Appendix
 
Additional Health Information and Tips
386 The Healthy Woman: A Complete Guide for All Ages

Know Your Body

Women’s Body Systems

Cardiovascular and Circulatory

Digestive (gastrointestinal)

Endocrine

Nervous (neurologic) and Skeletal

Reproductive

Respiratory

Urinary (renal)

See the systems diagrams on pages 387-390
Appendix 387

Know Your Body

Cardiovascular and Circulatory Systems

Digestive (gastrointestinal) System
388 The Healthy Woman: A Complete Guide for All Ages

Know Your Body

Endocrine System

Nervous (neurologic) and Skeletal Systems
Appendix 389

Reproductive System

Know Your Body

Respiratory System
390 The Healthy Woman: A Complete Guide for All Ages

Know Your Body

Urinary (renal) System

392 The Healthy Woman: A Complete Guide for All Ages

HOW TO

Talk to Your Doctor or Nurse

Waiting in your doctor’s office can make you feel nervous, impatient, or even scared. 

You might worry about what’s wrong with you. You might feel annoyed because you’re 

not getting other things done. Then when you see your doctor or nurse, the visit seems 

to be so short. You might have only a few minutes to explain your symptoms and concerns. Later that day, you might remember something you forgot to ask. You wonder 

if your question and its answer matter. Knowing how to talk to your doctor, nurse, or 

other members of your health care team will help you get the information you need. 

Tips: What to do

●	 List your questions and concerns.

Before your appointment, make a list 

of what you want to ask. When you’re 

in the waiting room, review your list 

and organize your thoughts. You can 

share the list with your doctor or 

nurse. 

●	 Describe your symptoms. Say when 

these problems started. Say how they 

make you feel. If you know, say what 

sets them off or triggers them. Say 

what you’ve done to feel better. 

●	 Give your doctor a list of your medications. Tell what prescription drugs 

and over-the-counter medicines, 

vitamins, herbal products, and other 

supplements you’re taking.

●	 Be honest about your diet, physical 

activity, smoking, alcohol or drug 

use, and sexual history. Not sharing 

information with your doctor or nurse 

can be harmful! 

●	 Describe any allergies to drugs, 

foods, pollen, or other things. Don’t 

forget to mention if you are being 

treated by other doctors, including 

mental health professionals. 

●	 Talk about sensitive topics. Your 

doctor or nurse has probably heard it 

before! Don’t leave something out because you’re worried about taking up 

too much time. Be sure to talk about 

all of your concerns before you leave. If 

you don’t understand the answers your 

doctor gives you, ask again.

●	 Ask questions about any tests and 

your test results. Get instructions on 

what you need to do to get ready for 

the test(s). Ask if there are any dangers 

or side effects. Ask how you can learn 

the test results. Ask how long it will 

take to get the results. 

●	 Ask questions about your condition 

or illness. When your illness is diagnosed, ask your doctor how you can 

learn more about it. What caused it? 

Is it permanent? What can you do to 

help yourself feel better? How can it 

be treated?

●	 Tell your doctor or nurse if you are 

pregnant or intend to become preg-
Appendix 393

nant. Some medicines may not be 

suitable for you. Other medicines 

should be used with caution if you are 

pregnant or about to become pregnant. 

●	 Ask your doctor about any treatments 

he or she recommends. Be sure to ask 

about all of your options for treatment. 

Ask how long the treatment will last. 

Ask if it has any side effects. Ask how 

much it will cost. Ask if it is covered 

by your health insurance.

●	 Ask your doctor about any medicines 

he or she prescribes for you. Make 

sure you understand how to take your 

medicine. What should you do if you 

miss a dose? Are there any foods, 

drugs, or activities you should avoid 

when taking the medicine? Is there 

a generic brand of the drug you can 

use? You can also ask your pharmacist 

if a generic drug is available for your 

medication.

●	 Ask more questions if you don’t understand something. If you’re not 

clear about what your doctor or nurse 

is asking you to do or why, ask to have 

it explained again. 

●	 Bring a family member or trusted 

friend with you. That person can take 

notes, offer moral support, and help 

you remember what was discussed. 

You can have that person ask questions, too!

●	 Call before your visit to tell them if 

you have special needs. If you don’t 

speak or understand English well, the 

office may need to find an interpreter. 

If you have a disability, ask if they can 

accommodate you. n
394 The Healthy Woman: A Complete Guide for All Ages

HOW TO

Get a Second Opinion

Even though doctors may get similar medical training, they can have their own opinions and thoughts about how to practice medicine. They can have different ideas about 

how to diagnose and treat conditions or diseases. Some doctors take a more conservative, or traditional, approach to treating their patients. Other doctors are more aggressive and use the newest tests and therapies. It seems like we learn about new advances 

in medicine almost every day. 

Many doctors specialize in one area of medicine, such as cardiology or obstetrics or 

psychiatry. Not every doctor can be skilled in using all the latest technology. Getting 

a second opinion from a different doctor might give you a fresh perspective and new 

information. It could provide you with new options for treating your condition.Then 

you can make more informed choices. If you get similar opinions from two doctors, 

you can also talk with a third doctor. 

Tips: What to do

●	 Ask your doctor for a recommendation. Ask for the name of another 

doctor or specialist, so you can get a 

second opinion. Don’t worry about 

hurting your doctor’s feelings. Most 

doctors welcome a second opinion, 

especially when surgery or long-term 

treatment is involved. 

●	 Ask someone you trust for a recommendation. If you don’t feel comfortable asking your doctor for a referral, 

then call another doctor you trust. You 

can also call university teaching hospitals and medical societies in your area 

for the names of doctors. Some of this 

information is also available on the 

Internet. 

●	 Check with your health insurance 

provider. Call your insurance company before you get a second opinion. 

Ask if they will pay for this office visit. 
Appendix 395

Many health insurance providers do. 

Ask if there are any special procedures 

you or your primary care doctor needs 

to follow.

●	 Ask to have medical records sent to 

the second doctor. Ask your primary 

care doctor to send your medical records to the new doctor. You need to 

give written permission to your current doctor to send any records or test 

results to a new doctor. You can also 

ask for a copy of your own medical 

records for your files. Your new doctor 

can then examine these records before 

your office visit.

●	 Learn as much as you can. Ask your 

doctor for information you can read. 

Go to a local library. Search the Internet. Find a teaching hospital or university that has medical libraries open 

to the public. The information you find 

can be hard to understand, or just confusing. Make a list of your questions, 

and bring it with you when you see 

your new doctor. 

●	 Do not rely on the Internet or a telephone conversation. When you get 

a second opinion, you need to be seen 

by a doctor. That doctor will perform 

a physical examination and perhaps 

other tests. The doctor will also thoroughly review your medical records, 

ask you questions, and address your 

concerns. n
396 The Healthy Woman: A Complete Guide for All Ages

HOW TO

Be Prepared for Emergencies

When disaster strikes, you may not have much time to act. To help protect loved ones, 

take simple steps now to prepare your family for sudden emergencies or other disasters.

