Daily Women's Health Policy Report
Friday, November 02, 2007
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National Politics & Policy
Contraception & Family Planning
Public Health & Education
Special Notice
Change in Kaiser Coverage of Women's Health Policy News
[Nov 02, 2007]
The Kaiser Family Foundation is pleased to announce that on Nov. 5, 2007, the National Partnership for Women & Families will become the new publisher of the Daily Women's Health Policy Report. To receive their free, daily report on women's reproductive health policy, please sign up at NationalPartnership.org/dailyreport.
The National Partnership, established in 1971, is a Washington, D.C.-based nonprofit, nonpartisan organization. Through its work on access to quality and affordable health care and on reproductive health and rights, the National Partnership promotes public policies and business practices that expand opportunities for women and strengthen families.
Also beginning Nov. 5, 2007, the Kaiser Daily Health Policy Report -- a news summary service also operated by the Kaiser Family Foundation -- will be expanded to include a new "Women's Health Policy" section covering issues related to health care coverage and access for women. Archives of the Kaiser Daily Women's Health Policy Report will continue to be accessible through the kaisernetwork.org search. In addition, other Kaiser Family Foundation Web sites will continue to provide resources and information on women's health policy issues - kff.org, kaiserEDU.org, and statehealthfacts.org.
Thank you for your readership of the Kaiser Daily Reports and your interest in the work of the Kaiser Family Foundation.
National Politics & Policy
House-Senate Conference Committee Approves Spending Bill That Includes $27.8M Increase in Abstinence Education Funding
[Nov 02, 2007]
A House-Senate conference committee on Thursday approved a fiscal year 2008 appropriations measure that would include a $27.8 million increase in funding of abstinence education programs, CQ Today reports. The legislation combines a Labor-HHS-Education spending bill (HR 3043) with a spending bill for the Department of Veterans Affairs and military construction (HR 2642) (Wayne, CQ Today, 11/1).
The House-approved version of the Labor-HHS-Education measure, which passed in July, included an increase in funding to $141 million for HHS' Community-Based Abstinence Education Program, which gives grants to groups that teach abstinence but not how to use contraception. The program's allocation in FY 2007 was $109 million, and President Bush requested a $137 million allocation for the program in FY 2008 (Kaiser Daily Women's Health Policy Report, 7/20). The Senate-approved version of the measure would have cut abstinence education funding by $28.4 million, but the conference committee agreed to include the $27.8 million increase from the House version, according to CQ Today.
Rep. James Walsh (R-N.Y.) said that House Republicans strongly are opposed to cutting the abstinence programs. Many House Democrats have said funding should be provided for comprehensive sex education programs, which include information on condom use and contraception. Bush has said he would veto the combined spending bill (CQ Today, 10/1). Bush had also threatened to veto the Labor-HHS-Education bill because the legislation exceeds his request for discretionary spending (Kaiser Daily Health Policy Report, 11/1).
In The Courts
4th U.S. Circuit Court Panel Hears Request To Review Ruling That Struck Down Virginia Abortion Law
[Nov 02, 2007]
A three-judge panel of the 4th U.S. Circuit Court of Appeals in Richmond, Va., on Thursday heard a request to review the panel's decision to overturn a 2003 Virginia law that bans so-called "partial-birth" abortion, the Washington Post reports (Barnes, Washington Post, 11/2).
