Message from the Director                            Summer 2016

Greetings! Welcome to the second issue of OWH Insights. Our office has been very busy, and we’re excited to share our activities with you. You’ll learn about two of our funding initiatives, one on college sexual assault and the second on female genital cutting. In this issue, you’ll also be introduced to one of our educational campaigns — Know the Facts First — and you’ll see highlights from two of OWH’s health observances, National Women’s Health Week and National Women and Girls HIV/AIDS Awareness Day. Read about our HIV Prevention Toolkit: A Gender-Responsive Approach and what’s happening in West Virginia through our Regional Spotlight feature. And check out the updated Dietary Guidelines for Americans and its top 10 list. All of us can learn something new from its findings! And in thinking about what’s new and old, I want to let you know that 2016 marks OWH’s 25th anniversary. Since 1991, women’s and girls’ health have improved in very significant ways. Over the next six months, OWH plans to celebrate the work we have done and the progress we have made. As always, we continue thinking about where and how we can make the most impact on the lives of women and girls. Will it be through education, campaigns, events, programs, grants, policy?  I feel honored to work for an organization that has provided national leadership in women’s health during this period of great change. Of course we have much left to achieve! We hope you can join us in our celebration. We’ll share details of our upcoming anniversary activities in the next issue of this newsletter. It's been an impressive 25 years in women's health. With your support, we will keep moving forward to meet our mission: to improve the health and well-being of U.S. women and girls. With best wishes to all for a healthy summer,

Nancy C. Lee, M.D.

Deputy Assistant Secretary for Health — Women's Health

Director, Office on Women's Health

Office on Women's Health Activities

College Sexual Assault Policy and Prevention Initiative

We’ve all heard alarming reports of violence against women on college campuses. About one in five female college students report having been sexually assaulted. The assault typically happens during her freshman or sophomore year, and she does not report it. In most cases, the perpetrator is an acquaintance, classmate, friend, or (ex-) boyfriend of the victim, and she was drugged, drunk, passed out, or otherwise incapacitated. Yet most colleges have no or limited policies and procedures in place to prevent sexual assault from occurring.

In July 2016, OWH awarded cooperative agreements totaling $2 million to organizations and post-secondary schools: colleges, universities, technical schools, community college, and trade schools. They will be tasked with implementing or strengthening sexual assault policies and prevention strategies on their campuses based on recommendations from the White House Task Force to Protect Students from Sexual Assault. (You can find information and resources on how to respond to and prevent sexual assault on the website Not Alone: Together Against Sexual Assault at www.notalone.gov. For information on President Obama’s It’s on Us Campaign to End Sexual Assault, go to www.itsonus.org.)

Female Genital Cutting Community-Centered Health Care and Prevention Project

Female genital cutting (FGC) refers to all procedures involving partial or total removal of the external genitalia or other injury to the female genital organs for non-medical reasons. Typically, FGC is done on girls before or during adolescence. It can lead to a range of short- and long-term health problems, such as wound infection, tetanus, scarring, menstrual difficulties, infertility, and obstetric complications during pregnancy, labor, and childbirth. While FGC is illegal in this country, there are women living in the United States who have experienced FGC, and there are girls living here who may be at risk of having it performed on them.

This summer, OWH awarded funding for the Female Genital Cutting (FGC) Community-Centered Health Care and Prevention Projects. Through this initiative, OWH is working with immigrant communities to prevent FGC in the United States and to improve FGC-related health care services for those who have already had the procedure. This initiative provides a total of $2 million in grants to six organizations for a period of up to three years. Awardees will address gaps in services and in prevention.

Know the Facts First STD Prevention Campaign

In collaboration with the National Alliance of State & Territorial AIDS Directors and the National Coalition of STD Directors, OWH launched Know The Facts First. This new public health awareness and education campaign addresses the high rates of STDs (sexually transmitted diseases) among teens. The campaign provides teen girls (ages 13–19) with accurate and up-to-date facts about STDs, dispels common myths, and highlights how to prevent getting them. The goal is to empower teen girls to make informed decisions about engaging in sexual activity. 

