[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

[[Page H1961]]

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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