Three basic steps for disaster or 

emergency preparedness

1.KNOW what natural or other disasters 

could occur in your area and how to 

prepare for them. Learn about local 

evacuation routes, so that you know 

how to leave an area quickly. The Federal Emergency Management Agency 

offers information on preparedness at 

www.fema.gov.

2.PLAN out on paper the steps you 

should take during an emergency 

and give family members a copy. Talk 

about potential disasters or emergencies and how to respond to each. 

Choose a meeting place, other than 

your home, for family members to 

gather in case you can’t go home. 

Make sure you choose an “emergency 

check-in” contact person and teach 

your children the phone number for 

this person. 

3.PACK emergency supplies in your 

home to meet your needs for 3 days. 

Always keep all your important documentation together, in one place, in 

case you have to “grab and go” during 

an evacuation. 

Need to evacuate? Have a kit 

ready that includes:

●	 identification for yourself and your 

children, such as birth certificates and 

social security cards

●	 important personal papers, such as 

health insurance identification cards, 

immigration papers, and children’s 

school records

●	 funds in the form of cash, traveler’s 

checks, credit cards, and checkbook 

●	 keys to the house, car, and safety deposit box or post office box

●	 ways to communicate, including a calling card, cell phone and extra battery, 

and the emergency check-in number 

for family members to call

●	 prescription medications, including 

written prescription orders, and supplies such as contact lens cleaner and 

feminine hygiene products
Appendix 397

Essential items for disaster 

preparedness

Relief workers will most likely be on the 

scene after a disaster, but they cannot 

reach everyone immediately. Gather the 

supplies below in case you have to stay 

where you are. 

Water. Keep at least a 3-day supply of 

water for each person, stored in plastic 

containers. Each person needs 1 gallon 

of water each day. 

Food. Store at least a 3-day supply of 

nonperishable food such as canned meat, 

beans, vegetables, fruit and juices; peanut 

butter or other high-energy food; and 

unsalted crackers. Keep a nonelectric can 

opener handy. If you have pets, stock up 

on canned pet food.

Infant care. Store baby formula and water to prepare it if a child is not breastfed. 

If you need to evacuate quickly, bring 

towels or sheets to carry a baby instead 

of a bulky stroller.

Other supplies. Make sure you have 

large plastic bags that seal for waterproofing important papers, a batterypowered flashlight and radio with extra 

batteries, and a first aid kit. 

Breastfeeding during an 

emergency

When an emergency occurs, breastfeeding saves lives.

●	 Breastfeeding protects babies from the 

risks of a contaminated water supply. 

●	 Breastfeeding helps protect against 

respiratory illnesses and diarrhea—

diseases that can be fatal in populations displaced by disaster. 

The basics of breastfeeding during an 

emergency are much the same as they are 

in normal times. Continuing to breastfeed whenever the baby seems hungry 

maintains a mother’s milk supply and is 

calming to both mother and baby. Visit 

www.lalecheleague.org for information 

on how to breastfeed in an emergency, 

even if you have been giving your baby 

formula. (See the Breastfeeding chapter 

on page 187 for more information.)

Food and water safety during an 

emergency

Food may not be safe to eat during and 

after an emergency. Water may not be 

safe to drink, clean with, or bathe in 

after an emergency such as a hurricane 

or flood because it can become contaminated with bacteria, sewage, agricultural 

or industrial waste, chemicals, and other 

substances that can cause illness or 

death. The Centers for Disease Control 

and Prevention has information about 

keeping your food and water safe at 

www.bt.cdc.gov/disasters/foodwater.

Staying safe from violence during 

an emergency

After disasters, women are at greater risk 

of sexual assault or other violence. Visit 

www.womenshealth.gov/violence for 

safety tips. n
398 The Healthy Woman: A Complete Guide for All Ages

HOW TO 

Read Drug Labels

Medicines, or drugs, come as either prescription or over the counter (OTC). Prescription drugs are used under a doctor’s care. OTC drugs can be bought and used without 

a doctor’s prescription, and you buy them at a drugstore or grocery store. When using 

any kind of drug, it’s really important to read the drug label for instructions. Not following the instructions can hurt your health. Read the label each time you use a new 

bottle of a drug, just in case there have been changes to it since the last time you used 

it. See the drug label below and on the next page to know what to look for. If you read 

the label and still have questions, call your doctor, nurse, or pharmacist for help. n
Appendix 399
400 The Healthy Woman: A Complete Guide for All Ages

Environmental Health

The quality of the environment can affect 

women’s health. Chemicals and other 

substances in the air, water, soil, and food 

may be toxic and cause health problems. 

The quality of the environment may have 

a greater impact on children than adults. 

This is because children are growing 

quickly and breathe more air, eat more 

food, and drink more water. Some toxins 

can be passed from mother to child during pregnancy or breastfeeding. If you 

are pregnant, nursing, or planning to become pregnant, talk to your doctor about 

environmental exposures you should 

avoid.

Outdoor air

There are many sources of pollution outdoors, such as emissions from cars and 

trucks, power plants that burn fossil fuels, factories, and forest fires.

Outdoor air pollution can irritate your 

eyes, nose, and throat. At high levels, 

some outdoor air pollutants may cause 

more serious health problems like cancer 

and lung damage. Children, the elderly, 

and people with heart or lung conditions 

are more likely to be affected by some 

types of outdoor air pollution.

The U.S. Environmental Protection 

Agency (EPA) protects the quality 

of the air throughout the country. However, some areas may have higher levels 

of outdoor air pollution than others. 

Find out about the air quality in your 

community. Check the daily Air Quality 

Index (AQI) in your local radio, television, or newspaper forecast. You can also 

find your AQI online at the EPA’s Web 

site.

You can reduce your exposure to air 

pollution by limiting outdoor activities 

when the AQI is high. By using less 

energy, you can help reduce the air pollution that comes from burning fossil fuels. 

l Replace incandescent lightbulbs with 

compact fluorescent bulbs.

l Turn off lights and appliances when 

they’re not in use. 

l Reuse and recycle to conserve raw materials and energy.

l Buy ENERGY STAR appliances.

l Choose a vehicle with good fuel economy and low emissions.

l Drive less. Carpool, walk, bike, or use 

public transportation if you can.

Indoor air

Indoor air pollution can irritate your 

eyes, nose, and throat. It can cause headaches or make you feel dizzy or tired. 

These symptoms may seem similar to the 

symptoms of a cold or flu. But if your 

symptoms disappear when you are away 
Appendix 401

from home, you may have an indoor air 

problem.

Indoor air pollution can also lead to serious health problems, such as heart and 

lung diseases and cancer. These problems 

may develop many years after exposure 

or after repeated exposures to indoor air 

pollutants. 

Children, the elderly, and people with 

heart or lung conditions are more likely 

to be affected by indoor air pollution.

