When Women are Healthy, Everybody Wins: Immigration Reform and Women’s Health

President Obama made clear in the State of the Union yesterday that immigration reform was at the top of his priority list; he demanded we “fix our broken immigration system.” Immigration reform is a constant topic of deliberation, but immigration will likely be brought to the forefront of debate again this year.
Joining the conversation will be women’s groups, health groups, and immigrant advocacy groups alike in order to draw attention to the issue of undocumented immigrant women’s health. “Immigrant women make important contributions to our nation’s economy, families, and communities, and will contribute even more under immigration reform. However, the very pressing health care needs of immigrant women and families continue to be marginalized in the national debate over immigration reform,” said Jessica González-Rojas, executive director of the National Latina Institute for Reproductive Health.
Women currently make up 51% of immigrants in the United States; 55% of all green card recipients were female in 2010. According to the National Network for Immigrant and Refugee Rights, immigrant women were less likely to access pre-natal care and other essential services after the 1996 Temporary Assistance to Needy Families program prohibited many immigrants from receiving public benefits. Firstly, the lack of access to health care for any person is harmful, and secondly, is dangerous for immigrants in particular. Undocumented men and women are at greater risk for health issues such as poor mental health and occupational hazards than the general population (for more information on specific health issues in the immigrant community check out: NIRR website).
The reality is that women’s health must be addressed when discussing immigration reform. Immigration reform will help undocumented immigrant women receive more affordable quality health care.  Studies have demonstrated that access to health insurance and lower out-of-pocket health costs promote a healthier community. The President explained that independent economists say immigration reform will help our economy significantly and shrink the U.S. deficits. Part of the growth in economy will be due to a healthier population.  Approximately one-sixth of the United States’ population is made up of documented and undocumented first generation immigrants and their children. Aspiring citizens are paying taxes, working, and contributing to our economy and communities, and it’s important that their health needs are addressed in a timely and affordable way. Looking out for women’s health across the board is vital to a healthy economy, a healthy nation, and to everyone having access to the care they need when they need it.
- See more at: http://cohealthinitiative.org/blog/2014-01-29/when-women-are-healthy-everybody-wins-immigration-reform-and-women%E2%80%99s-health#sthash.nHa18I6v.dpuf

President Obama made clear in the State of the Union yesterday that immigration reform was at the top of his priority list; he demanded we “fix our broken immigration system.” Immigration reform is a constant topic of deliberation, but immigration will likely be brought to the forefront of debate again this year.
Joining the conversation will be women’s groups, health groups, and immigrant advocacy groups alike in order to draw attention to the issue of undocumented immigrant women’s health. “Immigrant women make important contributions to our nation’s economy, families, and communities, and will contribute even more under immigration reform. However, the very pressing health care needs of immigrant women and families continue to be marginalized in the national debate over immigration reform,” said Jessica González-Rojas, executive director of the National Latina Institute for Reproductive Health.
Women currently make up 51% of immigrants in the United States; 55% of all green card recipients were female in 2010. According to the National Network for Immigrant and Refugee Rights, immigrant women were less likely to access pre-natal care and other essential services after the 1996 Temporary Assistance to Needy Families program prohibited many immigrants from receiving public benefits. Firstly, the lack of access to health care for any person is harmful, and secondly, is dangerous for immigrants in particular. Undocumented men and women are at greater risk for health issues such as poor mental health and occupational hazards than the general population (for more information on specific health issues in the immigrant community check out: NIRR website).
The reality is that women’s health must be addressed when discussing immigration reform. Immigration reform will help undocumented immigrant women receive more affordable quality health care.  Studies have demonstrated that access to health insurance and lower out-of-pocket health costs promote a healthier community. The President explained that independent economists say immigration reform will help our economy significantly and shrink the U.S. deficits. Part of the growth in economy will be due to a healthier population.  Approximately one-sixth of the United States’ population is made up of documented and undocumented first generation immigrants and their children. Aspiring citizens are paying taxes, working, and contributing to our economy and communities, and it’s important that their health needs are addressed in a timely and affordable way. Looking out for women’s health across the board is vital to a healthy economy, a healthy nation, and to everyone having access to the care they need when they need it.
- See more at: http://cohealthinitiative.org/blog/2014-01-29/when-women-are-healthy-everybody-wins-immigration-reform-and-women%E2%80%99s-health#sthash.nHa18I6v.dpuf

