20 Days of ACA: Support for Domestic Violence Survivors

Throughout 20 Days of ACA, we have discussed many ways the Affordable Care Act (ACA, or health reform) prioritizes the prevention of disease and illness. We have discussed the creation of the National Prevention Council and National Prevention Strategy as well as no co-pays for a wide range preventive care services including cervical cancer screening, pregnancy-related care, STI/HIV testing, and maternity and newborn coverage in the state insurance “exchanges.”

Today, we discuss another preventive health service that will be offered with no co-pay: domestic violence screening.

Starting on August 1, 2012 new health insurance plans must begin to cover this important service at no additional cost to patients. This important provision was included thanks to the Women’s Health Amendment (WHA).

How does domestic violence or inter-partner violence (IPV) impact Latinas?

According to year 2000 estimates, nearly 1 in 4 (23.4%) Latinas face domestic violence over the course of their lifetime. This violence comes in many forms including but not limited to verbal abuse, physical assault, and sexual assault. Abusive partners also cut off access to support systems and money (even partners’ earned wages.) Increasingly,  reproductive coercion – including sabotaging birth control methods, threatening to leave a women if she does not become pregnant, forcing contraception or abortion, and forcing partners to use recreational drugs to enhance arousal - is being used a form of violence against partners.

And while more data is needed, we know that immigrant Latinas are  overrepresented among IVP-related homicide victims and they face more barriers to leaving abusers due to lesser developed support systems, ineligibility for public benefits, and limited English proficiency among others. We also know a pregnant woman has a 35% increased chance of experiencing IPV compared to non-pregnant women and that IPV in LGBTQ communities occurs, but is often ignored.

To add to the challenges, states like Arizona and Alabama have enacted a series of dangerous immigration policies that only  decrease Latinas’ confidence in law enforcement, break apart families through incarceration, detention and deportation, and create an “anti-immigrant” culture.  Despite the creation of the U-Visa in 2000 to protect immigrants who assist law enforcement, these egregious state immigration policies threaten public safety and health by making it more difficult for Latina immigrants of IPV to leave their abusers.

Why is no co-pay for domestic violence screening and counseling important for Latinas?

Much needs to be done in this country to end domestic violence, address domestic violence in LGBTQ communities, and elevate the status of those who identify as women. For starters, NLIRH called for comprehensive immigration reform and condemned Arizona-like immigration policies.

The Affordable Care Act make a small but necessary contribution to the health of women who face domestic violence. By requiring no co-pays for domestic violence screening, the health care law removes a barrier for women whose wages and access to money have been cut off by abusers.

Health reform recognizes that women face unique barriers to health care that men do not face. From no co-pays for women’s-specific preventive care to non-discrimination protection, the ACA hopes to reduce health disparities faced by women, and particularly women of color by improving women’s access to health care insurance and public health services. And as Latinas have disproportionately been excluded from health services, they stand poised to gain from the reforms under the ACA.

There are only a few more posts in 20 Days of ACA — stay tuned throughout this week!

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Latinas and cervical cancer: the fight for greater health care access

This week you have been reading many perspectives on “what will it take to end cervical cancer?” as part of NLIRH’s blog carnival, ¡Acábalo Ya! Working Together to End Cervical Cancer.

All of us here at the  National Latina Institute for Reproductive Health (NLIRH) emphasize the importance of monitoring cervical cancer incidence rates because they serve as indicators of a community’s access to preventive health care services.

Why is this? Because no woman should be diagnosed, let alone die, of cervical cancer. For the first time, we have a comprehensive set of tools to prevent and fight the disease. Cervical cancer is highly preventable with regular Pap tests, the HPV test, and a provider’s monitoring and treatment of precancerous changes to the cells of a cervix. The HPV vaccines (both Gardasil® and Cervarix®) are also effective tools in the prevention of cervical cancer. Furthermore, the disease is also highly treatable when detected early.

Yet Latinas continue to have the highest incidence of cervical cancer among women of all ethnic/racial groups and the second highest mortality rate after African American women. In certain states, particularly along the southern border, Latinas have the highest incidence and mortality rates.