Some common sources of indoor air pollution include:

l gases from burning oil, gas, coal, wood 

used for heating and cooking

l smoke from tobacco products 

l building materials, such as asbestos 

insulation and products made from 

pressed wood

l outdoor pollutants, such as radon, 

which can build up indoors 

l chemicals used for cleaning, pest control, and painting

l personal care products such as hair 

spray and nail polish remover

l biological pollutants, such as bacteria, 

molds, mildew, and pet dander

You can improve the air quality in your 

home:

l Remove sources of pollution. 

l Increase the ventilation (flow of air). 

Run exhaust and attic fans or open 

doors and windows. This is especially 

important when using household products that contain harmful chemicals.

l Use a home air cleaner to remove pollutants, if necessary. 

Water quality

EPA sets standards for safe drinking 

water. Public water systems must meet 

these standards. Tap water, well water, 

and even bottled water may contain very 

small amounts of contaminants such as 

chemicals and bacteria. As long as levels are low enough to meet EPA’s safety 

standards, your water is safe to drink.

You can take steps to make sure your water is safe to drink.

l People with weakened immune 

systems, infants, children, and the 

elderly may be more sensitive to some 

contaminants. Talk to your doctor 

about whether you need to take extra 

precautions.

l If your water comes from a private 

well, have your water tested at least 

once a year. Contact your local, county, 

or state health department for more 

information about water testing. Some 

health departments may help you with 

testing. If not, they can recommend a 

state-certified laboratory in your area.

l If your water comes from a public 

source, your water supplier is required 

to send you an annual water quality 

report.
402 The Healthy Woman: A Complete Guide for All Ages

Lead

Lead exposure can cause reproductive 

problems, high blood pressure, muscle 

and joint pain, and problems with memory or concentration. Lead can harm the 

developing brain and nervous system of 

children, infants, and unborn children.

Some common sources of lead exposure 

include: 

l lead-based paint in houses built before 

1978

l soil and household dust that may 

contain chips or dust from lead-based 

paints

l water from lead-lined pipes

You can reduce your exposure to lead.

l Have your home tested for lead.

l If you plan to remove or disturb leadbased paint, hire a contractor with 

special training. Leave the house until renovations are complete and the 

house is cleaned to remove any lead 

dust.

l Use only cold water to cook or to 

make baby formula.

l Run cold water for at least 1 minute 

before using it.

l Use a water filter certified by NSF 

(National Sanitation Foundation) International to remove lead.

Mercury

In both children and adults, high levels 

of mercury may affect the brain, heart, 

kidneys, lungs, and immune system. 

Children, infants, and unborn babies are 

most sensitive to mercury.

The most common source of exposure to 

mercury is fish and shellfish, which contain small amounts of mercury. Different 

kinds of fish contain different amounts. 

Women who may become pregnant, 

women who are pregnant or nursing, 

and young children should follow these 

guidelines: 

l Don’t eat shark, swordfish, king mackerel, or tilefish. 

l Eat no more than 12 ounces (about 

2 meals) of fish low in mercury each 

week. Low-mercury fish include 

shrimp, canned light tuna, salmon, 

pollock, and catfish.

l Eat no more than 6 ounces (about 1 

meal) of albacore (white) tuna each 

week. 

l Before eating fish caught in your area, 

check local fish safety advisories. 

Mercury may also be found in thermometers, thermostats, and fluorescent 

lightbulbs. If these items break, people 

may be exposed to mercury. Do not use a 

vacuum to clean mercury spills. Contact 
Appendix 403

your local health department to find out 

how to properly clean and dispose of 

spilled mercury.

Pesticides

Chemicals used to kill pests such as insects, rodents, and mold can also affect 

human health. At high levels, pesticides 

may cause birth defects, nerve damage, 

and cancer.

Small amounts of pesticides may be 

found in air, water, and food. EPA limits 

pesticides used in farming to make sure 

your food is safe. Pesticides used in and 

around your home may contribute to indoor air pollution. 

You can reduce your exposure to pesticides.

l Wash and scrub fruits and vegetables 

under running water, peel off skins, 

and trim outer leaves.

l Trim fat from your meat.

l Choose organic foods, grown without 

the use of synthetic pesticides.

l Eat a variety of foods to avoid high 

exposure to a single pesticide.

l If you use pesticides in your home, 

follow the instructions carefully. Keep 

pesticides out of reach of children. n

Resources:

U.S. Environmental Protection Agency

Web site: www.epa.gov 

Indoor Air Quality Information 

Clearinghouse: www.epa.gov/iaq

Phone number: (800) 438-4318

National Lead Information Center: 

www.epa.gov/lead

Phone number: (800) 424-5323

Safe water information where you live: 

www.epa.gov/safewater/ccr/

whereyoulive.html 

Food Safety Information Center, 

USDA

Web site: http://foodsafety.nal.usda.gov 

Phone number: (301) 504-6835

National Center for Environmental 

Health, CDC

Web site: www.cdc.gov/nceh

Phone number: (800) 232-4636

National Institute of Environmental 

Health Sciences, NIH

Web site: www.niehs.nih.gov

National Poison Control Hotline

Web site: www.poison.org

Phone number: (800) 222-1222
404 The Healthy Woman: A Complete Guide for All Ages

Avian Flu

Avian influenza (flu) is not the same 

as pandemic flu. A pandemic flu is a 

global outbreak of a flu. A pandemic can 

happen when a new virus appears that 

people have little or no immunity against 

and for which there is no vaccine. (Having immunity means you are resistant to, 

or protected against, a disease.) A new 

virus can spread quickly from person to 

person around the world, causing severe 

illness and even death. Although it is 

hard to know when the next flu pandemic will happen or how dangerous it 

will be, you can be informed and take 

steps to prepare your family. Avian flu 

has received a lot of attention in recent 

years, raising many questions about the 

dangers of a flu pandemic. 

What is avian flu?

Avian or “bird” flu is caused by influenza 

viruses that naturally affect birds. Wild 

birds carry these highly contagious viruses, but they generally do not become 

sick. Domesticated birds, though, are at 

great risk. Avian flu can cause serious 

illness and death for infected chickens, 

ducks, and turkeys.

Why are health officials concerned 

about avian flu for humans?

Although people are not usually at risk 

of getting avian flu viruses, a virus called 

H5N1 is one of the few strains that has 

crossed over to infect people. The H5N1 

virus is powerful, having caused the 

deaths of more than half of the people 

infected. Experts think most of these 

cases have been caused by contact with 

infected birds. To date, there has been 

limited spread of the virus from person 

to person. The concern is that H5N1 will 

change into a virus that can pass from 

person to person more easily and more 

quickly. An increasing number of human 

cases have been found in Asian, European, and African countries. Health officials are watching the situation closely to 

prepare for the possibility that the virus 

may spread to other parts of the world. 

Will getting a seasonal flu shot 

prevent me from getting avian flu?

No. The flu shot can help protect you 

only from seasonal flu. No vaccine is 

available to protect against the H5N1 

virus that has been found in people, but 

researchers are working on making one.

What are the symptoms of avian 

flu?