The campaign encourages teens to visit the campaign website, Know the Facts First, which also provides teens with a way to find local STD testing centers. Public service announcements are being placed in malls, magazines, schools, and movie theaters; on television; and online.

National campaign partners are helping us maximize the number of teen girls we reach. They include federal government agencies, national advocacy groups, and local grassroots organizations. Our partners are vital to the success of the campaign, because their expertise includes reaching teen girls and boys, especially those considered most at risk, and understanding what influences teenagers. 

United State of Women Summit Event: “Healthy Women, Healthy Families”

The White House convened the first-ever United State of Women Summit in Washington, DC, June 14–15, 2016. The two-day event brought together 5,000 individuals — celebrities, health professionals, researchers, politicians, and community advocates. All were committed to improving women’s health and increasing women’s opportunities for achieving equality. The time was filled with powerful people, powerful words, and powerful ideas. Topics included women’s economic empowerment, health and wellness, entrepreneurship, leadership, and civic engagement.

“Today We’ll Change Tomorrow” was the title and theme for the first day. Speakers reflected on the work done over the years to build healthier and happier generations of women and girls. The importance of the summit was shown by who spoke: President Barack Obama, First Lady Michelle Obama, Oprah Winfrey, Warren Buffett, Patricia Arquette, Kerry Washington, Mariska Hargitay, Debra Messing, U.S. Attorney General Loretta Lynch, and many others.

The U.S. Department of Health and Human Services (HHS) had a special session on the second day, entitled “Healthy Women, Healthy Families.” We celebrated the amazing progress this country has made in health care since March 23, 2010. What’s so special about that date? President Obama signed the Affordable Care Act (ACA) into law.

The day’s event was moderated by Dr. Nancy Lee. Sylvia Burwell, Secretary of HHS discussed how the ACA is working for Americans:

• Twenty million more Americans now have health insurance.
• Because of the ACA, an estimated 55.6 million women with private insurance are guaranteed coverage of recommended preventive services with no out-of-pocket costs.
• No one can be denied coverage because of sickness or preexisting conditions.
• The public saved a total of $11 billion for prescription drug coverage under Medicare Part D.
• Between 2010 and 2015, the uninsured rate among women ages 18 to 64 decreased from 19.3 percent to 10.8 percent, a relative reduction of 44 percent.

The Centers for Disease Control and Prevention’s (CDC) Dr. Wanda Barfield then talked about new strategies to prevent transmission of the Zika virus. The Health Resources and Services Administration’s Dr. Michael Lu discussed the important role women play in reviewing and updating the Women’s Preventive Services Guidelines. Dr. Karen DeSalvo, Acting Assistant Secretary for Health, closed the event with a charge to “go back to your communities, towns, and cities and identify one way to make that place better!”

The United State of Women Summit can be viewed at www.theunitedstateofwomen.org/watchsummit/.

National Women’s Health Week 2016

Each May, OWH leads National Women’s Health Week (NWHW), a weeklong health observance that empowers women to improve their physical and mental health and lower their risks of certain diseases. Kicking off each year on Mother’s Day, NWHW encourages women to prioritize their health and to take small, manageable steps for healthier, happier lives.

During this week and beyond, OWH inspires women to take five specific steps to improve their health:

1. Schedule a well-woman visit (check-up) and preventive screenings.
2. Get active.
3. Eat healthy.
4. Pay attention to their mental health, including managing stress and getting plenty of sleep.
5. Avoid unhealthy behaviors like smoking and texting while driving.

This year, OWH focused on wellness tips and important screenings for women as they age. OWH offered checklists for every decade that outline what women can do to improve their health and well-being. (For more information, go to www.womenshealth.gov/nwhw/by-age/.) And we encouraged women to take the pledge to do at least one of the steps on the checklist for a healthier you.

In recognition of the week, President Obama released an official Presidential Proclamation on the importance of NWHW and the White House’s commitment to women’s health. The proclamation stressed that “ensuring women can live full and healthy lives is vital, and central to that mission is improving the quality, affordability, and accessibility of health care for women.“ Read President Obama’s official statement on the importance of NWHW on www.whitehouse.gov.

