in the context of this healthier diet -- decreasing fat, increasing whole grains, fruits and vegetables -- were significantly more likely to reduce or eliminate symptoms," she added.

Reduced hot flashes and night sweats, the key menopausal symptoms, were seen in both overweight and normal-weight women who lost weight, Kroenke noted.

And the reason for that is fairly simple, she said: Fat tends to retain heat and losing weight helps the body dissipate heat more easily.

The report, which was published July 11 in the online edition of Menopause, involved data on more than 17,000 women who took part in the Women's Health Initiative study.

The women with menopausal symptoms who were on a low-fat diet rich in whole grains, fruits and vegetables, who were not taking hormone-replacement therapy and who lost at least 10 pounds in a year were more likely to see night sweats and hot flashes reduced or disappear after a year than did women who maintained their weight (the "control" group), the researchers found.

Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City, commented that "this definitely goes along with the idea that good diet and exercise and losing weight contribute to general health."

And, she added, "It's a quick and easy fix for hot flashes and night sweats."

Wu noted that doctors are still reluctant to offer hormone-replacement therapy even though it works. "This is a low-risk fix," she said.

"I think it will work for some patients, and patients may only get a partial relief of their symptoms, but any help is good," Wu pointed out.

"Diet and weight loss is a healthy habit that will hopefully help menopausal symptoms. There is very little downside to doing it," she added.

Another expert agreed.

"Adopting a healthy diet is always a good idea," said Samantha Heller, a nutritionist, exercise physiologist and clinical nutrition coordinator at the Center for Cancer Care at Griffin Hospital in Derby, Conn.

"Healthy foods, including vegetables, soy, whole grains, legumes, nuts and fruits, decrease the risk of many chronic diseases and can improve health and well-being considerably. In this case, along with weight loss of 10 pounds or 10 percent of body weight, women who made healthy dietary changes tended to have decreased symptoms of hot flashes and night sweats," Heller noted.

"This study also highlights the positive effect of ongoing nutrition education by registered dietitians," she added. "Women in the intervention group, who were counseled by registered dietitians, were three times more likely to lose weight than women in the control group. A big factor in unsuccessful weight loss attempts is people not knowing how or where to begin. Nutrition counseling takes the guesswork out of creating a healthy lifestyle and helps motivate and empower people to stay on track."

The research was published just days after a coalition of leading medical groups concluded in a joint statement that hormone-replacement therapy can be useful and safe for many women suffering from the symptoms of menopause.

The coalition includes 15 medical groups, including the North American Menopause Society, the American Society for Reproductive Medicine, the Endocrine Society and the American Academy of Family Physicians.

More information

For more information on menopause, visit the U.S. National Library of Medicine.

WEDNESDAY, July 11 (HealthDay News) -- Drinking one or two alcoholic beverages several times a week may improve the bone health of older women and reduce their risk for osteoporosis, a small study suggests.

Bones are living tissue with old bone continually removed and replaced in a process called remodeling. In people with the bone-thinning disease osteoporosis, more bone is lost than replaced. Postmenopausal women are at particular risk because of reduced estrogen, a hormone essential for bone strength, the researchers explained.

"This study clearly demonstrates that even small amounts of alcohol have potent actions and can rapidly impact bone metabolism," said lead researcher Urszula Iwaniec, an associate professor in the College of Public Health and Human Sciences at Oregon State University.

As part of a healthy lifestyle, "moderate alcohol may slow bone loss by lowering bone turnover," she said. That means it may lower the risk for osteoporosis, she explained.

"Reducing bone turnover, however, while beneficial to the aging skeleton, may be detrimental to young adults who are still building bone," Iwaniec said.

Although alcohol abuse is a serious medical and public health problem, the effects of moderate drinking on health have not received a lot of attention, Iwaniec noted.

Roughly half of all U.S. women and one-fourth of men will break a bone because of osteoporosis, according to the U.S. National Institutes of Health, which provided partial funding for the study. Because prescription drugs aimed at preventing or treating osteoporosis are expensive and can create unpleasant side effects, it is important to identify lifestyle factors that protect the bones, the study authors said.

For the study, published in the July 11 online edition of Menopause, Iwaniec's team followed 40 postmenopausal women, average age 56, who drank moderately and were not using hormone replacement therapy.

"Moderate" drinking was defined as one-half to two standard drinks a day -- 8 to 10 grams of alcohol -- in the year before the study's start. In the United States, a standard drink is considered a 12-ounce beer, a 5-ounce glass of wine or 1.5 ounces of 80-proof liquor.

When the women stopped drinking for two weeks, the researchers found increased evidence in their blood of bone turnover, which is a risk factor for fractures resulting from osteoporosis.

In less than a day after the women resumed drinking, these markers of bone turnover returned to previous levels, the researchers found.

Previous studies have found moderate drinkers have higher bone density than nondrinkers or heavy drinkers, but the reasons why have been unclear.

It appears that alcohol acts like estrogen in reducing bone turnover, the researchers pointed out.

And the alcohol source doesn't seem to matter, Iwaniec said. "Most of the women in our study were wine drinkers," she said. "However, based on our data in rats, it is the alcohol that's important."

Whether this same effect would occur in men isn't known, Iwaniec said. Also, the study doesn't prove that moderate alcohol consumption wards off osteoporosis; it merely shows an association between the two.

Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City, noted that the study is especially welcome in light of recent U.S. Preventive Services Task Force recommendations against taking calcium and vitamin D supplements to prevent osteoporosis.

"From that perspective, this finding is very interesting," she said. "I am telling all of my postmenopausal women not to take calcium any more, and there is this panic about how do we help ourselves in preventing fractures and osteoporosis."

This study shows that a couple of drinks might help not only in preventing heart disease, but in preventing osteoporosis, Steinbaum said.

"I do not recommend taking a calcium supplement, but I do recommend a healthy diet that is high in nutrients and calcium and also weight-bearing exercises and one to two glasses of wine a day, which I also recommend to prevent heart disease," she said.

More information

For more information on osteoporosis, visit the U.S. National Library of Medicine.