Women as second-class (health) citizens

The role of women’s advocacy organizations

Waxman said that women’s advocacy organizations had a large part to play in the effort to educate and influence officials and citizens about the ways in which inadequacies in public health policy affect women. But she added that the focus on most women’s advocacy organizations has been on reproductive health, especially in recent years as a defensive response to an onslaught of anti-abortion, anti-contraception activity.

Lubetkin agreed. Broader public health issues besides reproductive rights are “kind of background issues,” she said. “The advocacy community usually organizes itself around the most politically contentious issue.”

Terry O’Neill, the president of the National Organization for Women (NOW), one of the country’s largest women’s advocacy groups, said that NOW’s main focus was in fact on defending reproductive rights, noting that securing reproductive freedom was, in her view, a crucial part of the larger battle to improve women’s health.

“What states are doing [by passing laws that restrict access to reproductive care] is deciding that they can withhold health care from a class of people,” O’Neill said. “Once you do that, you’ve decided that that class of people aren’t as human as the men, and once you go down that road, it’s easy not to care that women are not getting adequate services.”

O’Neill said that because reproductive rights are under such strong pressure in the states, it was important for advocacy organizations to use resources defending them. Amy Allina, the program and policy director at the National Women’s Health Network (NWHN), agreed.

While the NWHN does focus on reproductive rights and increasing women’s access to health care, Allina said that while she recognizes the other public health issues that affect women, with limited resources, “we can’t possibly work on every issue.”

Remapping Debate contacted several other groups that are involved in women’s rights advocacy — such as Families USA, the Guttmacher Institute, and the National Partnership for Women and Families — but those organizations declined to comment for this article, stating that the broader public health issues affecting women were not ones that they worked on.

Going forward

According to Waxman, the chief obstacle in passing public health legislation that could increase outcomes for women is apathy.

“Everybody says they care about women’s health and public health, and there are states who clearly care a huge deal about women’s health, but there are others who just don’t seem to care at all,” she said, mentioning Oklahoma and Louisiana as examples of the latter. “If they cared, they would have much stronger policies in place.”

While she stressed that states have a large responsibility for improving health outcomes for women, she also saw a role for the federal government to step in “when states simply won’t do what they need to do.”

In that vein, Waxman and many other women’s health advocates see the ACA as a victory, because it contains several measures aimed at improving public health, and women’s health in particular. Georges Benjamin of the American Public Health Association agreed that the ACA was a victory for women’s health, but added that it should not make legislators and advocates complacent about the work that still needs to be done, either nationally or on the state and local level. “We are seeing these devastating cuts right now in public health,” he said. “And we know that those cuts are going to disproportionately affect women. We need to make sure that we are going forward, and not backward.”

Waxman added that, ultimately, the pressure on legislators was going to have to come from their constituents, and stressed the need to think of strategies that could mobilize grassroots energy. When asked for specific ways that the advocacy and academic community could more effectively galvanize public support, however, Waxman said, “I don’t know. We clearly need to do more, and do something different, but I’m not sure how.”

“We need to be doing everything we can do to make people care about these issues,” she added. “Right now, we need all the help we can get.”

Research assistance: Alyssa Ratledge