Moving Forward on Reproductive Health (New Eng Jour Med)

[pinto]

Moving Forward on Reproductive Health

Allan Rosenfield, M.D., R. Alta Charo, J.D., and Wendy Chavkin, M.D., M.P.H.

Reproductive health policy has been mired in debates over abortion and sexuality, leaving unresolved a cluster of reproductive health problems. For a country of such wealth and technical prowess, the United States has long fared poorly in this key public health domain. The litany of grave public health problems is as familiar as it is long: elevated rates of pregnancy-associated deaths, infant deaths, low-birth-weight newborns and preterm births, adolescent pregnancies, sexually transmitted infections, and unintended pregnancies.1 Some of these rates have actually increased in recent years, and all are far higher than those in other developed countries. Moreover, these problems are concentrated among disadvantaged groups, and the disparities have persisted or worsened in the past three decades.

How, then, might a new presidential administration move forward? Reframing this cluster of issues in terms of public health — a field that favors pragmatic, evidence-based approaches over ideology — might lead to real progress toward improving women's health. When these issues are viewed from such a perspective, certain themes emerge.

<authors outline 5 major points>

The data are compelling. We know how to improve the reproductive health of Americans: base policies on evidence, not ideology; improve clinical research and postmarketing drug-safety studies; make accurate, comprehensive information about sexual health and family planning available to everyone, regardless of age; protect the privacy of patients; ensure access to reproductive health products and services; and adopt social policies that promote good health and facilitate individual choice about when to have children. As noted in the consensus documents from the 1994 International Conference on Population and Development, care that promotes all these aspects of reproductive health is not just good policy, it is a human right.

http://content.nejm.org/cgi/content/full/359/18/1869?query=TOC

Source Information

The late Dr. Allan Rosenfield was dean emeritus and professor of population and family health at the Mailman School of Public Health and a professor of obstetrics and gynecology at the College of Physicians and Surgeons — both at Columbia University, New York. Ms. Charo is a professor of law and bioethics at the University of Wisconsin, Madison. Dr. Chavkin is a professor of clinical population and family health at the Mailman School of Public Health and a professor of clinical obstetrics and gynecology at the College of Physicians and Surgeons — both at Columbia University, New York.

The New England Journal of Medicine is owned, published, and copyrighted © 2008 Massachusetts Medical Society. All rights reserved.

( :thumbsup: :thumbsup: - pinto )

[juno jones]

1. K&R

This is the kind of dialougue we need on the subject. Thanks.

[pinto]

2. Yeah. I really like how clearly this is presented.

Helps set the issues in the mainstream of health care discussion.