Detecting diabetes at its. earliest stages to prevent. complications is the emphasis 1 Not including gestational diabetes …
Women in the Middle Years, Diabetes, Obesity, and Physical Activity
Detecting diabetes at its earliest stages to prevent complications is the emphasis for women in the middle years from 45-64 Assisting women with meeting the social, physiological and psychological challenges of the middle years can impact their quality of life
Prevalence of diabetes, inadequate physical activity, overweight, and obesity among US women aged 45-64, BRFSS 2003
Diabetes
1
No Physical Activity in Past Month 230 371 267 370 319 423 531 339 228 146
Insufficient Physical Activity 2
Overweight BMI25-2999
Obese BMI 30
Race White Black Asian American Indian Multiracial Hispanic Education Less than HS HS grad Some college Technical 4 or more years college Income 15,000 15-24,999 25-34,999 35-49,999 50,000
81 195 76 157 153 138 202 115 96 57
398 395 432 306 393 372 338 404 415 384
285 292 292 307 282 349 313 300 294 280
236 427 40 330 306 293 353 295 265 183
221 143 117 101 51
483 395 320 238 162
335 409 432 432 394
274 303 304 292 304
390 337 305 275 197
1 Not including gestational diabetes 2 Moderate physical activity for 30 minutes or more per day for five or more days per week or vigorous
physical activity for 20 minutes or more per day for three or more days per week
Issues affecting Women in Their Middle Years
Women in their middle years may face major psychological and social challenges in priority setting for themselves such as menopause, the appearance of chronic disease, the death of a significant other, parent or child, divorce, or retirement Women tend to multi-task and their gender role may present barriers in establishing preventive health practices and healthy lifestyles One in four women in their middle years has a low level of formal education, therefore health literacy may be effecting their selfefficacy and confidence in health care decision making This age group of women tend to report barriers to leisure time physical activity but this age group is frequently caught in the
sandwich generation either caring for grandchildren or older adult parents Women in their middle years tend to work in small companies that provide fewer benefits and lower pay than larger companies and face being underinsured or uninsured One in seven women lacks health insurance Women in their middle years experience a greater burden of obesity and diabetes than women 18-44
years of age Some 38 million women 45-64 years of age have diabetes and diabetes is a leading cause of death for women in this age group For women with diabetes, coronary heart disease is an important complication of diabetes
The National Public Health Initiative on Diabetes and Womens Health recommends the following public health actions:
Diabetes Awareness: Educate women and providers to increase their awareness about diabetes, its risk factors, its preventability, where applicable, through lifestyle choices, and its association with other chronic diseases for example, cardiovascular disease Assess and evaluate existing messages, pro grams, and campaigns Increase the awareness of women and providers about the positive impact on both the quality and length of life for women with diabetes through preventing and delaying heart disease Develop an effective social marketing campaign, using focus groups or other qualitative methods Design and test messages and determine dissemination strategies for specific population subgroups
Expand intergenerational programs and activities: Encourage relationships among women across the life span Define the optimal parameters of
intergenerational programs and activities Identify barriers and enabling factors to participation in intergenerational programs Identify existing successful programs and activities in urban/rural areas and differen 
t ethnic/cultural groups through qualitative and quantitative public health research Use schools, churches, and other key venues within communities to create activities and occasions for women of all generations to congregate Research Agenda: What are the developmental characteristics of women in their middle years that affect or influence the risk for diabetes diagnosis, complications, and/or treatment? What interventions will have the best effect on long-term outcomes and improved quality of life? How can the delivery of preventive services, building on existing systems, be improved for women in their middle years?
Preventive Health Measures: Promote expansion of routine physical exams to include risk assessment and appropriate followup for diabetes among women in their middle years Develop practical and useful screening tools, such as assessment questions, appropriate physical activity, diet, hip and waist measurement, and body mass index, and incorporate them
into standard health assessments Train health personnel to conduct and use these assessments Increase provider awareness of the need for and value of integrated testing such as mammograms, pap or colo-rectal tests Promote the use of preventive measure tools among various health associations in clinical settings Market the need for expanding routine exams to purchasers, health plans, and payers Train future health professionals about womens health and diabetes to ensure that they are able to communicate with women and address their unique concerns
Success Story for Woman in Her Middle Years Veronica is a 51 year old registered nurse and diabetes educator, who was diagnosed with type 2 diabetes in her mid 20s She admits how challenging it was to accept the diagnosis of diabetes and to actually begin changing her lifestyle Veronica says that she found it difficult to manage her diabetes while focusing on her career and starting a family As a diabetes educator, she knew all of the things she should have been doing–exercising several times a week, changing her diet– but it took her some time to figure out how to fit it all into her busy schedule This is very common for women in
the middle years, who find themselves balancing careers with the needs of dependent children and aging parents What turned Veronica around and on a healthy path was that she had a strong support system that included her family and friends, especially her friends with diabetes They all work together to keep each other motivated Veronica now runs a support group of her own and she also visits local churches and neighborhoods to offer information about diabetes
This is a product of the National Association of Chronic Disease Directors, Womens Health Council and the Women, Physical Activity, Obesity, and Diabetes Steering Committee
Women, Physical Activity, Obesity, Diabetes Steering Committee
Jessica Hardy Womens Health Council, NACDD
The Call to Action: Inform professionals working with older women about diabetes and the relationship of being overweight, or obese, and the need for increased physical activity Utilize the Guide to Community Preventive Services and Physical Activity to guide interventions Spread the message of the CDC Womens Health and Diabetes Initiative
Barbara Larsen NACDD Consultant Paula Marmet Physical Activity Work Group, NACDD Michelle Owens CDC Division
of Diabetes Translation, Diabetes and Womens Initiative Laura Shea Diabetes Council, NACDD Dennis Shepard NACDD Consultant and PRC representative Joan Ware Cardiovascular School Health Councils, NACDD Adeline Yerkes Womens Health Council and Chair of Steering Committee
This product was funded by a contract from US PHHS Office on Womens Health
Source:princeton.edu