NLIRH recognizes and raises awareness of the myriad barriers Latinas face to preventing cervical cancer: lack of health insurance, stigmas around STIs and sexual health, cultural and linguistic barriers with health care systems and providers, the high cost of health care, fear associated to immigration status, racism and xenophobia.

Thus, while we serve to educate Latinas about the importance of gynecological health and demystify sexual health issues, we also will work year-round to bring down the barriers Latinas face in accessing health care.

This year, we will work to increase federal funding for Title X, the only federally funded family planning program, that provides cervical cancer screening and STI counseling to low-income women. We urge the federal government to support other programs that positively impact Latina health including Medicaid,  Community Health Center grants, funding for immunizations and school-based health programs. We will continue to advocate for access to health care for immigrants, for instance by urging Congress to lift the five-year ban for qualified legal immigrants from accessing means-tested benefits under Medicaid.

In 2012, there will be many opportunities to reduce health disparities and increase Latinas’ access to health services. Beyond January, we hope that our elected officials will not only speak about cervical cancer awareness, but work work us to ensure Latinas live cervical-cancer free.

For more information, please visit NLIRH’s resources on cervical cancer.

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Cervical cancer and women of color: What will it take to get to zero?

Guest post  by Marisa Spalding, Black Women’s Health Imperative

Each January we celebrate Cervical Cancer Awareness month. This month gives us an opportunity to reflect on our mothers, daughters, sisters, aunts, and friends that we have lost to this preventable disease, and a time to consider how we will get the cervical cancer incidence and death rate among women of color to zero. There is no better time to educate and empower women to protect themselves from cervical cancer and make their health a priority.

It is no secret that women of color—specifically Black and Latina women—are at greatest risk of cervical cancer.  Latina women have the highest incidence rate of cervical cancer and Black women have the highest death rate from the disease, which is almost two times greater than for White women. These staggering and unacceptable figures are only worsened by the knowledge that this disease is largely preventable through timely screening, diagnosis, and treatment.

Then what will it take to put an end cervical cancer?

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A health disparities bill (from the Hill) gets it right!

What if the federal government took action against the long-standing health disparities between groups of different race, ethnic group,  immigration and citizenship status, English proficiency,  sexual orientation and socioeconomic status? Sounds pretty awesome, right?!?

Well, we are closer than we have ever been thanks for the recent introduction of the Health Equity and Accountability Act (H.R. 2954)!

The Health Equity and Accountability Act was introduced on September 15th 2011 by Congresswoman Barbara Lee (D-CA-9th) with the support of the Congressional Tri-Caucus – the Congressional Asian Pacific American Caucus, Congressional Black Caucus, and the Congressional Hispanic Caucus – and has 72 co-sponsors.

The Latina Institute is proud to note that its recommendations on the issues of affordable mental health services, culturally appropriate care and expanding support for community health services were adopted into the final draft of the bill.

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HHS Secretary Sebelius: La prevención ayuda a mantener a las mujeres sanas

Por Kathleen Sebelius, Secretary of Health and Human Services

Ver en ingles

Todos queremos que nuestras familias se mantengan  sanas. Y un factor principal para lograrlo es asegurarse que nuestras madres, hijas y hermanas tengan acceso a los servicios médicos preventivos que necesitan. Cuando el tema es sobre  la salud, las mujeres son quienes a menudo se encargan de tomar las decisiones para el cuidado de la salud de sus familias y también son una fuente de información confiable para sus amigos.  De la misma manera, las mujeres son consumidoras importantes de atención médica.

Las mujeres tienen necesidades únicas de atención médica durante su ciclo de vida. También, tienen tasas altas de enfermedades crónicas, como la diabetes, enfermedades cardíacas y ataques cerebrales. A pesar de que las mujeres son más propensas a necesitar servicios preventivos de salud, a menudo tienen menos posibilidades para pagarlos.  Frecuentemente, las mujeres no reciben los servicios médicos de prevención necesarios debido a sus  bajos ingresos y al costo que tiene que pagar de su propio bolsillo por servicios médicos. Sin embargo, al eliminar los gastos compartidos requeridos por los seguros se puede mejorar el acceso de las mujeres a servicios preventivos importantes. De hecho, un estudio demostró que cuando se eliminaron los gastos compartidos, la tasa de las mujeres que se hacían una mamografía subió hasta un 9 por ciento.