First Lady Obama was featured in two videos launched by OWH that promote two of the five key NWHW messages. The videos included clips of recorded interviews of the First Lady speaking on the importance of healthy eating and mental health. By the end of NWHW, those two videos were viewed more than 47,000 times!

OWH worked with an amazing group of partners, national organizations, and celebrity ambassadors to help spread the word. This year’s ambassadors include Shonda Rhimes, TV writer and producer, author, and mother; Soledad O’Brien, journalist and CEO of Starfish Media Group; Padma Lakshmi, New York Times bestselling author and Top Chef host and executive producer; and many more. Read our blog for stories about how they stay healthy and to get health tips from the OWH Director Nancy Lee.

To learn more about NWHW, visit www.womenshealth.gov/nwhw. And save the date for the next NWHW, May 14–20, 2017!

An Educational Toolkit on Preventing HIV

HIV Prevention Toolkit: A Gender-Responsive Approach

Around one in four people living with HIV in the United States is female. We know that women face unique HIV risks and challenges that can prevent them from getting the care and treatment they need. The HIV Prevention Toolkit: A Gender-Responsive Approach was created by OWH in response to the U.S. National HIV/AIDS Strategy. The toolkit is designed to help increase the capacity of individuals and organizations to provide gender-responsive HIV prevention programs for the women and girls they serve. Those who may find the toolkit useful include health departments, clinical staff, academics, program planners, managers, and community providers who are involved in HIV prevention programs for women and adolescent girls.

The toolkit has six sections, the first four of which provide background on how sex and gender affect HIV risk and vulnerability. The last two sections explain how to conduct a gender analysis, which can include examining differences in the patterns of HIV incidence, modes of transmission, and access to treatment and care. Integrating the concept and reality of gender into programs to prevent HIV is a way to target women and girls and improve services offered to them.

The toolkit also contains a Facilitators Manual and Participants Manual. These materials provide the content needed for a three-day training for organizations that are implementing or want to implement gender-responsive HIV prevention programs around the country. By the end of the training, participants will be prepared to design and deliver such programming.

The products are available for download at www.aids.gov.

Women’s Health Research

Healthy Weight in Lesbian and Bisexual Women: Findings from a Ten-city Prevention Initiative

Research shows that lesbian and bisexual women are more likely to be obese than their heterosexual counterparts. To help address this disparity, OWH funded a study to assess interventions that promote improved nutrition and physical activity in lesbian and bisexual women over the age of 40. In 2013, five research organizations partnered with several lesbian, gay, bisexual, and transgender community organizations in 10 cities across the country. The findings have been published in a supplemental issue of Women’s Health Issues. This peer-reviewed, bimonthly, multidisciplinary journal publishes original research on women's health care and policy. The findings of the prevention initiative will help us better understand and meet the unique needs of lesbian and bisexual women. To access the supplement issue, visit www.whijournal.com.

Regional Spotlight

Region III: West Virginia Management of Maternal Smoking (MOMS) Initiative Summit

We know that smoking and tobacco use during pregnancy can increase the risk of poor health outcomes in both the mother and the child. Of all the states, West Virginia is of particular concern with the highest occurrence of tobacco use among pregnant women in the country.

The Office of the Assistant Secretary for Health's Region III Office collaborated with the West Virginia Bureau for Public Health (BPH) to facilitate the West Virginia MOMS Initiative summit. Stakeholders from various branches of BPH, federal partners, community-based partners, and health care providers attended the one-day meeting to develop new strategies to improve prenatal health in the state.

As a result of the summit, three working groups will continue work on a number of goals, which include (1) increasing the tobacco tax in West Virginia to meet the national average of $1.60 per pack, (2) ensuring that all Medicaid health plans in the state offer a consistent and robust tobacco cessation benefit for pregnant women, and (3) developing mandatory tobacco cessation training and certification programs for West Virginia health care providers.

Women’s Health Highlights

What You Need to Know About the Zika Virus

You’ve probably heard about Zika virus on the news. You may also be wondering what to do to protect yourself from Zika virus. Many people infected with Zika will have no symptoms or mild symptoms that last several days to a week. However, Zika infection during pregnancy can cause birth defects and severe fetal brain defects.
 
