January 03, 2006
Health Care for Plus Size Women
A few years ago, I was a member of the advisory board for a scientific study by researchers at the University of California, Berkeley, on the barriers to gynecological care faced by plus-size women. If you were a subscriber to BBW Magazine back then, you may have participated in a survey for the study.
The results of the study were published in the International Journal of Obesity in October 2005. The article was titled, "Barriers to Routine Gynecological Cancer Screening for White and African American Obese Women." The abstract for the study can be found at the International Journal of Obesity website.
Pat Lyons , who was instrumental in shepherding the study to completion, is a health educator who has been committed to the size acceptance movement for years. She was co-author of the book, Great Shape: The First Fitness Guide for Large Women. I received an email from her about a week ago. She summarized the study and the next steps that WomanCare Plus will take as follows:
"Based on survey data from 498 large white and African American women, we found that as weight increased, women faced increased barriers - including negative attitudes of providers, gowns and equipment that do not fit their bodies, being weighed at every visit, and receiving unsolicited weight loss advice regardless of the reason for their visit. Over 90% of the women surveyed had medical insurance, and thus were paying for care they could not routinely and easily obtain. PAP smear rates were lowest for the largest women; but regardless of weight, the women who'd dieted more than five times were most likely to delay care.
"The study also included surveys from 129 GYN health care providers, finding them sorely lacking in both clinical education and basic equipment to meet the needs of their large patients. The majority was also highly dissatisfied with referral resources for their patients.
"We discussed these results with our 16-member Project Advisory Board, composed of researchers, women's health advocates and fat activists, representatives of the California Black Women's Health Project, the California Coalition for Reproductive Freedom, physicians, and two medical anthropologists. We will be moving forward with our collaborators in the new year to address ethics, public policy, and clinical and community education programs to support every woman's right to health care delivery with dignity and respect regardless of weight. The first of these projects include:
"1) Formation of an Ethics and Public Health Policy subcommittee to sponsor a variety of educational forums to reduce health disparities caused by weight bias;
"2) In collaboration with Planned Parenthood Federation of America, development of a DVD training resource for clinical gynecological health care providers that includes an "entitlement to care" booklet for large women seeking gynecological cancer screening;
"3) Conducting 'training of trainers' focused on improving health care providers' and advocates' ability to reduce weight bias as part of their health disparities work;
"4) In a joint project with the California Black Women's Health Project, addressing the increase in gastric surgery in African American women, the risks and deaths that have gone unreported in the community and the development of alternatives to this drastic approach to weight loss;
"5) A joint project with the California Adolescent Nutrition and Fitness project to address potential delay of care in youth and adolescents, especially addressing experiences of larger youth who may be receiving aggressive dieting and weight loss advice as a result of the focus on the "childhood obesity epidemic"; and
"6) Ongoing research and education on the negative effects of dieting and weight cycling and it's relationship to delay of care."
If your experience with the health care delivery system is anything like mine, you know that receiving appropriate health care is a hit-or-miss proposition when you're a plus-size woman. I could tell you horror stories, but for now I'll share the remainder of Pat Lyons' email:
"In a Great Shape focus group we held in 1989 a woman said, " After a friend bugged me for a long time I finally went to the doctor for a PAP smear. He said I was too fat for an exam and to come back when I'd lost weight. That was 10 years ago and I haven't been back."
"I have been hearing horror stories like this - and worse - for more than 15 years in my health and fitness work across the country with large women...stories of shame and embarrassment as women have tried to access basic cancer screening and health care. Based on the publication of our two-year research study on barriers to gynecological cancer screening, I am finally in a position to mobilize community health efforts to put weight bias squarely on the table of medical ethics discussions, physician education and health advocacy training. I am asking for your tax-deductible contribution in any amount - small, large or supersize! - to launch our new project efforts in 2006.
"Your financial support will provide a community based office as a solid foundation for the WomanCare Plus Project at the CHT-Resource Group (CHT-RG) a 501(c)(3) non-profit organization in Oakland, California. CHT-RG is an affiliate of the Center for Health Training, which has for the past 26 years been a key federal family planning training contractor in several states and a major player in women's reproductive health policy, training and technical assistance. Their national reputation, networks of providers, and expertise, combined with their commitment to social justice and reducing health disparities makes them an ideal agency in which to base our efforts to ensure every large woman's cancer screening and reproductive health care rights. Ironically, beginning in 1972 I worked with the CHT founding staff and have been a consultant for them over the years. I know them well and we have already submitted two proposals to foundations to help us set up our activities. But as you know, grants take time. In the meantime, we are ready to roll!
"For those able to make a contribution, my great thanks in advance! Please make your check payable to CHT--Resource Group (put 'WomanCare Plus Project' in the 'For' line of the check). Mail it to: CHT-Resource Group, 614 Grand Ave., Suite 400, Oakland, CA 94610.
"With your help, we can make the future of health care better for all women who may be embarrassed about their weight and especially for the girls coming up behind us who have it even harder, given the current 'war on obesity.' We can share our strength and blaze the trail. I hope you'll join us!"
This project is definitely worthwhile, and I will be mailing in my contribution shortly. I will also continue to be a member of the WomanCare Plus Advisory Board.
I encourage you to support this project in whatever way you can, and to pass along this information to anyone whom you think may be interested.
Until next time,
Posted by conradb212 at January 3, 2006 04:16 PM