Symptoms can include regular flu symptoms such as fever, cough, sore throat, 

and muscle aches. Other symptoms may 

include eye infections, pneumonia, and 

severe respiratory problems. There may 

be other symptoms that we do not yet 

know about.

Are there treatments available for 

avian flu?

The H5N1 virus is resistant to two medicines used to treat the flu: amantadine 

(uh-MAN-tuh-deen) and rimantadine 

(rih-MAN-tuh-deen). Two other flu 

medicines called oseltamavir (o-suhlTAM-uh-vihr) and zanamivir (zuhNAM-uh-vihr) may work to treat the 
Appendix 405

flu caused by H5N1. More research is 

needed to test these medicines. Health 

researchers are also working on improving flu testing, to better detect which flu 

strain you have and where it came from. 

This will help government officials track 

dangerous flu viruses and help keep the 

public informed.

What can I do to help keep my 

family healthy?

You and members of your family can 

take steps to help limit the spread of 

germs. 

l Wash your hands with soap and warm 

water often.

l Use an alcohol-based hand cleanser if 

you don’t have soap handy.

l When coughing or sneezing, cover 

your mouth and nose with a tissue (or 

your upper sleeve if you don’t have a 

tissue), throw used tissue away, and 

wash your hands afterward.

l If you are sick, stay home.

l It is also important to eat a balanced 

diet, drink plenty of water, get regular 

physical activity, and get enough rest.

What should I do to help my family 

prepare for a flu pandemic?

Visit www.pandemicflu.gov to learn how 

to prepare your family. This Web site 

provides preparation checklists for families and businesses, information for people who deal with poultry, and the latest 

information on how avian flu is affecting 

people around the world. If H5N1 does 

cause a pandemic flu, this Web site will 

offer important safety information. You 

can also call the Centers for Disease 

Control and Prevention Hotline at (800) 

CDC-INFO (800) 232-4636) or (888) 

232-6348 (TDD) 24 hours a day, 7 days 

a week. n

www.pandemicflu.gov 

(800) CDC-INFO or 

(888) 232-6348 (TDD)
406 The Healthy Woman: A Complete Guide for All Ages

Caregiver Stress

As the U.S. population ages, more people 

are faced with the responsibility of caring 

for elderly loved ones with Alzheimer’s 

disease, cancer, or other health problems. 

Many parents are also raising children 

with severe disabilities at home. More 

often today, these caregivers are continuing to care for children with disabilities 

well into their adulthood.

The people needing care often need help 

with basic daily tasks. Caregivers help 

with a wide range of activities, including:

l cooking

l feeding

l giving medicine 

l bathing 

l running errands

People who do not get paid for providing 

care are known as informal caregivers or 

family caregivers. Most informal caregivers are women. Often, these women also 

have children to take care of and jobs 

outside the home.

Being an informal caregiver can have 

many rewards. It can give you a feeling of giving back to a loved one. It can 

make you feel needed and can lead to 

a stronger relationship with the person 

receiving care. However, caregiving can 

also take a toll on your mental and physical health.

What is caregiver stress?

Caregiver stress is the emotional strain 

of caregiving. It can take many forms. 

For instance, you may feel frustrated 

and angry taking care of someone with 

dementia (dih-MEN-chuh) who often 

wanders away or becomes easily upset. 

Or you may feel guilty because you think 

that you should be able to provide better 

care, despite all the other things that you 

have to do.

How can I tell if caregiving is 

putting too much stress on me?

Caregiving may be putting too much 

strain on you if you have any of the following symptoms:

l sleeping too much or too little 

l gain or loss of a lot of weight 

l feeling tired most of the time 

l loss of interest in activities you used to 

enjoy 

l becoming easily irritated or angered

l often feeling sad

l frequent headaches, bodily pain, or 

other physical problems

l abuse of alcohol or drugs, including 

prescription drugs

Talk to a counselor, psychologist, or 

other mental health professional right 

away if your stress leads you to physically 

or emotionally harm the person you are 

caring for.

How can caregiver stress affect my 

health?

Research shows that, compared with 

noncaregivers, caregivers:

l are more likely to have symptoms of 

depression or anxiety

l are more likely to have heart disease, 

cancer, diabetes, and arthritis
Appendix 407

l have a weaker immune response, 

which can lead to frequent infections 

and increased risk of cancers

l have higher levels of obesity

l may be at higher risk of mental decline, including problems with memory and paying attention

What can I do to prevent or relieve 

stress?

First, never dismiss your feelings as “just 

stress.” Caregiver stress can lead to serious health problems and you should take 

steps to reduce it as much as you can. 

Tips for reducing caregiver stress:

l Ask for and accept help.

l Say “no” to requests that are draining, 

such as hosting holiday meals.

l Stay in touch with family and friends.

l Join a caregiver support group.

l Attend a class to learn how to take 

care of someone with the disease that 

your loved one has.

l Prioritize, make lists, and establish a 

daily routine. 

l Set realistic goals for each day.

l Get an annual medical checkup.

l Stay active, eat a healthy diet, and try 

to get enough sleep.

What caregiving services can I find 

in my community?

Caregiving services include:

l transportation 

l meal delivery

l home health care services (such as 

nursing or physical therapy)

l nonmedical home care services (such 

as housekeeping or cooking)

l home modification (changes to the 

home that make it easier for your 

loved one to perform basic daily tasks, 

such as bathing, using the toilet, and 

moving around)

l legal and financial counseling

What can I do if I need a break?

Taking some time off from caregiving 

can reduce stress. “Respite care” provides 

substitute caregiving to give the regular 

caregiver a much-needed break. Respite 

care may be provided by:

l home health care workers

l adult day-care centers

l short-term nursing homes

How do I find out about caregiving 

services in my community?

Contact your local Area Agency on Aging (AAA) to learn about caregiving 

services where you live. AAAs are usually 

listed in the city or county government 

sections of the telephone directory under 

“Aging” or “Health and Human Services.” The National Eldercare Locator, 

a service of the U.S. Administration on 

Aging, can also help you find your local 

AAA.

Resources:

Administration on Aging

www.aoa.gov

www.eldercare.gov

Eldercare Locator: (800) 677-1116

Family Caregiver Alliance

www.caregiver.org n
408 The Healthy Woman: A Complete Guide for All Ages

Understanding Genetics and Your 

Health

Humans have between 20,000 and 

25,000 genes. Most genes are the same 

in all people. But small differences in 

these genes give you a one-of-a-kind 

look and contribute to your personality 

and talents. Genes also can affect your 

health. To understand how, it’s helpful to 

learn what genes do.

Genes: Your body’s blueprint

Genes, which are made up of DNA, 

contain the instructions your body’s cells 

need to function. Genes are located on 

structures called chromosomes. Information from your genes is used to make 

proteins. Each cell contains thousands 

of proteins. Each protein has a specific 

job to do at a specific time for the cell to 

work properly. 

Sometimes, a gene can have something 

wrong with it. This is called a gene mutation or a mutated gene. A mutation 

causes the gene to give the wrong instructions for making a protein, so that 

the protein works improperly or is missing. If the mutation affects a protein that 

plays an important role in the body, a 

medical problem could result. Most gene 

mutations have no effect on health or 

development.

