[Congressional Record Volume 143, Number 53 (Tuesday, April 29, 1997)]
[House]
[Pages H1966-H1968]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         WOMEN'S HEALTH ISSUES

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Indiana [Mr. Roemer] is recognized for 5 minutes.
  Mr. ROEMER. Mr. Speaker, I would just like to hopefully wrap up this 
very successful special order on women's health issues and congratulate 
my classmate, the gentlewoman from the District of Columbia [Ms. 
Norton], and the gentlewoman from Connecticut [Mrs. Johnson] for a 
very, very successful hour of discussion on very critical matters of 
women's health.
  I would like to be the last speaker on that particular issue and talk 
about an issue that is very important to me as a Congressman, as a 
father, as a taxpayer, as somebody that believes in a woman's health 
issue known as the WIC program.
  What is the WIC Program? It is the Women, Infants and Children 
Program, and it is a program that has always enjoyed wide bipartisan 
support. Republicans and Democrats alike have supported this program 
because it accomplishes some very important things.
  First, it reduces low birth weight in babies. Second, it reduces the 
infant mortality rates, death rates for babies born prematurely. Third, 
it reduces child anemia. And last, it has been directly linked to 
improving cognitive development for children.
  Now why am I as a Member of Congress concerned about this? I am 
concerned, Mr. Speaker, because milk prices have increased this year 
and last, and the caseload experience and the caseload numbers have 
increased in the WIC Programs in an alarming rate. So the White House 
has very, very wisely asked for a $76 million increase to take care of 
this increase in milk prices and caseload.
  Mr. Speaker, just recently in a Committee on Appropriations markup, 
the Republicans cut this $76 million increase in half, cut $36 million 
out of the WIC Program. Now at a time, Mr. Speaker, when we are 
learning from Newsweek and Time Magazine, on the front covers of these 
magazines, that everything we can do when that child is in the womb, 
the fetus, or when that child is between 1 and 5 is critical to help 
these children to learn and grow and that this is the most critical 
time for a child to maybe pick up a new language and learn intellectual 
skills and cognitive development.
  We are talking about cutting this program by $36 million. What does a 
$36 million cut result in?
  It results in 180,000 children not getting access to this good 
program. One hundred and eighty thousand children. Now I do not think 
that is smart.
  I support balancing the budget, and I am willing to cut a space 
station that does not work, I am willing to cut Star Wars in half, but 
I am not willing to cut children and women out of the WIC Program. Why? 
The General Accounting Office has said not only is this the best thing 
for children and young mothers, but for every dollar we invest in the 
WIC Program, we save $3.50 on Social Security disability payments and 
on Medicaid and on other government programs.
  So, if we cut $36 million and cut 180,000 children out of this 
program, we are probably going to cost the taxpayer $120 million later 
on down the line in increased costs.
  So I strongly urge this body to adopt an amendment and put this $36 
million back into the WIC Program this week when we consider the 
emergency supplemental program and continue to do what the White House 
urged us to do last week in their conference on early childhood 
development. Let us invest in our children. Let us not just talk about 
an America that puts their children and their families first. Let us 
put our money where our mouth is. Let us make sure that the WIC Program 
is adequately funded.
  Mr. Speaker, I would just say in conclusion that I am strongly 
committed to this program, I am strongly committed to making sure that 
our children have access, all children across America, and I would just 
say that I am honored to be the last speaker on this special order on 
women's health and delighted that it went so well.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise tonight to speak about 
an issue of vital importance to the women of this Nation--breast 
cancer. As a woman and a mother, I feel that there are few issues as 
important as the breast cancer epidemic facing our Nation.
  As you may know, breast cancer is the most commonly diagnosed cancer 
in American women today. An estimated 2.6 million women in the United 
States are living with breast cancer. Currently, there are 1.8 million 
women in this country who have been diagnosed with breast cancer and 1 
million more who do not yet know that they have the disease. It was 
estimated that in 1996, 184,300 new cases of breast cancer would be 
diagnosed and 44,300 women would die from the disease. Breast cancer 
costs this country more than $6 billion each year in medical expenses 
and lost productivity.
  These statistics are powerful indeed, but they cannot possibly 
capture the heartbreak of this disease which impacts not only the women 
who are diagnosed, but their husbands, children, and families.
  Sadly, the death rate from breast cancer has not been reduced in more 
than 50 years.

