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Chesney Suggests New Ways of Thinking
About Women's Health

By Susan M. Persons

"You've come a long way baby," a phrase often used to convey the progress of women in U.S. society, was actually coined years ago by a tobacco company as a campaign slogan targeted to increase the number of women who smoke. The irony is that today, lung cancer is the leading cause of cancer death among women.

"This is hardly progress," reported Dr. Margaret A. Chesney, invited speaker at the NIH behavioral and social sciences research coordinating committee seminar series. "The importance of smoking to women's health cannot be overemphasized. It is simply unacceptable that the number of women who smoke has increased while the number of men who smoke has decreased; that women are more likely than men to return to smoking after stopping; and that more adolescent girls than boys initiate smoking. We need to continue social and behavioral research to examine why this is so, and to develop new, effective campaigns to address this health threat."

Dr. Margaret A. Chesney

Professor of medicine and epidemiology at the School of Medicine, University of California, San Francisco, Chesney began her presentation with expressions of gratitude for those who have contributed to the real progress in the arena of women's health. "We have come a long way in women's health research, thanks to the strong support in Congress by Representatives Snowe, Schroeder and Waxman, among others," she said. "But much of the science simply wouldn't have happened had it not been for the support of NIH scientists Dr. Ruth Kirschstein [NIH deputy director] and Dr. Vivian Pinn [director, NIH Office for Research on Women's Health]." Chesney, who dedicated her speech to Kirschstein and Pinn, provided an overview of women's health for the past decade, as well as a framework for organizing themes and integrating competing approaches to the field of women's health. Seeking a flexible, nonhierarchical model that would adapt as knowledge about women's health evolves, Chesney decided that a multilevel circular model might serve the purpose.

"Picture a pie that is divided into segments representing the content area in the study of women's health," she said. "And now make that pie a multilayered cake, with one layer representing process issues such as participants, variables and measures, and methods; a second layer represents conceptual models such as those from the various disciplines."

Chesney hopes that this dynamic model will encourage communication and collaboration among scientists. She has selected seven content areas: reproductive health, diseases more common in women than in men, leading causes of death among women, gender influences on health risk, societal influences on women's health, violence against women, and women and health care policy. "We need to work together -- psychologists with biomedical scientists with sociologists with anthropologists -- to get the answers to the health questions women ask every day," she said.

She challenged the audience to think about critical questions the behavioral and social sciences must confront: What do we gain from mammograms if women are afraid to have them? Why is it that the public is still largely unaware that heart disease is the leading cause of death for women? What do we gain by encouraging women to ask their partners to use condoms if it means they place themselves at risk for physical abuse? Why is it that 70 percent of adolescent girls restrict their calorie intake when only 15 percent to 20 percent are actually overweight? What role is the media playing in producing the eating disorders common among young women today? Why is it that when women return home at the end of the day their blood pressure remains elevated while men's declines? What is the effect of this on their health over the years?

The next lecture in the series will feature Dr. Stephen Porges of the University of Maryland. He will discuss "Motion, Emotion, and Social Communication: Emergent Properties of the Evolution of the Autonomic Nervous System" on Monday, May 18 in Wilson Hall, Bldg. 1, from 3 to 4 p.m. All are invited to attend.

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