Genetic disorders: The basics

The genes you are born with can affect 

your health in these ways:

l Single gene disorders are caused by a 

mutation in one gene. There is a patWe are learning more and more about 

the role specific genes play in our 

health. For example, you may have 

heard about “breast cancer genes,” 

called BRCA genes. All people have 

BRCA genes. But only women and men 

born with mutated BRCA genes are 

at higher risk of breast cancer. Still, 

some women born with mutated BRCA

genes don’t get breast cancer. And 

most women who get breast cancer 

are born with normal BRCA genes. 

Keep in mind that genes themselves 

do not cause disease, but that mutated genes may cause health problems.

How sickle cell anemia runs in families

Two unaffected parents each carry one copy of a 

gene mutation for sickle cell anemia. They have one 

child with sickle cell anemia and three unaffected 

children. Two of the unaffected children inherit one 

copy of the gene mutation—as carriers, they can 

pass the sickle cell trait on to their children.
Appendix 409

tern to the way these genetic disorders 

show up in families. Even though the 

mutated gene is passed down from 

parent to child, not all family members 

are affected. Some members are “carriers” of the mutated gene. Examples of 

single-gene disorders are cystic fibrosis 

(SISS-tik-feye-BROH-suhss) and 

sickle cell anemia (uh-NEE-mee-uh).

l Chromosome disorders occur when 

all or part of a chromosome is missing or extra, or if the structure of one 

or more chromosomes is not normal.

This can affect some of the genes. 

Most chromosome disorders involving whole chromosomes do not run in 

families. Genes can influence your risk 

of getting some diseases, such as breast 

cancer, heart disease, diabetes, and thyroid conditions. But other factors, such 

as lifestyle and environment, also play 

a role in developing these conditions. 

Rarely, single genes are responsible for 

these diseases; however, most of the 

time they are due to a combination of 

genes and environment. The role genes 

play in developing these conditions often is not known, but our understanding of this continues to grow through 

research.

Genetic counseling: What it is and 

who needs it

Genetic counseling gives information 

and support to people who have, or may 

be at risk of, genetic disorders. Some reasons a family might seek genetic counseling are:

l a family history of a genetic condition, 

birth defect, chromosomal disorder, or 

cancer

l two or more pregnancy losses, a stillbirth, or a baby who died

l a child with a known inherited disorder, birth defect, mental retardation, or 

developmental delay

l a woman who is pregnant or plans to 

become pregnant at 35 years or older

l test results that suggest a genetic condition is present

l increased risk of getting or passing on 

a genetic disorder because of one’s ethnic background

l people related by blood who want to 

have children together

Your doctor can help you find a genetic 

professional if you might benefit from 

this service. During a consultation, the 

genetics professional meets with a person 

or family to discuss genetic risks or to 

diagnose, confirm, or rule out a genetic 

condition. Sometimes, a family chooses 

to have genetic testing. Most of the time, 

testing is used to find changes that are 

linked to genetic disorders. The results 

can confirm or rule out a condition. Tests 

also can help to know the chances that a 

person will get or pass on a genetic disorder. The genetics professional can help 

a family decide if genetic testing is the 

right choice for them. n

Some companies offer genetic tests 

that you can do yourself through the 

mail. These tests may not provide true 

or meaningful information. These tests 

might even provide harmful information to consumers. Talk to your doctor 

before using this type of test.
410 The Healthy Woman: A Complete Guide for All Ages

Becoming a Research Volunteer 

Today, women are living longer and 

healthier lives thanks, in part, to medical 

research. Because of research studies:

●	 We know what foods to eat to prevent 

heart disease.

●	 Doctors have better tools to detect 

health problems, such as mammograms for breast cancer. 

●	 New drugs are available to treat diabetes, depression, and other diseases.

●	 We know that women respond differently than men to some drugs and 

medical treatments.

Important findings like these are not 

possible without the help of research 

volunteers. Many volunteers—and especially women—are needed for research 

studies. Whether to participate in a research study is a personal choice. Getting

all the facts about the study will help you 

decide if volunteering is right for you. 

Frequently asked questions about 

research studies

Are there different kinds of research studies?

Yes. Here are some examples.

● Observational studies follow one 

or more groups of the same people 

over a period of time to see how their 

health changes. A recent example is 

the Women’s Health Initiative. This 

study tracked 93,676 postmenopausal 

women for about 8 years to learn more 

about risk factors for heart disease, 

cancer, and fractures. 

l
Appendix 411

Who can participate in a research study? 

The study’s protocol sets guidelines 

about who can participate. Sometimes, a 

person who is willing to participate does 

not qualify. If this happens to you, don’t 

take the rejection personally. Strict participation guidelines are in place to keep 

participants safe and to ensure that study 

results are reliable.

Will participation in a research study help me?

Research is not the same as treatment. 

Sometimes, participation in clinical trials gives you access to new treatments or 

drugs before they become widely available. These treatments may or may not 

help you. There also might be unpleasant, 

serious, or even life-threatening side effects. Or a study could involve not using 

a drug that can help you. Even if you are 

not helped personally, the study results 

could help many others in the future.

How will my safety be protected?

Researchers are required to care for your 

well-being just like the doctors who 

provide your regular medical care. Also, 

medical research studies that involve 

people have federally controlled safeguards, such as an “institutional review 

board,” or IRB. The IRB is a group of 

people who make sure that a trial is 

ethical and the rights of participants are 

protected. Keep in mind that “protected” 

doesn’t mean the study is risk free.

What is informed consent?

This is the process of learning the key 

facts about the research study before 

deciding whether to participate. The research team will explain all the study details to you. This includes the purpose of 

the study, how the trial might affect your 

daily life, how long the study will last, 

and the potential benefits and risks of 

participating. It’s helpful to have a friend 

or family member with you during this 

discussion. If you agree to participate 

after learning all the facts, you will be 

asked to sign an informed consent form. 

This is not a contract. By signing the 

form, you are showing that you understand what is involved.

Who will pay for my medical care during the 

trial?

This depends on the study and your 

health insurance plan. Health plans do 

cover the costs that are part of your routine medical care. Often health plans do 

not cover the patient care costs related 

to clinical trials they deem to be “experimental.” In many cases, the research 

team can help by talking with your plan 

provider. Also, many states require health 

plans to cover the costs for certain clinical trials, such as for new cancer treatments. There also are some government 

programs to help pay the costs of care. 

The research team can help you sort 

through any cost issues.

Can I quit after the study has begun?

Yes. You can leave a research study at 

any time. But be sure to tell the research 

team that you are withdrawing and your 

reasons why. n

Where do I find out about 

research studies?

Talk to your doctor if you are interested 

in becoming a research volunteer. You 

also can find out about clinical trials at 

www.clinicaltrials.gov.
 
