CHAPTER 22
Women’s Health Psychology
PAMELA A. GELLER, MARIA C. GRAF, AND FAITH DYSON-WASHINGTON
513PHYSICAL HEALTH ISSUES 514
Coronary Heart Disease 514
Cancer 515
Stroke 516
Chronic Obstructive Pulmonary Disease 517
HIV/AIDS 517
Domestic Violence 517
Chronic Health Conditions 518
MENTAL HEALTH ISSUES 519
Depressive Disorders 519
Anxiety Disorders 520
Eating Disorders 520
Substance Use 521
Issues Relevant to Treatment of Mental Disorders 522
HEALTH CARE 522
Health Insurance 523
Relationships with Health Care Providers 523
STRESSFUL CONDITIONS RELATED TO PREGNANCY 524
Miscarriage 524
Infertility 525
Postpartum Reactions 526
Peripartum Cardiomyopathy 527
SOCIAL AND CULTURAL INFLUENCES ON
WOMEN•S HEALTH 527
Socioeconomic Status and Women 528
Multiple Roles: Risk or Protective Factor? 529
Sex Roles, Socialization, and Women’s Health 533
CONCLUSIONS AND FUTURE DIRECTIONS IN
WOMEN•S HEALTH 534
Health Care 534
Psychology 534
Mentorship 535
Research 535
Why Women’s Health? Why Now? 535
REFERENCES 536Women represent approximately 52% of the U.S. population
(U.S. Census Bureau, 1999), yet only in the 1990s did
women•s health begin to gain recognition as an important
area of research. Prior to 1990, limited medical research at-
tended to the many health issues important to women, and
women were consistently underrepresented in clinical trials.
According to the American Medical Association•s Council on
Ethical and Judicial Affairs (1991), research focused on men
because •a woman•s menstrual cycle may often constitute a
separate variable affecting test results,Ž thereby requiring re-
searchers to apportion funds and develop a plan to monitor
women•s hormone levels throughout the experimental
process. Researchers also were hesitant to conduct studies on
women in their childbearing years for fear of affecting fertil-
ity (American Medical Association [AMA], 1991). The re-
search that was completed with women stemmed from a
biomedical perspective and largely focused on diseases that
affect fertility and reproduction. As a result, women tradi-
tionally have received diagnoses and treatment based largely
on research conducted on men, as in the case of coronary
heart disease, which is discussed later in this chapter.
According to Haynes and Hatch (2000), several occur-
rences fueled the emergence of action in women•s health in
the past decade. First, a report from the General Accounting
Of“ce (GAO) highlighted the National Institutes of Health•s
(NIH) failure to include women in research (Nadel, 1990).
Then, in response to the GAO report, the Of“ce of Research
on Women•s Health (ORWH), a national entity, was created.
Pinn (1994) remarked that the ORWH functions for three
major purposes:(1) to strengthen, develop and increase research into diseases,
(2) to ensure that women are appropriately represented in re-
search studies, and (3) to direct initiatives to increase the number
of women in biomedical careers.Finally, the NIH Revitalization Act of 1993 was passed,
which mandated that women and minorities be included in
federally funded research, including clinical trials.
Whereas there had been a biomedical focus, research-
ers and clinicians now recognize the importance of address-
ing women•s health issues from a more comprehensive