A code that covered all rather than single groups might be useful

Perhaps there was a time when professional ethics alone gave health care a sufficient moral compass. If so, that time has passed. The fate of patients and the public's health depends now on interactions so complex that no single profession can credibly declare that its own code of ethics is enough. We think that we need an ethical code to cover everybody involved in health care, and we have embarked on the search for such a code.

Consider the following cases.

A doctor working in an NHS trust thinks it wrong that his patients will be denied a new treatment for cancer—despite the hospital formulary committee deciding that it should not be prescribed. Should he contact the local media? Should the trust punish him if he does?

A staff surgeon employed full time by a not for profit health maintenance organisation develops an approach to postoperative pain control for a surgical procedure that shortens average length of stay by 1.5 days. Is she ethically obliged to share information of her discovery with the world?

A British general practice that plans to become a fundholding practice deliberately keeps its prescribing costs high for a year so that it will receive a bigger budget in its first year as a fundholder (the budget is based on the previous year's activity). Is this defrauding other practices and health organisations or doing the best by the patients in the practice?

A health maintenance organisation considers investing in improvements in its system for caring for AIDS patients. The vice president for marketing warns that such improvements may lead to selective enrolment of unprofitable HIV positive members. Is the organisation ethically bound to improve its HIV care, even if that …

Women's Health: 'Everybody Loses'

The legislative budget conferees agreed last week to leave in place nearly $62 million in cuts to the state's family planning program authorized by the House in April, a move that advocates believe will shutter dozens of small clinics – and leave 200,000 women without access to basic health services. And although lawmakers have reauthorized the successful Medicaid-waiver Women's Health Program, it is unclear whether there will be enough providers left to keep up with the more than 100,000 clients currently in the program. In short, cutting off funding for family planning could strip the life out of the WHP.
The compromise budget plan leaves just $37.9 million in family planning funding for the biennium, down from the roughly $99 million originally allotted, which last year provided services to nearly 260,000 clients. Family-planning funding covers basic reproductive health screenings, including Pap smears, as well as screenings for breast cancer, hypertension, diabetes, and communicable diseases like HIV. Although none of the money, pass-through federal funds, may be spent on abortion, foes of family-planning services successfully framed the defunding as a way to keep money away from providers that also provide abortion care – namely their arch foe, Planned Parenthood. While Texas Right to Life has dubbed the budget gutting as a victory for "life," the reality is that Planned Parenthood will not be closing its doors; instead, the nearly 100-year-old nonprofit will simply be unable to provide preventative health care for the neediest Texas women. Moreover, the cuts mean that many small providers, including independent health clinics, will likely shut their doors this summer, says Fran Hagerty, CEO of the Women's Health and Family Planning Association of Texas, which represents many of the state's smaller women's health care providers.
Also included in the budget is a rider by Sen. Tommy Williams, R-The Woodlands, which devises a matrix for allocating the funds that remain: less than $19 million per year. According to the rider, the funds must first be allocated by the Department of State Health Services to "public entities" – including county and city health departments, local community clinics, and federally qualified health centers – that provide family planning services in addition to other health services; remaining funds can then be awarded to "non-public" entities that provide "comprehensive primary and preventative care as a part of their family planning services"; then, if any money remains, it can then be allocated to nonpublic providers of family-planning services – in other words, Planned Parenthood and other specialized providers. The thinking, of course, is that there won't be any money left for the third tier. In fact, at this low level of funding, there isn't even enough money to cover the needs of the providers in the first group. In 2010, there were 25 "public" contractors and 26 FQHC contractors; together these two groups received nearly $28 million to provide basic health services to low-income Texas women (and some men). "It's almost impossible to accept," says Hagerty. "Everybody loses."
Equally troubling is the ripple effect the massive budget cut could have on the WHP, which provides family-planning services for women who wouldn't otherwise be eligible for Medicaid unless they were pregnant. In 2008, the program saved the state more than $40 million in Medicaid costs. Before last week's reauthorization of WHP, it appeared the program might die altogether because of a poison-pill measure written by Sen. Robert Deuell, R-Greenville, which would have shut down the program in the event that Planned Parenthood successfully sued over the state's attempts to keep it from providing services under WHP. Currently, Planned Parent­hood serves some 40% of WHP clients. If the state succeeds in keeping PP out of the mix, it is unclear who would be left to serve WHP clients, says Hagerty. Many WHP providers also get family-planning funding; without their federal tax money allocation to provide those services, many won't be able to remain in business to serve WHP clients, and the larger providers, like Dallas' Park­land Hospital, will also be taking a hit, making the future of WHP's programs bleak. "The little guys will close," she said. "And the big guys, like Parkland, will be a skeleton of what they once were." If the WHP is indeed crippled by the broader cuts to family planning, the state could be cutting off well over 300,000 low-income Texans from access to basic health services.
Meanwhile, the budget compromise actually includes a revenue increase for the Williams-created Alternatives to Abortion program, which provides "counseling" and "support" to women in crisis pregnancies, to encourage them to carry their pregnancies to term – often with Medicaid support. The program has gotten a budget increase each session since its creation in 2005 (with an initial $5 million stake pulled from family-planning funds); this year lawmakers are throwing in an additional $300,000, pushing its biennial budget up to $8.3 million. The program provides no medical services, but does provide referrals to other government programs. According to the compromise budget, this money should provide "services" for roughly 16,000 women a year; in contrast, last year the state's FQHCs got roughly $7.6 million to provide actual medical care to more than 30,000 women. (For more on the Legislature's attack on women, see "The War on Women's Health," April 22.)

