[Congressional Record Volume 143, Number 53 (Tuesday, April 29, 1997)]
[House]
[Pages H1960-H1961]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PROGRESS REPORT ON WOMEN'S HEALTH
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 7, 1997, the gentlewoman from Maryland [Mrs. Morella] is
recognized for 60 minutes as the designee of the majority leader.
Mrs. MORELLA. Mr. Speaker, I am really very pleased to sponsor
tonight's special order on women's health with my colleagues Nancy
Johnson, Louise Slaughter, and Eleanor Holmes Norton, and so many of
our colleagues who are here this evening.
The Congressional Caucus for Women's Issues has spent a number of
years attempting to address the neglected women's health research at
the National Institutes of Health. The caucus asked the General
Accounting Office in 1989 to investigate the NIH policy regarding the
inclusion of women in clinical studies.
Women had been routinely excluded from many studies, such as the
Physicians' Health Study which studied the effects of aspirin on heart
disease of 22,000 male physicians. Another study, the Multiple Risk
Factor Inventory Trial, a 15-year project studying the risk factors for
cardiovascular disease, included 13,000 men and no women.
In 1990, the GAO reported that the NIH had made quote, little
progress in implementing a 4-year-old policy to encourage the inclusion
of women in research study populations. The caucus in 1990 introduced
omnibus legislation, the Women's Health Equity Act, which included the
establishment of an Office of Research on Women's Health and the
requirement that women and minorities be included wherever appropriate
in research studies funded by NIH.
Well, in the fall of 1990, at a meeting with many caucus members, NIH
announced the formation of the Office of Research on Women's Health, to
ensure that greater resources were devoted to diseases primarily
affecting women and to ensure that women were included in clinical
trials. Since 1990, great progress has been made in funding for women's
health concerns, particularly breast, ovarian, and cervical cancer,
osteoporosis, and the women's health initiative.
While I focus my remarks tonight on HIV AIDS, osteoporosis, and
domestic violence, there are so many issues critical to women's health
that will not be mentioned tonight but are still high priorities for
all of us.
Since 1990 I have been the sponsor of legislation to address women
and AIDS issues. Women are the fastest growing group of people with
HIV, and AIDS is the third leading cause of death in women ages 25 to
44. While the overall number of AIDS deaths declined last year, the
death rate for women actually increased by 3 percent, resulting in a
record 20 percent of reported AIDS cases in adults.
Low-income women and women of color are being hit the hardest by this
epidemic. African-American and Latino women represent 75 percent of all
U.S. women diagnosed with AIDS.
NIH is currently working to develop a microbicide. This is a chemical
method of protection against HIV and STD infection, which is sexually
transmitted disease infection, with an emphasis on methods that women
can afford, control without the cooperation and knowledge of their male
partners, and use without excessive difficulty.
We must acknowledge the issues of low self-esteem, economic
dependency, fear of domestic violence, and other factors which are
barriers to empowering women to negotiate safer sex practices. Research
on a safe and effective microbicide must be a priority for our research
and prevention agendas, and we must also work to answer the full range
of questions important to understanding HIV in women, including
adequate funding for the women's interagency HIV study, the natural
history study of HIV in women.
In order to address these priorities for women, I will be introducing
my women and AIDS research bill next week, and I hope my colleagues
here tonight will join me as original cosponsors.
The gentlewoman from California [Ms. Pelosi] and I have also
introduced H.R. 1219, a comprehensive HIV prevention bill which
includes the provisions of my bill from the last Congress to address
the need for more targeted prevention programs for women. Our bill
authorizes funding for family planning providers, community health
centers, substance abuse treatment programs, and other providers who
already serve low-income women to provide community-based HIV programs.
Our bill also creates a new program to address concerns about HIV for
rape victims.
In my work focusing on the needs of women in the HIV epidemic, the
effectiveness of community-based prevention programs has been
demonstrated time and time again. Providers with a history of service
to women's communities understand that prevention efforts must
acknowledge and respond to the issues of low self-esteem, economic
dependency, fear of domestic violence, and other factors which are
barriers to empowering women. I urge my colleagues to cosponsor this
legislation.
Now on to osteoporosis. Mr. Speaker, it is a major public health
threat for 28 million Americans who either have or are at risk for the
disease. One out of every 2 women and 1 in 8 men over age 50 will have
an osteoporosis-related fracture.
A woman's risk of hip fracture is equal to her combined risk of
breast, uterine, and ovarian cancer. Often a hip fracture marks the end
of independent living. Many enter nursing homes and a large percentage
die within 1 year following the fracture. The costs incurred due to the
1.5 million annual fractures are staggering at $13.8 billion, or $38
million a day. Osteoporotic fractures cost the Medicare Program 3
percent of its overall cost.
I have reintroduced H.R. 1002 along with the gentlewoman from
Connecticut, [Mrs. Johnson], the gentlewoman from New York, [Mrs.
Lowey] and the gentlewoman from Texas, [Ms. Eddie Bernice Johnson], to
standardize Medicare coverage for bone mass measurement tests for the
diagnosis of osteoporosis. Without bone density tests, up to 40 percent
of women with low bone mass could be missed at a time when we now have
drugs that promise to reduce fractures by 50 percent.
At this time, Medicare leaves the decision to cover bone density
tests to local Medicare insurance carriers, and the definition of who
is qualified to receive a bone mass measurement varies from carrier to
carrier. H.R. 1002 would standardize Medicare coverage in order to
avoid some of the 1.5 million fractures caused annually by
osteoporosis. Since these tests are already covered by every carrier,
the cost to the Medicare Program will not be substantial. As a matter
of fact, with Congresswoman Johnson, we just met with representatives
of the Congressional Budget Office to talk about that.
With regard to domestic violence, we have made great progress, yes,
in training law enforcement personnel about domestic violence and
funding battered women's shelters and starting up the national domestic
violence hotline. I want to say that our speaker this evening has been
certainly very cooperative and generous in the funding of the Violence
Against Women Act.
But one area where we have room for improvement is in the training of
our
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health care professionals, doctors, dentists, nurses, and emergency
personnel who are also in the frontlines in the fight against domestic
violence. Many health professionals are unaware or unsure about the
symptoms, treatment, and the means of preventing domestic violence, and
many unknowingly send victims home with abusive husbands and
boyfriends.
That is why I have introduced the Domestic Violence Identification
and Referral Act, which is H.R. 884, which will amend the Public Health
Service Act to give a preference in awarding Federal grants to those
schools, medical, dental, nursing, and allied professionals that
provide significant training in identifying, treating, and referring
victims of domestic violence.
The gentleman from Vermont [Mr. Sanders] and I have introduced the
Victims of Abuse Insurance Protection Act, H.R. 1117, that would outlaw
discrimination in all forms of insurance: Health, life, homeowners,
auto, and liability. Although the Kennedy-Kassebaum health care reform
bill included language prohibiting insurers from denying coverage to
victims of domestic violence, companies can still charge domestic
violence victims prohibitively higher rates; in effect, ban them from
affordable health insurance coverage.
{time} 1845
H.R. 1117 would also protect the confidentiality of victims records.
I urge my colleagues to join us in cosponsoring these bills.
There is more we could say, but I have many of my distinguished
colleagues, and I appreciate their being here, who do also want to
speak.
Mr. Speaker, I yield the balance of my time to the gentlewoman from
Connecticut [Mrs. Johnson].
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