Journal of women's health
-
Journal of women's health · Aug 2024
Impact of Mandated Insurance Coverage of Assisted Reproductive Technology on Clinic Website Transparency.
Objective: The purpose of this study was to determine whether website transparency of service costs, accepted insurance plans, and financing options differs between reproductive endocrinology and infertility clinics located in states that do and do not mandate insurance coverage of assisted reproductive technology (ART). Methods: Six hundred forty-six clinics were identified using the Society for Assisted Reproductive Technology online locator. Clinics were excluded for missing website links, duplicate entries, broken websites, or permanent closure. ⋯ Clinics in states with mandated coverage were more likely to mention discount programs, but there was no significant difference for other types of financial assistance. Conclusion: Clinics located in states that mandate insurance coverage of ART are more likely to list specific costs, accepted insurance plans, and the availability of discount programs on their website. Patients living in states without mandated coverage are more likely to need to finance their own treatment, yet these patients are less likely to have nearby clinics that provide financial transparency on their websites.
-
Journal of women's health · Aug 2024
Population Density and Health Outcomes in Women with HIV in the Southern United States: A Retrospective Longitudinal Analysis.
Purpose: Published studies have revealed challenges for people with human immunodeficiency virus (HIV) living in rural areas compared to those in urban areas, such as poor access to HIV care, insufficient transportation, and isolation. The purpose of this study was to examine associations between population density and multiple psychosocial and clinical outcomes in the largest cohort of women with HIV (WWH) in the United States. Methods: Women's Interagency HIV Study (WIHS) participants from Southern sites (n = 561) in 2013-2018 were categorized and compared by population density quartiles. ⋯ Results: Although women in the lowest density quartile were unexpectedly more highly resourced, women in that quartile had greater odds of not attending an HIV care visit in the last six months (odds ratio [OR] = 0.64, 95% confidence interval [CI] [0.43-0.95]), yet higher odds for having fully suppressed HIV when compared to women in the highest density quartile (OR = 1.64, 95% CI [1.13-2.38]). Highly urban WWH had greater likelihood of unsuppressed HIV, even after controlling for income, employment, and health insurance, despite reporting greater HIV care adherence and similar medication adherence. Discussion: Further investigation into the reasons for these disparities by population density is needed, and particular clinical attention should be focused on individuals from high population density areas to help maximize their health outcomes.
-
Journal of women's health · Aug 2024
Number of Pregnancies and Risk of Atherosclerotic Cardiovascular Disease in Postmenopausal Women: A Cross-Sectional Study of NHANES from 1999 to 2018.
Background: Atherosclerotic cardiovascular disease (ASCVD) remains the most common cause of death in women. Pregnancy is an exposure unique to women leading to significant changes in maternal cardiovascular function. However, studies of the relationship between the number of pregnancies and ASCVD are rare. ⋯ Across the full population, every model that accounted for these variables consistently indicated that with an increasing number of pregnancies, we observed higher ORs for ASCVD risk (all p values <0.05). Conclusions: A higher number of pregnancies was associated with a higher risk of ASCVD after menopause, especially among women aged 45-64 years. Moreover, this association is particularly significant in the risk of stroke, cardiovascular heart disease, and heart attack.
-
Journal of women's health · Aug 2024
Racial and Socioeconomic Disparities in Preconception Health Risk Factors and Access to Care.
Background: Black birthing people have significantly higher risks of maternal mortality and morbidity compared with White people. Preconception chronic conditions increase the risk of adverse pregnancy outcomes, yet little is known about disparities in preconception health. This study applies an intersectional framework to examine the simultaneous contributions of racial marginalization and economic deprivation in determining disparities in preconception risk factors and access to care. ⋯ White respondents had higher probabilities of utilizing preconception care across all income levels, despite similar probabilities of insurance coverage. Conclusions: Higher income does not protect against the risk of preconception obesity and other preconception risk factors for Black birthing people as it does for White birthing people. Results point to the need to consider multiple forms of intersecting structural factors in policy and intervention research to improve preconception and maternal health.
-
Journal of women's health · Aug 2024
Accuracy of Maternal Self-Report of Recent Preeclampsia among Healthy Women.
Background: Preeclampsia history signals a higher risk for cardiovascular disease, but its value as a risk marker relies primarily on self-report. To identify the accuracy of maternal self-reports of recent preeclampsia, we conducted a validation study among women recruited to a web-based trial. Methods: Women with preeclampsia in the past 5 years were recruited to Heart Health 4 Moms. ⋯ Conclusions: In this validation study of U. S. women, the majority accurately self-reported their preeclampsia diagnosis based on medical record review. A higher proportion of self-reports validated by clinician diagnosis than ACOG criteria, suggesting women remember the diagnosis given by their provider and providers may not always follow or document criteria when making a diagnosis.