Protecting Women’s Health
The committee found sufficient evidence to endorse eight recommendations for specific preventive services and screenings that support women’s overall health.
For sexually active women, the committee found that current recommendations of screening for cervical cancer, counseling for sexually transmitted infections, and HIV counseling and screening are too limited in scope and should be expanded. It also made several recommendations that support women’s reproductive health. These include a fuller range of contraceptive education, counseling, methods, and services so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes. Additional recommendations address needs of pregnant women, including screening for gestational diabetes and lactation counseling and equipment to help women who choose to breastfeed to do so successfully.
The committee recommended including at least one well-woman preventive care visit annually for women to receive comprehensive services. Depending on a woman’s health status, health needs, and risk factors, multiple visits might be recommended to provide the full range of preventive services.
Finally, the committee recommended that all women and adolescent girls be screened and counseled for interpersonal and domestic violence in a culturally sensitive and supportive manner. An estimated five million women are physically, sexually, or emotionally abused by their partners each year in the United States. Screening for risk of abuse is central to women’s safety, as well as to addressing current health concerns and preventing future health problems.
Keeping Preventive Care Up-to-Date
The committee made several recommendations that will enable HHS to periodically update the review of preventive services covered under the ACA. The committee recommends developing the structures within HHS that involve accountability and processes to ensure that preventive services meeting the requisite criteria will be considered in the future, as science emerges. Further, HHS should establish an independent commission to support the process.
The committee noted that the public health system and community-based preventive services are important to achieving the aims of preventive health services. Community-based health services can play significant roles in providing preventive care to many different populations. The committee encourages HHS to consider widening the proposed commission’s scope of authority so that public health efforts work in coordination with the new and existing bodies that are charged with overseeing other elements of the ACA.
Positioning preventive care as the foundation of the U.S. healthcare system is critical to ensuring Americans’ health and well-being. Although the ACA addresses preventive services for both men and women of all ages, women particularly stand to benefit from additional preventive health services. The inclusion of evidence-based screenings, counseling, and procedures that address women’s greater need for services over the course of a lifetime may have a profound impact for individuals and the nation as a whole.