Women's Health

Mention women's health, and traditionally we think of reproductive health. However, this issue of the North Carolina Medical Journal takes a much broader look at this topic. We include articles on improving maternal and infant outcomes, but we also cover issues that affect women across the life span: cardiovascular disease, which is the leading cause of death among women; osteoporosis, a debilitating illness that has only recently seen improvements in diagnosis and treatment; and incontinence, which requires careful screening to connect women with therapy. New evidence-based guidelines for cervical cancer detection and prevention are also well explained in this issue, as are recommendations for human papillomavirus vaccination.

This issue of the NCMJ also calls out what we know about social determinants of health and places their recognition and remediation squarely with the provider in the exam room. Domestic violence, human trafficking, and eating disorders are women's health issues that have been poorly recognized, yet these issues can be addressed if we have the clinical acuity to notice and the community concern to act.

Finally, this issue shows how North Carolina is trying to improve the social determinants of women's health. Several articles describe a clear connection between women's health and economic mobility. While North Carolina's newly adopted perinatal health plan is years overdue, it is now available as a blueprint for improving the state's persistent disparities in birth outcomes. Sadly, reported statistics show that North Carolina continues to rank in the lowest quintile nationally for birth outcomes. The North Carolina Perinatal Health Strategic Plan lists social determinants that must be addressed in order to improve the health of women, infants, children, families, and communities.

There is an old proverb that says, “Women hold up half the sky.” This issue of the NCMJ challenges us to improve women's health and to make that burden easier.

• ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.