[[Page H1967]]

One out of four women with breast cancer dies within the first 5 years; 
40 percent die within 10 years of diagnosis. Furthermore, the incidence 
of breast cancer among American women is rising each year. One out of 
eight women in the United States will develop breast cancer in her 
lifetime--a risk that was one in fourteen in 1960. For women ages 30 to 
34, the incidence rate tripled between 1973 and 1987; the rate 
quadrupled for women ages 35 to 39 during the same period.
  I am particularly concerned about studies which have found that 
African-American women are twice as likely as white women to have their 
breast cancer diagnosed at a later stage, after it has already spread 
to the lymph nodes. One study by the Agency for Health Care Policy and 
Research found that African-American women were significantly more 
likely than white women to have never had a mammogram or to have had no 
mammogram in the 3-year period before development of symptoms or 
diagnosis. Mammography was protective against later-stage diagnosis in 
white women but not in black women.
  We have made progress in the past few years by bringing this issue to 
the Nation's attention. Events such as Breast Cancer Awareness Month 
are crucial to sustaining this attention. There is, however, more to be 
done.
  It is clear that more research and testing needs to be done in this 
area. We also need to increase education and outreach efforts to reach 
those women who are not getting mammograms and physical exams.
  We cannot allow these negative trends in women's health to continue. 
We owe it to our daughters, sisters, mothers, and grandmothers to do 
more. Money for research must be increased and must focus on the 
detection, treatment, and prevention of this devastating disease.
  Mr. BARRETT of Wisconsin. Mr. Speaker, as history has proven, 
research for women's health issues has consistently been underfunded. I 
rise today to recognize yet another case of injustice concerning 
women's health. Currently there are 10 million U.S. citizens suffering 
from temporomandibular jaw disorder, (TMD). This disorder targets 
women; nearly 90 percent of TMD patients are female. TMD is a very 
painful condition that can lead to severe dysfunction of the muscles 
that control chewing.
  Complicating the disorder even further, in 1973, medical devices 
containing silicone were approved to replace part of the jaw in an 
irreversible surgery. This procedure, although not adequately 
researched, was aggressively marketed by alloplastic device suppliers. 
Approximately 150,000 women with TMD received implants between 1973 and 
1990. Today, these implants have proven disastrous.
  In 1989, nearly 20 years after they went on the market, the FDA 
declared alloplastic implants unsafe. The medical complications caused 
by the sharding of the silicone in TMD implants over time has resulted 
in bone and tissue deterioration as the alloplastic particles travel 
throughout the body. Bone loss in some cases has resulted in holes in 
the skull leading to the brain. Many women have been left disfigured; 
lacking bone structure and/or muscular control. The magnitude of 
suffering undergone by TMD patients with implants can only be 
categorized as a medical catastrophe.
  Compounding the issue, there is currently no procedure to treat women 
with silicone implants other than removal. In the case of TMD, however, 
the implants often cannot be removed because there are no good 
alternative materials and the ramus of the jaw cannot be replaced. 
Women who have undergone alloplastic surgery now require life-long 
dependency on medical technology. It is not uncommon to find patients 
with 15, 20, 30 or more surgeries on their TM joint. This only 
exasperates the emotional and financial complications that accompany 
the disorder. I quote from Stan Mendenhall's article in Orthopedic 
Network News:

