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Health disparities, legislation to focus on women The Presidential Scholars Program brings students from each of MUSC’s six colleges together each year to study broad issues impacting health care. The overall theme this year is the relationship between health care disparities and legislation. Students worked in interdisciplinary teams on specific areas of this theme. This piece on immigrant health is the first of a series of articles highlighting the results of their work.   Women in this country face may health problems, especially in South Carolina. Our state has a higher death rate than the national average for breast, cervical and uterine cancers. Significant effort is needed to increase the accessibility and awareness of cancer screenings for the state’s underprivileged and underserved women.   The South Carolina Cancer Alliance (SCCA) is a non-profit organization dedicated to reducing the impact of cancer on all people in South Carolina. The SCCA currently has over 800 members throughout the state. Membership is open to any individual organization interested in reducing the impact of cancer. More information about cancer in South Carolina and the importance of cancer education can be found at http://www.sccanceralliance.org.   Our review of pending federal legislation affecting women’s health issues revealed eight different bills intended to change insurance policy coverage for cancer screenings and treatment, in addition to establishing funding for breast cancer research and cancer awareness.   Two national legislative bills of interest are the Cancer Screening Coverage Act of 2005 (H.R. 2812), and the Breast Cancer Patient Protection Action of 2005, S. 910. The Cancer Screening Coverage Act amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code. Essentially the amendment will require providers of group health insurance to provide cancer screenings, as well as procedures for certain common cancers seen in women and men. It also provides the frequency schedule for testing and prohibits the ability to provide incentives to participants to lessen or annul this section of health coverage. The Breast Cancer Patient Protection Action of 2005 amends the same established acts. It would require health insurance providers who have surgical coverage to include inpatient and outpatient lumpectomy and radiation therapy. Time restrictions less than 48 hours for inpatient mastectomies, breast conserving surgery or lymph node resection would be prohibited. Providers of such treatment will not be obliged to get insurance pre-approval for these treatments.   In 2000, the Waxman Deal provided for breast and cervical cancer screening for poor, uninsured and minorities. South Carolina was one of four states to receive assistance from this deal and created the Best Chance Network. This program provided screening to 50,000 women however major limitations exist which included stringent age and financial requirements, and limited treatment options. For instance, non-insured low-income women between the ages of 47-64 were permitted screening, but younger women were excluded. Only women diagnosed under the Best Chance Network were eligible for treatment under this legislation.   Although not specifically targeted to women, on the state level, two significant pieces of legislation have the potential to impact health for all citizens. The Clean Indoor Air Act would create more smoke free environments in our state.  A cigarette tax increase would increase funding for Medicaid and help prevent youth smoking. Implementation of these acts would help decrease a major cancer risk factor for the citizens of South Carolina.   Major improvements were made in South Carolina through policy changes accomplished by political and cancer associated organizations. During our review of legislative issues affecting women’s health issues, it became apparent that there was a significant need for individuals to become effective legislative advocates. Both our state representatives and lobbyists, whom we met on our legislative trip, agreed that healthcare providers are indispensable for educating political representatives on the medical needs of their patients.   While South Carolina women have seen an improvement in their rights and legislative representation, more work is required to improve their health status. The lack of attention to women’s health issues at the legislative level makes it clear that health professionals need greater involvement in the legislative process. As many Medical University members have done in the past, the presidential scholar program women’s health group supports initiatives that could improve women’s health in South Carolina such as the Clean Indoor Air Act and a cigarette tax increase. We encourage support of these legislative initiatives.     Friday, March 31, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island papers at 849-1778, ext. 201.