La Ley de Cuidado de Salud a Bajo Precio ayuda a que los servicios médicos de prevención sean accesibles y estén al alcance de todos.  La Ley requiere  que los nuevos planes de salud cubran los servicios preventivos recomendados y eliminen los gastos compartidos, tales como los deducibles, copagos o co-seguros, para muchos servicios de prevención. La ley también requiere que las compañías de seguros cubran otros beneficios de salud preventiva adicionales para las mujeres.

Por primera vez, el Departamento de Salud y Servicios Humanos de los Estados Unidos (HHS por su sigla en inglés) está tomando pasos importantes para mejorar los servicios médicos de prevención de las mujeres que se basa en recomendaciones existentes.  Hoy, HHS anuncio un guía nuevo sobre los servicios preventivos de salud de la mujer. El guía ayudara  que la mujer se mantenga saludable en todas las etapas de su vida.

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Guest post from HHS Secretary Sebelius: Prevention at the Heart of Keeping Women Healthy

By Kathleen Sebelius, Secretary of Health and Human Services

Read in Spanish

Everyone wants their family to be healthy. And a key component of this is ensuring that mothers, daughters, and sisters have access to the preventive services they need. When it comes to health, women are often the sole decision maker for their families and the trusted source in circles of friends – and they are also key consumers of health care.

Women have unique healthcare needs across their life span and have high rates of chronic disease, including diabetes, heart disease and stroke.  Yet while women are more likely to need preventive health care services, they often have less ability to pay. Too often, the combination of women’s lower incomes and out-of-pocket health costs mean that women forgo necessary preventive services. But removing cost sharing requirements improves women’s access to important preventive services. In fact, one study found that the rate of women getting a mammogram went up as much as 9 percent when cost sharing was removed.

The Affordable Care Act helps make prevention affordable and accessible for all Americans by requiring new health plans to cover recommended preventive services and by eliminating cost sharing, such as deductibles, copayments or co-insurance, for  many preventive services. The law also requires insurance companies to cover additional preventive health benefits for women.

For the first time ever, HHS is adopting a new comprehensive set of guidelines for women’s preventive services that builds on and fills the gaps in existing preventive services recommendations for women’s health.  Together, these guidelines will help ensure that women stay healthy at every stage of life.

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National Latina Institute Denounces Racist Anti-Choice Billboards

In a statement released today, the National Latina Institute for Reproductive Health strongly denounced the deeply offensive and racist billboard campaign by an anti-choice organization targeting African American women. This organization posted a three-story high billboard in New York City this week claiming that “the most dangerous place for an African American is in the womb” in conjunction with a national campaign during Black History Month.

“These offensive billboards are nothing more than political ploys designed to stigmatize African American women and communities of color and restrict access to reproductive health care”, said Silvia Henriquez, executive director of the National Latina Institute for Reproductive Health. “The organizations promoting these ads are focused on sensationalizing abortion and cutting even more women off from the reproductive health care they seek.”

Studies show that African American women and Latinas are more likely to be uninsured or underinsured and often lack basic access to birth control and comprehensive sex education due to fundamental structural inequities in society.

“We should be doing all we can to support women making the best personal reproductive health care decisions for themselves and their families”, added Henriquez. “As the only national Latina reproductive health and justice organization, we stand with other women of color to speak out in opposition to these condescending ad campaigns.”

For more information about NLIRH, visit: http://www.latinainstitute.org

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NLIRH in the News: Supporting NYC Legislation Requiring Crisis Pregnancy Centers to Come Clean

Photo Credit: New York Times

 

On Tuesday, October 12, the National Latina Institute for Reproductive Health announced its support for a piece of legislation in New York City that would require crisis pregnancy centers, or limited-service pregnancy centers, to disclose on all signage and advertising that they do not provide contraception or abortion services, or referrals to either.  The legislation would also require the centers to disclose if they do not have a licensed medical provider on site, and would hold them to the same confidentiality standards as licensed medical centers.

