Thoughts from Rural America

The Girl Effect

From the Care2.com website:

"This powerful video uses simple language to showcase the ability of adolescent girls in developing countries to bring unprecedented social and economic change to their families, communities and countries.

"The Girl Effect movement was started by the NIKE Foundation and Peter and Jennifer Buffet (Warren's son and daughter-in-law). Here's how they explain the issues and solution:

"In impoverished communities, lack of resources drives girls out of school and into early marriage, childbirth, and HIV infection at rates dramatically higher than boys. The results are irreversible for girls, and devastating to communities caught in intergenerational cycles of poverty. Yet when girls gain a different path – supported, educated and empowered – everyone benefits.

“Investing in the girl effect offers the potential for tremendous economic impact, which leads to more stability, less poverty and more opportunity for economic growth,” Peter writes. “Just one component of the girl effect – the increase in family income associated with an additional year of a girl’s education – nets more than a 40-fold return according to conservative calculations. The intergenerational benefits, however, go far beyond this to impact a range of issues including declining fertility rates and improved health and nutrition for the next generation. That’s a return on investment we can’t ignore.”

What is One Life Worth?

As you know by now, mammogram recommendations changed this week. No longer are women supposed to get mammograms once a year starting at age 40, women need to wait until they are 50, and then only have a screening mammogram every two years! This is supposedly to cut down on unnecessary biopsies. Right. The god doctors are saving women pain. I have heard this song and dance before. Throughout history women have been on the receiving end of such "benevolence" (think chastity belts, hysterectomies, forced sterilizations). Thank you, but no thank you.

I heard a proponent of the new recommendations talking about the supposed reasons for the change. He said, basically, that it took too many mammograms to find the one woman who had cancer in her 40s. I believe it was something like 1900 mammograms to find one case of breast cancer in a woman in her 40s. The reporter pointed out that at age 50 it took around 1300 mammograms to find one case of breast cancer. She wondered why it was okay to screen 1300 50+ year old women, but not worth it to do 600 more 40-49 year old women. The doctor said that the data simply did not support doing the test in a woman's 40s.

Next week I turn 43. Under the recommendation of my doctor, I started having mammograms at 36. A year ago this past July I got a call from the mammography department at Dartmouth. They had seen something on my mammogram. I ended up having a biopsy. Fortunately, the sample was clean. I guess that makes me a poster child for the new mammogram recommendations camp. The new recommendations could have saved me from the biopsy. Do I care? Do I feel imposed upon because my biopsy turned out to be okay? No, of course not. I think most women would rather be safe that sorry, especially if you are the one woman out of 1900 whose biopsy picked up cancer.

Despite denials that the recommendations were  changed to save money, I personally have my doubts. I am even more suspicious that money is involved in the decision making since the PAP smear test recommendations are also being changed. Couple that with the health care legislation being debated and the fact that insurance companies are looking at potential loss of revenue, I am not one bit surprised that these two foundational screening tests are under fire.

Take one look at the news and you can see I am not alone in my opinion. The new mammogram recommendations have created a furor among doctors and women. I am glad to see that people are not taking this supposedly independent panel's recommendations completely at face value. If we, as women, are not advocates for our own health care, we will see other screening procedures scaled back and eventually may not be covered by insurance at all.

photo by merfam