Everybody Belongs. years: 4-6, key area of learning: Mental Health

Introduction

This online version of the book Everybody Belongs, one of the series The Curriculum in Action, supports the implementation of Health and Physical Education in the New Zealand Curriculum. Body image issues are about much more than just physical size and shape. They also encompass attitudes, beliefs, and practices. For the purpose of this resource, body image means "a person's perceptions, thoughts and feelings about his or her body"(Grogan 1999: p 118). The Mental Health key area of learning requires that students have opportunities to develop:

• knowledge, understandings, and skills to strengthen personal identity and enhance a sense of self-worth;
• knowledge, understandings, and skills to examine discrimination and stereotyping, and to evaluate their impact on people's mental health;
• values and attitudes that support the enhancement of mental health for the students themselves, other people, and society.

Everybody Belongs provides teachers with ideas for planning units of work to meet the identified learning needs of their students. Teachers are not expected to implement all the suggested activities in this book. However, the key concepts do describe a developmental process that should be followed when planning and implementing this unit. These concepts are:

• personal identity and self-worth,
• societal attitudes and beliefs,
• critical thinking and action.

Why provide opportunities to consider issues about body image?

Body image is primarily a mental health issue with links to all other dimensions of well-being. Psychological research journals abound with articles describing the consequences of disordered ideas about body image for adolescents. So why should we be raising issues about body image with our eight- to ten-year-old students? In a 1992 British study of body satisfaction and body figure preferences:

They [the researchers] argue that children "consume" adult beliefs, values and prejudices around body shape and size, and adopt them as their own.