       One woman had over five surgeries on her joints and was 
     unable to find a dentist in three states who would treat her 
     and is now suicidal. A 30-year old woman must now be cared 
     for by her parents after 32 surgeries and $300,000 in medical 
     expenses. Another patient received a bill from an oral 
     surgeon in excess of $30,000 for a procedure which was a 
     revision for a previous surgery and will, at best, only 
     provide temporary relief from constant pain. One physician 
     wrote on behalf of one of his patients who had applied for 
     social security disability payments: ``As Leigh's physician, 
     I've witnessed her decline throughout 7 of her surgeries and 
     seen her travel all the avenues of TMJ surgery. Instead of 
     improving after each method, she has developed more daily 
     pain. Unfortunately the surgeries that she has had, I feel, 
     have probably left her joint in much worse shape. Her 
     depression has now reached a dangerously high level in which 
     she describes herself as having nothing left, having no 
     hopes, no dreams. She states only that she hopes her life 
     will be short in duration so that she will not have to exist 
     in the constant painful state that she is in.''

  The silicone TMD implants, so hastily marketed, have victimized women 
with TMD.
  To make matters worse, women suffering from TMD have a hard time 
finding a health insurance program that will carry them. Because there 
is not a clear diagnosis of TMD and treatment is often considered 
experimental, health insurance companies refuse to underwrite patients. 
Without the proper research, there will never be proper diagnosis and 
without proper diagnosis, there will never be proper coverage.
  This is very unfair. These women have been served a great injustice 
and have no where to turn. Women suffering from TMD are paying the 
price for someone else's mistakes. Should TMD victims have to pay the 
consequences for devices that the FDA approved and their doctors 
recommended? Should patients have to pay for high-cost long-term 
medical bills because the government has not properly funded basic 
research? Temporomandibular joint disorder is a medical tragedy and it 
is time to do something about it.
  The question we must ask now is--how do we help these women that have 
been treated so unjustly?
  I urge the Congressional Caucus for Women's Issues to take up the 
cause of women suffering from TMD and help them in finding a solution 
to this tragedy. We must better define TMD and properly fund research 
to find effective treatment for people who have TMD implants. We must 
encourage the National Institute of Health to make TMD research a 
higher priority. We can no longer tolerate the lack of concern for 
these women.
  Ms. MILLENDER-McDONALD. Mr. Speaker, the high number of minority 
women infected with the HIV virus reflects their reduced access to 
health care which is associated with disadvantaged socio-economic 
status, cultural or language barriers that may limit access to 
prevention information as well as differences in HIV risk behaviors.
  Among minority women, the most prevalent modes of contacting HIV are 
injecting drug use, 37 percent, and heterosexual contact, almost 38 
percent.
  Rates of heterosexual anal and oral intercourse in minority youths 
are comparable with estimated rates in adults.
  In the inner-city community, there are often greater perceived 
notions that sex is not as good if a condom is used. Frequently women 
do not encourage their sexual partners to use condoms for fear of 
retribution. Their low-income status makes them feel more dependent 
upon their partners and they do not want to risk losing them insisting 
on safe sex.
  Minority youths have a higher tendency to engage in sex with multiple 
partners, therefore creating higher risks for HIV infection. Minority 
communities are in need of better efforts to promote condom use and 
discourage multiple partners.
  AIDS rates are highest among Blacks and Hispanics.
  AIDS rates among Blacks are six times greater than among whites, and 
two times greater than among Hispanics.
  In 1995, racial and/or ethnic minorities accounted for over 77 
percent of AIDS cases among adolescent and adult females, and over 84 
percent of AIDS cases among children.
  By the year 2000, between 72,000 and 100,000 children and teens will 
have lost their mothers to HIV/AIDS. The cities that will be the 
hardest hit are Los Angeles, Washington, DC, Newark, New York City, 
Miami, and San Juan.
  Ms. WATERS. Mr. Speaker, first I would like to thank Representative 
Connie Morella and Representative Louise Slaughter and Members of the 
Congressional Caucus for Women's Issues for the opportunity to 
participate in this special order on women's health.
  I come before you today to speak on an issue of great importance to 
all women, and in particular women of color, that has yet to reach 
prominence on the national agenda. I am speaking of heart diseases.
  Cardiovascular diseases--which include heart attacks, strokes, and 
high blood pressure--are the No. 1 cause of death and disability among 
American women, yet most Americans aren't even aware of the risks 
facing women.
  I want to talk with you about a bill to do something about this--the 
Women's Cardiovascular Diseases Research and Prevention Act--that I am 
introducing which aims to prevent and aggressively treat heart diseases 
among women and educate the public and health professionals alike about 
the grave risks of these diseases to women.
  Although most people believe cancer, specifically breast cancer, is 
the No. 1 women's health risk, in reality five times as many women die 
from cardiovascular diseases than die from breast cancer. The threat is 
so great in fact, that 479,000 women die each year from heart disease--
almost double the number of deaths from all forms of cancer combined.
  And heart disease strikes broadly, affecting one in five women in the 
Nation. Even more ominous is the unusually silent approach of