The Virginia law defined "partial-birth infanticide" as intentional vaginal delivery of an infant "for the purpose of performing an overt act that the person knows will kill the partially delivered, living infant" and established it as a felony. The Center for Reproductive Rights challenged the law on behalf of the Richmond Medical Center for Women and abortion provider William Fitzhugh. A three-judge panel of the 4th Circuit Court in June 2005 voted 2-1 to overturn the law because it lacked an exception to protect the health of pregnant women. The panel cited the 2000 U.S. Supreme Court ruling in Stenberg v. Carhart, which struck down a similar Nebraska law for lacking a health exception. However, the U.S. Supreme Court in April ordered the 4th Circuit Court to review its decision to overturn the law in light of the Supreme Court's 5-4 ruling in the Gonzalez v. Carhart case, which upheld a federal law (S 3) banning partial-birth abortion (Kaiser Daily Women's Health Policy Report, 4/25). Arguments
Stephanie Toti, an attorney with CRR, told the panel that physicians performing a routine type of abortion called dilation and extraction would be at risk of accidentally breaking the Virginia law. "The only way to avoid the risk is to not do the [procedure] altogether," Toti said. Judge Paul Niemeyer, who dissented in the 4th Circuit Court's 2005 ruling, challenged Toti's claim and said only deliberate violations are covered by the law (O'Dell, AP/Hampton Roads Daily Press, 11/1).
Virginia Solicitor General William Thro told the panel that the Supreme Court's decision in Gonzalez v. Carhart "removes any doubt that the Virginia act is constitutional." Judge Blane Michael, who voted with the majority in the 2005 case, told Thro that the Supreme Court's decision "doesn't really quite get you home" (Washington Post, 11/2). Thro also said that it was hard to see prosecutions for accidental violations, which he argued would be so rare that invalidating the entire law would be overreaching. Michael suggested that any chance of violating the law might deter abortion providers, adding, "Whether it's three times out of 100 or whatever it is, that's a big risk" (AP/Hampton Roads Daily Press, 11/1).
The panel might rule in a few weeks or months, the Richmond Times-Dispatch reports (Campbell, Richmond Times-Dispatch, 11/2). According to the Post, the panel's review is a "key test" on how the Gonzales v. Carhart decision will affect state abortion restrictions (Washington Post, 11/2).
Contraception & Family Planning
Majority of U.S. Adults Favor Distribution of Contraceptives in Public Schools, Poll Finds
[Nov 02, 2007]
Sixty-seven percent of U.S. adults favor allowing public schools to provide contraceptives to students, including 37% who favor providing them only to children whose parents have consented and 30% who favor providing them to all students who ask, according to a recently released Associated Press-Ipsos poll, the AP/Columbus Dispatch reports.
The poll, taken from Oct. 23 to Oct. 25, found that minorities, older and lower-income people are most likely to prefer requiring parental consent, while those who support no restrictions primarily are younger and from urban or suburban areas. People who oppose providing birth control at school are more likely to be white and higher-income earners. The majority of respondents said young people should have access to birth control either beginning at age 16 or age 18, compared with one-third who chose age 15 or younger.
The poll also showed that 51% of people believe sex education and birth control are more effective ways to reduce teen pregnancies than emphasizing abstinence and morality, compared with 46% who prefer moral and abstinence messages. About 64% of minorities and 47% of whites consider sex education and birth control the most effective method. Nearly seven in 10 white evangelicals said they prefer abstinence, as well as about 50% of Catholics and Protestants. About 62% of all people surveyed believe providing birth control reduces the number of teen pregnancies.
According to the poll, 49% of people said providing teens with birth control would not encourage sexual promiscuity and 46% said it would. Fifty-five percent of women and 43% of men believe that providing contraceptives to students would not encourage sexual intercourse. Forty-five percent of Republicans said birth control should not be provided to any students, compared with 19% of Democrats, according to the survey.
The survey involved telephone interviews with 1,004 adults and has a margin of error of 3.1 percentage points. It was conducted after a school board in Portland, Maine, voted to allow a middle school health center to provide students with full contraceptive services without obtaining their parents' consent, the AP/Dispatch reports (Fram, AP/Columbus Dispatch, 11/1).
 The poll is available online.
Public Health & Education
USA Today Examines Reasons Pap Tests Used More Than HPV Tests for Cervical Cancer Screening
[Nov 02, 2007]
USA Today on Thursday examined the reasons Pap tests remain the top cervical cancer screening tool despite some recent studies that found human papillomavirus tests to be "superior" tools (Rubin, USA Today, 11/1). According to two studies published last month in the New England Journal of Medicine, HPV tests were more accurate than Pap tests in the detection of cervical cancer and precancerous changes in the cervix.
