Political Constraints in Conducting a County-Level Women’s Health Needs Assessment 135th APHA Conference, Washington, DC Cheryl Vamos, MPH* Karen Dyer, BA Jeannine Coreil, PhD *Doctoral Candidate Department of Community and Family Health College of Public Health University of South Florida

Background A special committee of the County Commission contracted with USF COPH to produce a women’s health report Researchers’ definition and approach to women’s health: Broad, holistic, gender perspective, life-span Health promotion, disease prevention, treatment, rehabilitation Mental and emotional well-being, health behaviors, health services utilization Special populations

Purpose To review the results from the status of women’s health report. To examine the difficulties involved when translating research into community practice.

Methodology Data collection during August 2005 - January 2006 Mixed-methodology Review of secondary data (national, state and county) Government publications Websites Access via person-in-charge Key informant interviews; semi-structured guide (n=20) GIS mapping

Hillsborough County, FL Located in central-west FL 1,048 square miles of land and 24 square miles of inland water area (Total of 1,072 square miles) Special populations Migrant workers Immigrants, refugees Elderly

Results Demographics: 589,793 females (2006) 50.8% of > 1 mill. total pop. 79%-White 17%-African American 18%-Hispanic

Key Findings Population growth sustains and increases need for services despite overall improvements in health. Racial and ethnic disparities cross-cut many health issues, especially cardiovascular disease (CVD), diabetes and obesity in African American women. Access to services and transportation is uneven across the county. Health care coverage is available to indigent women through the Hillsborough County Health Plan (HCHP), but less than 1/2 of eligible persons use it (access HCHP primarily for acute episodic care).

Recommendations Need to expand use of HCHP. Need for better access to clinics and transportation services. Need for more preventive health services, including screening and health promotion.

Recommendations (cont’d) 4. Need to address special needs of African American and Hispanic women. 5. Need to improve reproductive health services and utilization. 6. Need for comprehensive school health services. 7. Need for increased availability of family planning services.

Logistical Issues Comparing data across 3 levels Availability of county-level data Is this a health disparity? Breadth of women’s health issues

Political Issues Inclusion and exclusion criteria of health issues Prioritizing recommendations Wording of recommendations Disagreement regarding report and issues highlighted Strategic delay in the delivery of the report

Discussion Racial and ethnic disparities are present Poverty, access to health care, and transportation as underlying issues Florida not progressive in growth and transportation planning ~ influences access and availability to health services Logistical and political issues inhibit comprehensive analyses of concerns specific to women’s health

Conclusion First county in Florida to produce a Women’s Health Report Case study illustrates women’s health issues that are reflected throughout the U.S. Women’s health involves diverse populations, diverse values and sensitive issues Political and logistical issues are inherent to conducting this type of study when one is dealing with a myriad of political agendas A need for balancing views of the researcher and views of the agency/group who contracted the study