Here’s a list of the top five things everyone should know about Zika:

1. Zika is primarily spread through infected mosquitos. You can also get Zika through sex. Many areas in the United States have the type of mosquitoes that can spread Zika virus. Also, Zika can be passed through sex from a person who has Zika to his or her sex partners.
2. Zika is linked to birth defects. A pregnant woman and her fetus are at most risk for complications of infection with Zika virus. Infection during pregnancy may result in the fetus being infected with Zika and developing serious birth defects such as microcephaly.
3. Pregnant women should not travel to areas with Zika. If you must travel to an affected area, talk to your health care provider first and strictly follow steps to prevent mosquito bites during your trip.
4. The best way to prevent Zika is to prevent mosquito bites. Wear long-sleeved shirts and long pants, and use U.S. Environmental Protection Agency-registered insect repellent. You can also stay in places with air conditioning or window and door screens.
5. Returning travelers infected with Zika can spread the virus through mosquito bites. During the first week of infection, Zika virus can be found in a person’s blood and can pass from an infected person to a mosquito through mosquito bites. An infected mosquito can then spread the virus to other people. Individuals who live in or have traveled to an area with Zika should take steps to protect themselves and their partners during sex by using condoms or not having sex for at least eight weeks after travel if no symptoms are present. If symptoms are present, they should consider using condoms or not having sex for at least six months after symptoms begin.

Take a look at our conversation with a Zika expert at www.womenshealth.gov/news/spotlights/index.html.

Get more information from CDC on Zika and pregnancy. CDC also has more information about preventing, diagnosing, and treating Zika.

2015‒2020 Dietary Guidelines for Americans: 10 Things You Need to Know

The Dietary Guidelines for Americans is the nation’s go-to source for evidence-based nutrition recommendations. Since 1980, a new edition of the Dietary Guidelines for Americans has been published every five years. The guidelines provide the general public, policy makers, and health professionals with the information they need to make informed choices about their diets. 

In January 2016, HHS Secretary Sylvia M. Burwell and Secretary of the U.S. Department of Agriculture Tom Vilsack released the updated 2015–2020 Dietary Guidelines for Americans. These recommendations encourage Americans to improve how they eat to reduce obesity and prevent chronic diseases. The latest updates include guidance on topics such as sugars, sodium, and cholesterol; new information on caffeine; and much more. The complete guidelines are available at health.gov/dietaryguidelines/.

Here are the “Top 10 Things You Need to Know About the 2015‒2020 Dietary Guidelines for Americans,” a list provided by the Office of Disease Prevention and Health Promotion:

1. A lifetime of healthy eating helps prevent chronic diseases.
2. Healthy eating is one of the most powerful tools we have to reduce the onset of disease.
3. Following a healthy eating pattern that’s right for you is important to improving health through nutrition.
4. A healthy eating pattern includes a variety of fruits, vegetables, grains, protein foods, fat-free or low-fat dairy, and oils (including natural oils and those from plants).
5. Healthy eating patterns limit added sugars.
6. Healthy eating patterns limit saturated and trans fats.
7. Healthy eating patterns limit sodium.
8. Most Americans can benefit from making small shifts in their daily eating habits to improve their health over the long run. Small shifts in food choices can make a difference in working toward a healthy eating pattern that works for you.
9. Regular physical activity is one of the most important things individuals can do to improve their health. 
10. Everyone has a role — at home, school, workplaces, and food retail outlets — in supporting healthy food choices.

Upcoming Women's Health Events/Observances

OWH 25th Anniversary Event, October 20, 2016

National Immunization Awareness Month, August 2016

National Breastfeeding Month, August 2016

Women’s Equality Day, August 26, 2016

National Ovarian Cancer Awareness Month, September 2016

National Campus Safety Awareness Month, September 2016

National Day of Service and Remembrance, September 11, 2016

National HIV/AIDS and Aging Awareness Day, September 18, 2016

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE ON WOMEN'S HEALTH