Consider these statistics:

  • While heart disease has decreased 20 percent on average for all Americans in the past 35 years, it has decreased by only 13 percent for African Americans.

  • 80 percent of children born with HIV are born to African-American and Hispanic women.

  • Women report more depressive symptoms than men, with African Americans and Hispanics reporting the highest levels of symptoms.

  • 32 million Americans have no insurance and millions more are underinsured.

Data like these underscore that America needs a revolution in health care, said former Assistant Surgeon General Marilyn H. Gaston, MD, the keynote speaker at APA's conference on "Enhancing Outcomes in Women's Health."

"Webster's defines 'revolution' as a radical change in a situation," she said, "And there is no question that we need a radical change in the situation of our health in this nation."

Gaston urged health-care advocates to work to improve access to quality care on multiple levels:

  • Service delivery system. Instead of the current system, which relies heavily on tertiary care, such as emergency rooms, to provide health care, America's service delivery system should be based on primary care. Tertiary care is costly and episodic, while primary care can promote prevention and early diagnosis and treatment--measures that not only save money but promote healthier outcomes in women. Moreover, primary care needs to integrate physical and mental heath and be accessible, affordable, culturally competent and focused on self-care, she said.

  • Research. Gaston called for more information on genetic differences and on why women from some ethnic groups get diseases earlier in life than others. Research is also needed on the best ways to help women change their lifestyles to prevent and cope with chronic illness.

  • Training. The health professions need to train more women and minorities to become health researchers and providers.

  • Policy and legislation. Advocacy is needed for universal coverage, mental health parity, parity of funding of women's health services and research, as well as for federal and state governments to maintain or establish offices of women's heath.

  • Community. "No one group can make these changes that have to happen," said Gaston, who advised attendees to get involved in their churches, offices, schools and other groups to back health parity activities, women and depression support groups, and smoking-cessation campaigns.

  • Individual women. "The revolution has got to start with you," Gaston said. "I plead with you to make your own health your No. 1 priority." Just as airplane safety videos instruct parents to put on their oxygen mask before helping their children, Gaston explained, women cannot take care of anyone else unless their own health is attended to first.

"The good news is we can change the lives of women and their health in this nation," Gaston declared, quoting abolitionist Sojourner Truth: "If Eve, a single woman, can turn the world upside down, all of us certainly ought to be able to turn it right side up again."