Despite seeming progress during the last two decades by charitable organizations in recognizing and providing programs geared to the needs of women and girls, such programs-particularly in the field of health care-remain underfunded.
That was the message behind the first National Conference on Philanthropy and Women`s Health, recently held in New York. The day-long conference brought together medical experts and grantmakers representing public and private philanthropic organizations, people who decide which charitable services and research projects receive funding each year.
The most immediate goal of the conference`s co-sponsors, Women and Foundations/Corporate Philanthropy and Grantmakers in Health, was to encourage grantmakers to grant funding to women`s health-care projects and services.
The two non-profit organizations, each comprised of corporate and foundation grantmakers, settled on the issue of women`s health as
representative of the general need for funding women`s programs.
Conference organizers saw the goal as having even greater urgency because the U.S. Supreme Court recently agreed to hear a Pennsylvania case that might overturn the Roe vs. Wade decision, which gave women the right to legal abortions 19 years ago.
Jane Ransom, president of Women and Foundations, was one of many speakers to express the concern that ”the ability to push a broad women`s health program would be threatened if Roe vs. Wade is overturned.”
If women have to start putting their energies toward fighting a battle that presumably had been won, Ransom said, they`ll be less able to concentrate on other issues such as breast cancer and violence against women.
The organizations represented by Women and Foundations/Corporate Philanthropy members support a complete range of women`s programs, while those belonging to Grantmakers in Health are concerned with funding programs for men and women but only in the areas of health care-related human services.
Together the long-term goal was to make corporate and foundation grantmakers understand that there really is no such thing as ”gender-neutral” causes.
”We`re saying to funders that if your foundation gives money to something like cancer research, you can`t assume it will automatically trickle down to research programs benefiting women.”
Dr. Allan Rosenfield, dean of Columbia University`s School of Public Health, cited prenatal care as an example. While the mother benefits, its true focus is to insure the child`s health, he said.
Dr. Florence Haseltine, director of the National Institutes of Health`s Center for Population Research, said a typical example of the country`s lack of concern is the fact that the NIH, the country`s largest health institute, has no staff gynecologist.
”That`s like putting together all the major hospitals in New York City and wiping out their gynecology departments,” she said.
Nancy Woods, professor at the University of Washington`s Center for Women`s Research, said health-care professionals and grantmakers have to get away from just treating issues involving women`s reproductive organs:
”Pregnancy, birthing, menopausal problems . . . these are the things women are treated for. The system of health care for women is grounded in their role as child-bearers.”
While not denying the importance of such issues as contraception and access to adequate prenatal care, Woods said the definition of women`s health care must be broadened.
Specifically that means studying women not just in such gender-specific medical ailments as breast cancer, but in relation to more universal ailments, such as asthma and heart disease.
Woods said the definition also could be broadened by focusing on issues that are not obviously health-related, such as caregiving, which can bring about numerous stress-related ailments, ranging from fatigue to high blood pressure.
Dr. John Rowe, president and CEO of New York`s Mt. Sinai Medical Center, noted: ”As many as 50 percent of older female caregivers show a substantial reduction in their health status.”
The experts agreed that there are numerous options open-not only to grantmakers but also to politicians and society at large-for addressing these and other women`s health issues.
Among the specific suggestions from conference speakers:
– Make health trials less gender-specific. Although the NIH recommended including women in clinical trials in 1987, keynote speaker Dr. Vanessa Gamble noted such changes have yet to occur. Gamble, an assistant professor at the history of medicine medicine at the University of Wisconsin, noted that for years such trials almost have exclusively consisted of males, particularly white males. Scientists` explanations have ranged from fear of causing birth defects to the importance of having ”homogeneous” study populations.
– Provide more awards to female researchers. If women are to achieve positions of influence, one road is through garnering awards that Haseltine noted ”are critical to career advancement.” Female researchers also must pursue such awards actively, she said.
– Encourage more doctors to go into the field of gerontology (problems of the elderly). Americans are an aging population and women are the majority of that population, yet according to Rowe, who is also Mt. Sinai`s professor of medicine and geriatrics and adult development as well as past president of the Gerontological Society of America, the current health-care numbers show that there is one gerontologist for every 100,000 elderly people.
– Provide support to caregivers. Ideas offered ranged from adult day care and respite care to on-line computer services that would allow caregivers to communicate with each other and provide support.
– Support political solutions. Some states are trying to find their own solutions to the need for affordable health insurance. Democratic State Rep. Charlene Rydell of Maine noted that in a pilot program known as MaineCare, employers of businesses of 15 employees or less pick up a minimum of 50 percent of health insurance costs. The program, which has been in effect since 1988, now covers about 1,500 people who previously had no coverage or at best the bare minimum.
– Grantmakers should avoid getting trapped in a strict ”women`s health” mindset. Andrea Kydd, director of Health Programs at New York`s Nathan Cummings Foundation, emphasized that foundations shouldn`t necessarily drop everything to focus solely on women`s medical issues. Instead, she urged the grantmakers, ”Focus on (providing) housing, income, jobs-these can be seen as affecting women`s health, too.”
– Put more money toward educating women. John Murphy, chair of Grantmakers in Health, noted that the Flinn Foundation, of which he is executive director, conducted a study of Arizona residents regarding who was most likely to use health-care services. The respondents` level of education was the key factor, he noted. Women with less than a high school education were less likely to use services such as Pap smears, mammograms and prenatal care, regardless of their income level or even their insurance status.
– Join or help start a woman`s fund. Across the country women are coming together-individuals, as well as those representing public and private foundations-to decide on, then fund, the needs of women in their community. The activities they support include scholarships to low-income woman and girls, shelters for battered women and advocacy for women with disabilities.
The National Network of Women`s Funds, which helps strengthen such funds and create new ones, notes that as of 1992 there are 60 women`s funds either established or being developed; there were four in 1981.
(To obtain information on finding or establishing a local women`s fund, send a stamped, self-addressed envelope to National Network of Women`s Funds, 1821 University Ave., Suite 409 N, St. Paul, Minn. 55104.)
Felicia Lynch, senior vice president of the Hitachi Foundation and chair of Women and Foundations, in a conference speech seemed to capture the urgency behind the conference`s call to action in the area of women`s health care:
”Thirty-one years ago I was a registered nurse, taking care of my first dying patient, a 28-year-old white mother of three suffering from cervical cancer. With the naivete of an 16-year-old, I kept asking her why hadn`t she gone to the doctor sooner, why hadn`t she had a Pap smear and other such questions. She calmly explained that if it was a choice between treating a child ear`s infection and a preventive measure like a Pap smear for herself, the child`s treatment had to come first.
”Now here we are 31 years later, and women are still choosing between their health and their children`s, still dying prematurely, still living in ignorance, still not getting answers.
”We need to understand this lack of responsiveness in women`s health care and to do something about it now.”
