The Healthy People 2020 report highlights some of women’s top concerns.  

Laura Byrd was a young adult when her grandmother died of breast cancer.

“It made a significant impact in my life. It helped me realize the importance of being proactive in my own health-care regimen,” says Laura, vice president of institutional development and executive director of the Lake-Sumter State College Foundation.

“My grandmother’s experience with poor access to quality health care and a delay in seeking help gave me a desire to gain a better understanding of my risks,” adds Laura, who learned more about recommended breast cancer screenings based on her family history.

Women’s health and proactive approaches are focal points of Healthy People 2020, a report developed by the U.S. Department of Health and Human Services and available at healthypeople.gov. 

The report takes a 10-year view and aims to improve Americans’ health by identifying health improvement priorities; increasing public awareness; providing measurable objectives and goals; and identifying research, evaluation and data collection needs. The project has benchmarks and will monitor progress over time.

Of the report’s 42 topics, 16 are geared toward women and girls. The objectives for cancer and genomics are of particular interest to nurse practitioner Nicole McCain, of Minneola.

“My mother passed of breast cancer one year ago at the age of 60,” Nicole says. “Her mother, who is now 94, also had breast cancer and survived. After my mom passed at such an early age, I wanted to get genetic testing to see if my sister or I were a carrier of the BRCA (breast cancer) gene. But, as most insurances go, it wasn’t covered, even though I had two very close family members with the disease. I decided it was important enough to me to proceed with the testing, but I had to pay out of pocket.”

The report’s goals for cancer include: reduce female breast cancer rate; reduce death rate from cancer of the uterine cervix; reduce invasive uterine cervical cancer; reduce late-stage female breast cancer; increase the proportion of women who receive breast cancer screening based on the most recent guidelines; increase the proportion of women counseled by their providers about mammograms.

The HHS Department also wants more women with a family history of breast and/or ovarian cancer to receive genetic counseling.

Nicole also was interested in the report’s goal of reducing hip fractures among older adults, including women ages 65 and older.

“This is something interesting I learned in nurse practitioner school this past year: women start losing bone density starting at age 30,” Nicole says. “While more attention is given to those more at risk for falls and fractures, women really should begin taking calcium and vitamin D supplements at age 30, when bone-density loss first begins.”

Physical therapist Cathy Hunter, however, believes the hip fracture objective is too challenging.

“Reducing hip fractures in the elderly for 65 and up is actually difficult,” says Cathy, of Leesburg. “As we age and get more diagnoses, our diagnoses make us a higher fall risk. If you’re on certain medications, that makes you a higher fall risk. If you get neuropathy of your feet from diabetes, that makes you a fall risk.”

She finds many people don’t know they have osteoporosis until they experience a fracture.

“We have a good population of people who need to use a walker or a cane, but they refuse because they’re vain, and that makes you a bigger fall risk,” Cathy says.

She believes early intervention is crucial to prevent future health woes.

“If you have an injury that doesn’t go away within a week, you need to get it checked because that turns into arthritis,” Cathy says. “Arthritis can start sooner depending on what you’ve done with your joints your whole life.”

Healthy People 2020 also proposes increasing the proportion of college students who receive information from their institution on health risk behavior areas of unintentional injury; violence; suicide; tobacco use and addiction; alcohol and other drug use; unintended pregnancy; HIV/AIDS and STD infection; unhealthy dietary patterns; and inadequate physical activity.

Lake-Sumter State College is committed to providing health-related information to students and staff, Laura says.

“We do have support for our students who are suffering from any type of mental health challenges. We have a program we’ve worked with the last three months which is very beneficial, especially during this time (of COVID-19 pandemic),” Laura says. “Also, our college is tobacco-free, and when we talk about health, we offer a wellness program and have wellness-type activities that are offered to employees at no cost.”

Laura believes women need to make their health a top priority.

“I think taking that time to go to the doctor visits that we need to go to, making sure that we are getting our mammograms, getting our yearly checkups, getting the vaccinations that we need and just living a life that is healthy overall is important,” she says. “We can better take care of our families if we are taking good care of ourselves.”

Dr. Nitza Alvarez, cardiovascular disease specialist and president of Tri-County Heart Institute in Lady Lake, also encourages women to be proactive about their overall health. She would prefer to see more heart-related goals listed for women in Healthy People 2020, which lists only one: increase aspirin use among adults with no history of cardiovascular disease, especially women ages 55-79.

“Heart disease is our No. 1 health threat. Half a million women die every year from a condition that is preventable 80 percent of the time, due to lack of recognition and lack of appropriate care,” says Dr. Alvarez, who adds that more women die from heart disease than all other cancers combined.

“My main advice to all women is to learn what their risks are, understand the differences between heart disease in women and men and to get checked. You don’t know if you are at risk for heart disease or stroke unless you get checked,” she says. “You have to be your own advocate. Don’t wait until it’s late. Prevention is the most important intervention.” 

Dr. Alvarez also notes arthritis and chronic back conditions are chronic inflammatory states that increase a person’s risk for hardening of the arteries, which can increase the risk for heart attack and stroke.

“There is a clear association between inflammation and blood clots,” she says. “Take care of your inflammation; don’t ignore the symptoms.”

Dr. Alvarez points out that it’s common for heart disease to be associated with pregnancy.

“Conditions such as gestational diabetes (a form of diabetes that appears during pregnancy) and/or high blood pressure that commonly occur during pregnancy significantly increase the risk of a heart attack later in life,” she says. “One in five women in the United States has a form of these conditions during at least one pregnancy. With more professional women waiting to start their family later in life, and with the increased incidence of obesity and diabetes, the number of women at risk for these pregnancy complications continues to rise.”

Healthy People 2020 addresses pregnancy goals: reduce the rate of maternal mortality; reduce cesarean births among low-risk women and those giving birth for the first time or who have had a prior cesarean birth; increase the proportion of pregnant women receiving prenatal care; and increase women’s intake of folic acid from fortified foods or dietary supplements. 

While the report does not specifically address obesity and diabetes, it does list this nutrition and weight loss goal: reduce iron deficiency among young children and females of childbearing age, including females ages 12-49 years.

Dr. Alvarez says diet plays a crucial part in prevention and treatment of heart disease and is vital for overall health.

“However, even among the experts, there is no clear consensus on what is the most appropriate diet to follow to prevent heart disease. The consensus is that the future health of the global population largely depends on a shift to eating healthier food,” Dr. Alvarez says. “I would like to share trends that appear to be good starting points. They are backed up with evidence supporting their heart benefits. Eat more plants!”

Her interest was piqued by a recent study that showed a link between animal-versus-plant intake and death.

“The evidence suggests that a diet that is mostly plant-based improves risk factors for heart disease and reduces progression of heart disease,” Dr. Alvarez says. “Eating mainly plants can not only reduce your risk of getting heart disease in the first place, but if you have been diagnosed already, a plant-based diet can prevent it from getting worse.”