Important Screenings and Tests
414 The Healthy Woman: A Complete Guide for All Ages

Common Screening and Diagnostic Tests Explained

Test name Definition

Angiography (an-jee-OG-ruh-fee) Exam of your blood vessels using x-rays. The doctor inserts a small tube into 

the blood vessel and injects dye to see the vessels on the x-ray.

Barium enema A lubricated enema tube is gently inserted into your rectum. Barium flows into 

your colon. An x-ray is taken of the large intestine. 

Biopsy A test that removes cells or tissues for examination by a pathologist to diagnose for disease. The tissue is examined under a microscope for cancer or 

other diseases.

Blood test Blood is taken from a vein in the inside elbow or back of the hand to test for a 

health problem.

Bone mineral density (BMD) test Special x-rays of your bones are used to test if you have osteoporosis, or a 

weakening of the bones.

Bronchoscopy (brong-KOSS-kuh-pee) Exam of the lungs. A bronchoscope, or flexible tube, is put through the nose or 

mouth and into your trachea (windpipe).

Clinical breast exam (CBE) A doctor, nurse, or other health professional uses his or her hands to examine 

your breasts and underarm areas to find lumps or other problems. 

Chest x-ray An x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm. 

Colonoscopy (KOH-luhn-OSS-kuh-pee) An examination of the inside of the colon using a colonoscope, inserted into 

the rectum. A colonoscope is a thin, tube-like instrument with a light and lens 

for viewing. It may also have a tool to remove tissue to be checked under a 

microscope for disease.

Computed tomography (tuh-MOG-ruhfee) (CT or CAT) scan The patient lies on a table and x-rays of the body are taken from different 

angles. Sometimes, a fluid is used to highlight parts of the body in the scan.

Echocardiography (ek-oh-kar-dee-OGruh-fee)

An instrument (that looks like a microphone) is placed on the chest. It uses 

sound waves to create a moving picture of the heart. A picture appears on a TV 

monitor, and the heart can be seen in different ways. 

Electrocardiography (ih-lek-troh-kar-deeOG-ruh-fee) (ECG or EKG)A test that records the electrical activity of the heart, using electrodes placed 

on the arms, legs, and chest.

Electroencephalography (ih-lek-troh-ensef-uhl-OG-ruh-fee) (EEG)A test that measures the electrical activity of the brain, using electrodes that 

are put on the patient’s scalp. Sometimes patients sleep during the test.

Exercise stress test Electrodes are placed on the chest, arms, and legs to record the heart’s activity. A blood pressure cuff is placed around the arm and is inflated every few 

minutes. Heart rate and blood pressure are taken before exercise starts. The 

patient walks on a treadmill or pedals a stationary bicycle. The pace of the 

treadmill is increased. The response of the heart is monitored. The test continues until target heart rate is reached. Monitoring continues after exercise for 

10 to 15 minutes or until the heart rate returns to normal.

Fecal occult blood test (FOBT) Detects hidden blood in a bowel movement. There are two types: the smear 

test and flushable reagent pads.
Appendix 415

Common Screening and Diagnostic Tests Explained

Test name Definition

Laparoscopy (lap-uh-ROSS-kuh-pee) A small tube with a camera is inserted into the abdomen through a small cut 

in or just below the belly button to see inside the abdomen and pelvis. Other 

instruments can be inserted in the small cut as well. It is used for both diagnosing and treating problems inside the abdomen.

Magnetic resonance imaging (MRI) A test that uses powerful magnets and radio waves to create a picture of the 

inside of your body without surgery. The patient lies on a table that slides into 

a large tunnel-like tube, which is surrounded by a scanner. Small coils may be 

placed around your head, arm, leg, or other areas. 

Mammogram X-rays of the breast taken by resting one breast at a time on a flat surface that 

contains an x-ray plate. A device presses firmly against the breast. An x-ray is 

taken to show a picture of the breast. Mammography is used to screen healthy 

women for signs of breast cancer. It can also be used to evaluate a woman 

who has symptoms of disease. It can, in some cases, detect breast cancers 

before you can feel them with your fingers.

Medical history The doctor or nurse talks to the patient about current and past illnesses, 

surgeries, pregnancies, medications, allergies, use of alternative therapies, 

vitamins and supplements, diet, alcohol and drug use, physical activity, and 

family history of diseases.

Pap test The nurse or doctor uses a small brush to take cells from the cervix (opening of 

the uterus) to look at under a microscope in a lab.

Pelvic exam A doctor or nurse asks about the patient’s health and looks at the vaginal 

area. The doctor or nurse checks the fallopian tubes, ovaries, and uterus by 

putting two gloved fingers inside the vagina. With the other hand, the doctor or 

nurse will feel from the outside for any lumps or tenderness.

Physical exam The doctor or nurse will test for diseases, assess your risk of future medical 

problems, encourage a healthy lifestyle, and update your vaccinations.

Positron emission tomography (POZih-tron ih-MISH-uhn tuh-MOG-ruh-fee) 

(PET) scan

The patient is injected with a radioactive substance, such as glucose. A scanner detects any cancerous areas in the body. Cancerous tissue absorbs more 

of the substance and looks brighter in images than normal tissue. 

Sigmoidoscopy (SIG-moi-DOSS-kuh-pee) The sigmoidoscope is a small camera attached to a flexible tube. This tube, 

about 20 inches long, is gently inserted into the colon. As the tube is slowly 

removed, the lining of the bowel is examined.

Spirometry (spuh-ROM-uh-tree) The patient breathes into a mouthpiece that is connected to an instrument 

called a spirometer. The spirometer records the amount and the rate of air 

that is breathed in and out over a specified time. It measures how well the 

lungs exhale.

Ultrasound A clear gel is put onto the skin over the area being examined. An instrument 

is then moved over that area. The machine sends out sound waves, which 

reflect off the body. A computer receives these waves and uses them to create 

pictures of the body. 

Note: Anesthesia (medicine to block pain or sedate you) is given during some of these tests to keep you comfortable. Be sure 

to talk with your doctor or nurse about what to expect during and after tests, and how to prepare for tests.
416 The Healthy Woman: A Complete Guide for All Ages

General Screenings and Immunizations for Women

These charts are guidelines only. Your doctor will personalize the timing of each test 

and immunization to meet your health care needs.

Screening tests Ages 18–39 Ages 40–49 Ages 50–64 Ages 65 and older

General health:

Full checkup, including weight and height

Discuss with your doctor or nurse.Discuss with your doctor or nurse.Discuss with your doctor or nurse.Discuss with your doctor or nurse.

Thyroid test (TSH) Start at age 35, then 

every 5 years

Every 5 years Every 5 years Every 5 years

Heart health:

Blood pressure test

At least every 2 years At least every 2 years At least every 2 years At least every 2 years

Cholesterol test Start at age 20, discuss with your doctor 

or nurse.

Discuss with your doctor or nurse.Discuss with your doctor or nurse.Discuss with your doctor or nurse.

Bone health:

Bone mineral density 

test

Discuss with your doctor or nurse.Discuss with your doctor or nurse.Get a bone mineral 

density test at least 

once. Talk to your 

doctor or nurse about 

repeat testing.