Crisis pregnancy centers are often innocuously labeled: “Pregnant?  Need Help?”  What many of these signs do not say is that these centers have an explicit anti-choice agenda, and often spread misinformation about abortion, such as the outdated and clinically-disproved claim that abortion increases risk of breast cancer.  The bill follows an investigation by NARAL Pro-Choice New York, who released a report documenting the tactics of these centers.

NLIRH’s own Senior Policy Analyst, Verónica Bayetti Flores, was interviewed in Spanish by Telemundo regarding this story. Read the story here, or watch here.

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Study Queries Latina Victimization, Seeks to Fill Gap in Social Science Research

By Lucy Panza, DC Policy Intern

Two professors from Penn State and Northeastern University, in conjunction with the Department of Justice, have released the findings of a three-year long study of the rate of sexual and other forms of victimization of Latinas.  The Sexual Assault Among Latinas (SALAS) Study sought to fill in the dearth of social science research on Latina victimization specifically.  Approximately 1% of the published literature that looks at interpersonal victimization focuses on Latinos, the authors said.  And in a nation that is 14% Latino as of 2004, that is unacceptable.  As the report states, the goals of SALAS were:

Determine extent of sexual victimization in a sample of adult Latino females.

Determine the coexistence of other forms of victimization among those sexually victimized and the risk for subsequent victimization.

Examine formal service utilization among sexually victimized Latino women.

Examine informal help-seeking among sexually victimized Latino women.

Examine culturally-relevant factors associated with experience and responses to sexual violence.

Determine the psychosocial impact of sexual victimization on Latino women.

2,000 Latinas were interviewed on the phone by “[t]rained professionals from an experienced survey research firm … in either English or Spanish.”  The participants were selected from a randomized list of land-line phone numbers, and they were paid $10 for their participation.  Counselors followed up with any participants who suffered emotionally from the interviews, which asked questions from preexisting social science questionnaires that seek to measure various symptoms of victimization like depression or anxiety.  The interviewers also asked about whether the participants sought formal or informal help.

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“Pink Viagra” up for approval from FDA

A German pharmaceutical company has produced a new drug called flibanserin, which has been shown to improve women’s sexual desire. Flibanserin was previously used in a clinical study to treat Hypo Sexual Desire Disorder (HSDD), in which the results reflected in an increase of satisfying sexual events and minimizing distress, a symptom associated with HSDD. On June 18, the FDA’s Reproductive Health Drugs Advisory Committee will meet to discuss the approval of Flibanserin as the new Viagra for women.  Unlike Viagra, which stimulates blood flow, flibanserin works in the brain, decreasing serotonin while increasing dopamine and norepinephrine, two neurotransmitters that regulate mood and behavior. While there are many reasons why a woman could have a decreased sex drive, flibanserin could very well become an option for treatment.

Amy Allina of the National Women’s Health Network stated, “Achieving a happy and healthy sex life can be a real and important problem for some women,” she also added that, “But we have lots of questions about the ‘pink Viagra.” I agree with Ms. Allina that before the FDA approves the new drug, we need to know more about it. Dr. Joel Match, a Reston-based OB-GYN was interviewed in the article, “On Your Side: ‘Female Viagra’ Up for FDA Approval” saying that while he welcomes new treatment for women with low libido, he cautions women with low sex drive to find the cause given that low libido could be a sign of other problems, such as diabetes or depression. I also hope that doctors do not start immediately prescribing this drug without investigating the cause of the decreased sex drive.  Female sexual dysfunction is a topic that is merely spoken in society, which is why even if the ‘pink pill’ doesn’t get approved, it brought attention to something that affects women across the country. I am happy that we are recognizing a woman’s sexual health as something important and being able to provide options for it such as flibanserin, a step towards women’s sexual health equity.

By Sheila Reynoso, Research Intern

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