[[Page H1968]]

this killer. Amazingly, nearly two-thirds of women who died suddenly of 
heart attack had no prior history of heart disease, and no risk was 
detected.
  Public health experts have drawn many links between the difficulties 
poor and working women face and increased risk of disease. 
Cardiovascular diseases are no exception to these health effects of 
inequality.
  Furthermore, cardiovascular diseases strike African-American women 
particular hard. African-American women die of heart attacks at twice 
the rate of other women, and die from strokes at a 33-percent higher 
rate that white women.
  The risk factors that increase likelihood of cardiovascular diseases 
are also greater for African-American women than white women, including 
a higher incidence of diabetes, higher percentage with elevated 
cholesterol levels, less physical activity, and a greater rate of 
obesity.
  These factors--often stemming from stress and struggle of trying to 
make ends meet--are commonly known with health care professionals--yet 
these factors and the deadly cardiovascular diseases that result are 
almost invisible in the policy debates and public discussions of our 
Nation's health and welfare.
  That is why I urge you to join me in supporting the Women's 
Cardiovascular Diseases Research and Prevention Act. We who know better 
must create the kind of pressure, through broad education and study 
that will put this issue at the center of our public health 
initiatives, not stuck on the fringes, while striking, literally, at 
the heart of the women in America.
  This bill aims to lay the critical foundation for the research and 
public education that is needed to turn around this largely silent 
killer of America's women. The bill authorizes $140 million to the 
National Heart, Lung, and Blood Institute of the National Institutes of 
Health to expand studies on heart diseases to include women and conduct 
outreach that will reach women. This authorization will start to make 
up for the many years in which women and minorities have been greatly 
underrepresented in heart and stroke research.
  Currently, most if not all, diagnostic equipment and treatments are 
based on studies limited to men. The results of this research bias has 
meant many health care professionals remain unaware of the varied and 
often subtle symptoms of heart diseases women may have, like dizziness, 
breathlessness, and arm pain.
  This bill will provide those responsible for detecting and treating 
women with the knowledge necessary to combat these diseases among 
women.
  This bill seeks to use the results of this research as well, 
spreading this knowledge beyond the hospitals and laboratories. This 
bill would establish targeted outreach programs for women and health 
care providers alike to educate all of us on the common symptoms of and 
risk factors contributing to cardiovascular diseases among women.
  The Women's Cardiovascular Diseases Research and Prevention Act can 
be a crucial first step in getting timely diagnosis, effective 
treatment and broad, effective prevention measures for the leading 
killer of American women. I look forward to working with the members of 
the Congressional Caucus of Women's Issues, and all other interested 
Members of Congress to pass this legislation. Again, I would like to 
thank you for the opportunity to speak to you today.

                          ____________________