Grogan, 1999, p. 118

Children learn to make judgments about others from a very early age. At first, these judgments focus on tangible physical things like size and physical differences, but as they grow older, young people develop stereotyped views about other people based on these judgments, and they make assumptions based on these views. Everybody Belongs provides a context within which we can challenge stereotyping and other cultural myths and encourage young people to develop views that are less judgmental.
In present-day western society, the media exert an enormous influence on the social construction of an ideal body image. Much of what present-day society holds to be "ideal" is driven, and perpetuated, by the media. Media messages about "image" impact deeply on our emotional, intellectual, spiritual, and social well-being. Young children are bombarded with messages about "acceptable" body images and the gender roles associated with them through their toys, television programmes, magazines and books, fashion trends, and music, and through the games they play. However, these messages do not reflect the diversity in our population.
Although anecdotal evidence suggests that messages about body image are increasingly impacting on male well-being, they are typically associated with female dieting and eating disorders rather than with such concepts as developing self-worth and well-being for all. The bulk of available research refers to women and girls.
In this country, preliminary findings from research being conducted by Dr Robyn Dixon from the School of Education, University of Auckland, indicate that concern about body image has already become an issue for some ten- to thirteen-year-olds (source: personal communication). Two-thirds of intermediate-age girls were dissatisfied with their weight. Sixteen percent thought that they were thinner than was ideal and fifty-one percent thought they were heavier than ideal. Forty percent of the girls believed that they would be happier if they were thinner (sample size = 700, aged ten to thirteen years).
Many people, even those who fall within a healthy weight range, undertake diets, exercise, or more drastic methods to "control" their size. Huge amounts of money are invested in combating "fat", and this reinforces poor societal attitudes and the development of stereotypes. In this book, body image is not about dieting and eating disorders.

Providing direct instruction and information about eating disorders and problem... eating may inadvertently serve to introduce young people to the beliefs, attitudes and behaviours which precede eating problems.

O'Dea, 1998, p. 1

Everybody Belongs is about:

• considering the thoughts and feelings that contribute to our self-perceptions – not only those that relate to our physical selves but also those that relate to such influences as our nutrition, our work, the media, peer pressure, the literature we read, and our recreational activities;

• accepting diversity in both ourselves and others and acknowledging and celebrating the differences in size and general appearance, abilities, ethnicity, and cultural practices that make each of us unique;

• creating mentally and emotionally safe environments in which all people work towards eliminating judgments, assumptions, and discrimination based on stereotypes, promoting the tolerance of difference, and reducing the hurt caused by remarks about appearance and difference, even those made in fun.

Everybody Belongs focuses on accepting individual differences and promoting a sense of belonging and security. Being connected to someone or to a group is important for maintaining well-being.
Schools are unlikely to develop specific policies about body image. However, the need to create safe physical and emotional environments (National Administration Guideline 5.1) requires schools to develop supportive policies and procedures to ensure the safety of their students. For these procedures to be effective, classroom programmes and the school's ethos or climate must be mutually supportive.

Children need to know that human beings come in a wide variety of sizes and shapes, and that there is no "ideal" or "perfect" body. They should be taught that every body is a good body, and that each person is responsible for taking care of his or her body. Most importantly, children should learn to respect the bodies of others even when they are quite different from their own.

Ikeda, 1995, p. 109

Everybody Health and Fitness

We understand that all of our customers' health and fitness goals are different, so our programme brings together a massive variety of activities in a wide range of locations throughout Cheshire East so that there really is something for everybody.

Everybody Membership

Becoming an Everybody member is both easy and affordable. There are no joining fees, no hidden costs and a range of membership packages and prices to suit you.
To join, simply contact your nearest centre to arrange for a visit, where a member of staff will discuss all of the membership options available to make sure you get the best value for money. Unfortunately we are not able to offer online membership applications at this time.
Enjoy the full benefits of an Everybody package including:

• Fitness Suites
• Swimming Pools (including the unique outdoor brine pool in Nantwich during the summer months)
• A wide range of group fitness classes
• Guidance and advice from qualified and friendly instructors to take you through your Everybody Member Journey.

Our fitness suites contain a wide range of cardiovascular and resistance fitness equipment. There is also a great variety of group fitness classes ranging from yoga and pilates to spin cycling and high-impact aerobics. All of our centres are friendly and informal, giving you the chance to relax, make friends and achieve your fitness and weight loss goals.

Latest News and Special Offers 

• You can now download our 2013/14 Everybody Guide to Health & Fitness in Cheshire East (PDF,1.5MB). This guide details our new membership scheme, terms and conditions, our main facilities and the Everybody Member Journey. Please note this guide may not be accessible to those using assistive technologies to browse this site, however all information is available within the Everybody Health and Fitness area of the site.
• Refer a friend to Everybody and get a month free for each new referral! Ask an Everybody instructor on your next visit for more information.