For one of the studies, Canadian researchers led by Eduardo Franco of McGill University performed an HPV test and a Pap test on 10,154 women ages 30 to 69. The HPV test detected 95% of cases in which participants had precancerous changes in the cervix, compared with 55% for the Pap test, the study found (Kaiser Daily Women's Health Policy Report, 10/19).
According to USA Today, about 60 million Pap tests are performed annually in the U.S., and "switching to screening with only an HPV test would represent a sea change in women's health care." The "most obvious roadblock" toward greater HPV testing in the U.S. is that a test manufactured by Digene is the only HPV test approved by FDA, and it is approved only to be used in conjunction with a Pap test or as a follow-up screening, USA Today reports. In addition, a clinical trial to prove that screening with the HPV test will lead to lower mortality rates "might be prohibitively costly and time-consuming," according to USA Today.
Some researchers said that other reasons Pap tests remain the top cervical cancer tool include malpractice concerns, marketing of Pap tests, and reluctance among many physicians and women to not use the Pap tests, according to USA Today. Walter Kinney, a cytologist at Kaiser Permanente in California, said that even if HPV testing were approved as a stand-alone primary screening tool, convincing physicians and patients of its efficacy would be a challenge (USA Today, 11/1).
International News
Cultural Preference for Male Children in Vietnam Increasing Gender Imbalance in Asia, UNFPA Reports Say
[Nov 02, 2007]
A cultural preference for male children in Vietnam is "further tipping the balance between the sexes in Asia," where couples in China and India also prefer boys, according to a series of reports released this week by the United Nations Population Fund, the AP/Washington Post reports. The reports -- presented at a reproductive health conference in Hyderabad, India -- examined birth trends in China, India, Nepal and Vietnam (Mason, AP/Washington Post, 10/31).
Vietnam for decades had a two-child-per-family policy, but it was not enforced as rigorously as China's one-child policy, Agence France-Presse reports. Vietnam in 2003 banned fetal sex selection, but many physicians continue to tell couples the sex of their fetus. According to the reports, the two-child policy, combined with increased access to ultrasound and abortion, are fueling gender imbalance in the country (Agence France-Presse, 10/31). The reports found that about 110 boys for every 100 girls are born in Vietnam, compared with the typical sex ratio of about 105 boys to 100 girls.
In China, about 120 boys were born for every 100 girls in 2005, and in India the ratio in 2001 was about 108 boys for every 100 girls, according to the AP/Post. In some areas of China and India, the ratio is as high as 130 boys per 100 girls and 120 boys per 100 girls, respectively (AP/Washington Post, 10/31). The highest provincial ratio in Vietnam was 123 boys per 100 girls, the reports found (Agence France Presse, 10/31).
The reports estimated that Asia in 2005 was short 163 million females, compared with rates for other areas of the world and said that the gender imbalances increased social unrest and trafficking of women. The reports called for increased awareness, government intervention and promotion of gender equality in the region. UNFPA also recommended that gender ratios be monitored in Nepal, Pakistan and Bangladesh to avoid similar trends (AP/Washington Post, 10/31). In addition, the reports said that Vietnam "needs to act now if it is to avoid the situation of more men than women evident elsewhere in Asia" (Agence France-Presse, 10/31). Reaction
Daniele Belanger, research chair and director of the Population Studies Centre at the University of Western Ontario, in a recent research paper wrote that sex-selective abortion in Asia "has the power to free" women from a "clash between the high demand for sons and the low demand for children." Although sex-selective abortion empowers women in the short term, it likely will "further threaten their position in the long term," she wrote, adding, "Once this imbalance reaches marriageable age groups, a shortage of women poses serious problems, particularly in societies where marriage is a nearly universal norm" (Agence France Presse, 10/31).
Christophe Guilmoto, a report author, said that it is "difficult to imagine what's going to be the exact impact of these missing girls in 20 years," adding, "No human society that we know has faced a similar problem" (AP/Washington Post, 10/31).
The reports are available online.
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