Diabetes:

Blood glucose test

Discuss with your doctor or nurse.Start at age 45, then 

every 3 years

Every 3 years Every 3 years

Breast health:

Mammogram (x-ray of 

breast)

Every 1–2 years. Discuss with your doctor 

or nurse.

Every 1–2 years. Discuss with your doctor 

or nurse.

Every 1–2 years. Discuss with your doctor 

or nurse.

Reproductive health:

Pap test and pelvic 

exam

Every 1–3 years if 

you have been sexually active or are older 

than 21

Every 1–3 years Every 1–3 years Discuss with your doctor or nurse.

Chlamydia test Yearly until age 25 if 

sexually active. Older 

than age 25, get this 

test if you have new or 

multiple partners.

Get this test if you 

have new or multiple 

partners.

Get this test if you 

have new or multiple 

partners.

Get this test if you 

have new or multiple 

partners.

Sexually transmitted 

infection (STI) tests

Both partners should 

get tested for STIs, 

including HIV, before 

initiating sexual 

intercourse.

Both partners should 

get tested for STIs, 

including HIV, before 

initiating sexual 

intercourse.

Both partners should 

get tested for STIs, 

including HIV, before 

initiating sexual 

intercourse.

Both partners should 

get tested for STIs, 

including HIV, before 

initiating sexual 

intercourse.

Mental health 

screening

Discuss with your 

doctor or nurse.

Discuss with your 

doctor or nurse.

Discuss with your 

doctor or nurse.

Discuss with your 

doctor or nurse.

Colorectal health:

Fecal occult blood test

Yearly Yearly

Flexible sigmoidoscopy (with fecal occult 

blood test is preferred)

Every 5 years (if not 

having a colonoscopy)

Every 5 years (if not 

having a colonoscopy)

This chart lists recommended screenings and immunizations for women at average risk for most diseases. Citations for these 

recommendations can be found online at www.womenshealth.gov/screeningcharts/general/citations.cfm.
Appendix 417

General Screenings and Immunizations for Women

These charts are guidelines only. Your doctor will personalize the timing of each test 

and immunization to meet your health care needs.

Screening tests Ages 18–39 Ages 40–49 Ages 50–64 Ages 65 and older

Colorectal health 

(continued):

Double contrast barium enema (DCBE)

Every 5–10 years (if not 

having a colonoscopy 

or sigmoidoscopy)

Every 5–10 years (if not 

having a colonoscopy 

or sigmoidoscopy)

Colonoscopy Every 10 years Every 10 years

Rectal exam Discuss with your doctor or nurse.Discuss with your doctor or nurse.Every 5–10 years with 

each screening (sigmoidoscopy, colonoscopy, or DCBE)

Every 5–10 years with 

each screening (sigmoidoscopy, colonoscopy, or DCBE)

Eye and ear health:

Complete eye exam

At least once between 

the ages 20 and 29 

and at least twice 

between the ages 30 

and 39, or any time you 

have a problem with 

your eye(s)

Every 2–4 years Every 2–4 years Every 1–2 years

Hearing test Starting at age 18, 

then every 10 years

Every 10 years Every 3 years Every 3 years

Skin health:

Mole exam

Monthly mole selfexam; by a doctor 

every 3 years, starting 

at age 20

Monthly mole selfexam; by a doctor 

every year

Monthly mole selfexam; by a doctor 

every year

Monthly mole selfexam; by a doctor 

every year

Oral health:

Dental exam

One to two times every 

year

One to two times every 

year

One to two times every 

year

One to two times every 

year

Immunizations:

Influenza vaccine

Discuss with your doctor or nurse.Discuss with your doctor or nurse.Yearly Yearly

Pneumococcal vaccine One time only

Tetanus-diphtheria 

booster vaccine

Every 10 years Every 10 years Every 10 years Every 10 years

Human papillomavirus 

(HPV) vaccine

Up to age 26, discuss 

with your doctor or 

nurse.

Meningococcal 

vaccine

Discuss with your doctor or nurse if attending college.

Herpes zoster vaccine 

(to prevent shingles)

Starting at age 60, 

one time only. Ask your 

doctor if it is okay to 

get it.

Starting at age 60, 

one time only. Ask your 

doctor if it is okay to 

get it.

This chart lists recommended screenings and immunizations for women at average risk for most diseases. Citations for these 

recommendations can be found online at www.womenshealth.gov/screeningcharts/general/citations.cfm.
418 The Healthy Woman: A Complete Guide for All Ages

Recommended Screenings, Tests, and Immunizations 

for Women With High Risk Factors in the Family

This chart lists screenings, tests, or exams you might need more often or earlier because of having high risk factors or things in 

your life that increase your chances of developing a condition or disease. Citations for these recommendations can be found 

online at www.womenshealth.gov/screeningcharts/highrisk/citations.cfm.

✔ if it 

applies

Does your family history include? Then ask your doctor or nurse if you need the following screenings, tests, exams, or vaccines more often 

or at a younger age:

High blood pressure Blood pressure test

High cholesterol Cholesterol test

Heart disease, premature heart disease, or heart 

attack

Blood pressure test, cholesterol test, exercise stress 

test 

Diabetes Blood glucose test

Breast cancer Mammogram, ovarian cancer tests

Endometrial cancer Colon screening

Ovarian cancer Pelvic exam, ovarian cancer tests, colon screening, 

clinical breast exam

Osteoporosis, bone fracture in adulthood Bone mineral density test

Thyroid disease or thyroid cancer Thyroid test and/or genetic counseling

Gum (periodontal) disease Oral exam

Hearing problems, deafness Hearing test

Vision problems, eye disease, blindness Vision exam

Inflammatory bowel disease; colon polyps; colon, 

ovarian, or endometrial cancer

Colonoscopy, sigmoidoscopy, double contrast barium 

enema, rectal exam, fecal occult blood test, Pap test, 

pelvic exam, ovarian cancer tests

Cancer, heart disease, or any illness at an unusually 

young age (50 or younger)

Genetic counseling, possible early screening tests

Two relatives with the same kind of cancer Genetic counseling, possible early screening tests

Birth defects or genetic disorder (you or your partner) Genetic counseling, possible early screening tests. If 

you want to become pregnant, genetic counseling for 

you and your partner.
Appendix 419

Recommended Screenings, Tests, and Immunizations 

for Women With High Individual Risk Factors

✔ if it 

applies

Are you? Then ask your doctor or nurse if you need the following screenings, tests, exams, or vaccines more 

often or at a younger age:

African American Blood pressure test, cholesterol test, blood glucose 

test, vision exam, colonoscopy, genetic counseling for 

sickle cell anemia

Latina Blood pressure test, cholesterol test, blood glucose 

test, colonoscopy

Alaska Native or Pacific Islander Blood glucose test, pneumococcal vaccine

American Indian Blood glucose test, pneumococcal vaccine

Ashkenazi Jewish descent Genetic counseling for Tay-Sachs disease, if you want 

to become pregnant

Ashkenazi Jewish descent with family history of breast 

or ovarian cancer

Genetic counseling for possible BRCA1/2 mutation

Asian American Blood glucose test

Age 65 or older Bone mineral density test, flu vaccine, pneumococcal 

vaccine

Between the ages of 60 and 64, weigh less than 154 

lbs, and not taking estrogen

Bone mineral density test

College age MMR vaccine, varicella vaccine, human papillomavirus (HPV) vaccine, meningococcal vaccine

Postmenopausal Bone mineral density test

Pregnant Blood pressure test, blood glucose test, urine test, 

HIV test, STI tests, MMR vaccine, hepatitis B antigen 

test

A nonpregnant woman of childbearing age MMR vaccine, varicella vaccine

A smoker Blood pressure test, cholesterol test, bone mineral 

density test, oral exam, vision exam

Overweight Blood pressure test, blood glucose test, weight

Living in prison Tuberculosis (TB) test, HIV test, STI tests, hepatitis A, 

B vaccines

Living in long-term care TB test, influenza vaccine, pneumococcal vaccine

A health care worker TB test, influenza vaccine, pneumococcal vaccine, 

MMR vaccine, varicella vaccine, HIV test, hepatitis 

test, hepatitis B vaccine if exposed to blood

This chart lists screenings, tests, or exams you might need more often or earlier because of having high risk factors or things in 

your life that increase your chances of developing a condition or disease. Citations for these recommendations can be found 

online at www.womenshealth.gov/screeningcharts/highrisk/citations.cfm.

MMR: measles, mumps, and rubella

STI: sexually transmitted infections
420 The Healthy Woman: A Complete Guide for All Ages

Recommended Screenings, Tests, and Immunizations 

for Women With High Individual Risk Factors

✔ if it 

applies

Do you have or have you had? Then ask your doctor or nurse if you need the following screenings, tests, exams, or vaccines more 

often or at a younger age:

High blood pressure Blood pressure test, cholesterol test, blood glucose 

test

High cholesterol Blood pressure test, cholesterol test, blood glocose 

test

Heart disease Blood pressure test, cholesterol test, blood glucose 

test, influenza vaccine, pneumococcal vaccine

Diabetes Blood pressure test, cholesterol test, blood glucose 

test, vision exam, urine test

Gestational diabetes (diabetes during pregnancy) Blood glucose test

A baby weighing more than 9 lbs Blood glucose test

Breast cancer Mammogram, ovarian cancer tests

Dense breast Digital mammogram, clinical breast exam

Cervical, uterine, endometrial, vaginal cancer Pap test, pelvic exam, ovarian cancer tests, colon 

screening

Ovarian cancer Pelvic exam, ovarian cancer tests, mammogram, 

colon screening

Previous abnormal Pap tests Pap test, pelvic exam, human papillomavirus (HPV) 

vaccine

Early menopause (natural or surgically induced); absent 

or infrequent menstrual periods; advanced age; a personal history of bone fracture in adulthood; lifelong low 

calcium intake; lifelong inactive lifestyle or little physical activity; low body weight (less than 154 lbs), or a 

history of an eating disorder such as anorexia nervosa

Bone mineral density test

An autoimmune disease (including lupus, rheumatoid 

arthritis, scleroderma, multiple sclerosis, psoriasis)

Thyroid test, TB test, influenza shot, MMR vaccine, 

pneumococcal vaccine, autoimmune screening test, 

bone mineral density test

This chart lists screenings, tests, or exams you might need more often or earlier because of having high risk factors or things in 

your life that increase your chances of developing a condition or disease. Citations for these recommendations can be found 

online at www.womenshealth.gov/screeningcharts/highrisk/citations.cfm.
Appendix 421

Recommended Screenings, Tests, and Immunizations 

for Women With High Individual Risk Factors

✔ if it 

applies

Do you have or have you had? Then ask your doctor or nurse if you need the following screenings, tests, exams, or vaccines more often 

or at a younger age:

Chronic lung disease Influenza vaccine, pneumococcal vaccine

Chronic liver disease Hepatitis A and B vaccines

Thyroid disease Thyroid test, influenza vaccine, pneumococcal vaccine, 

bone mineral density test (if hyperthyroid)

Gum (periodontal) disease Oral exam

Colon polyps; inflammatory bowel disease Colonoscopy

Colon cancer Endometrial cancer screening, colon cancer screening 

tests

A developmental delay Vision exam, hearing test 

Eye injury or disease Vision exam

Ear injury or prolonged exposure to loud noise Hearing test

HIV/AIDS Oral exam, vision exam, Pap test, pelvic exam, TB test, 

thyroid test, STI tests, influenza vaccine, pneumococcal vaccine, hepatitis screening, hepatitis A and B 

vaccines

A blood transfusion or solid organ transplant before 

1992

Hepatitis C test

Received clotting factor concentrates made before 

1987

Hepatitis C test

A blood transfusion before 1985 HIV test

Multiple sex partners (or a partner who has or had multiple sex partners)STI tests, HIV test, hepatitis B vaccine, Pap test, pelvic 

exam, human papillomavirus (HPV) vaccine

Alcoholism Pneumococcal vaccine, TB test, psychological screening, liver tests

Injection drug use (IDU) or addiction Hepatitis A and B vaccines, hepatitis C test, TB test, 

STI tests, HIV test, psychological screening

A sexually transmitted infection (STI) STI tests, HIV test, Pap test, pelvic exam, hepatitis B 

vaccine, HPV vaccine

Lived or worked with someone exposed to tuberculosis 

(TB)

TB test

A serious injury (cut or laceration) Tetanus-diphtheria booster vaccine

A baby recently (within the past few weeks or months) Postpartum depression screening

This chart lists screenings, tests, or exams you might need more often or earlier because of having high risk factors or things in 

your life that increase your chances of developing a condition or disease. Citations for these recommendations can be found online at www.womenshealth.gov/screeningcharts/highrisk/citations.cfm.
 
Health Resources for Women and Families
424 The Healthy Woman: A Complete Guide for All Ages

Health Resources for Women

General health

womenshealth.gov

200 Independence Ave SW, Room 712E

Washington, DC 20201

Web site: www.womenshealth.gov

Illnesses and Disabilities: 

www.womenshealth.gov/wwd

Phone number: (800) 994-9662, 

(888) 220-5446 TDD

Agency for Healthcare Research and 

Quality Clearinghouse

PO Box 8547

Silver Spring, MD 20907

Web site: www.ahrq.gov/research/

womenix.htm

Phone number: (800) 358-9295, 

(888) 586-6340 TDD

ClinicalTrials.gov

ClinicalTrials.gov is a registry of clinical 

trials. The Web site gives you information 

about a trial’s purpose, who may participate, locations, and phone numbers for 

more details.

Web site: www.clinicaltrials.gov

Health Resources and Services 

Administration Information Center

PO Box 2910

Merrifield, VA 22116

Web site: www.hrsa.gov/WomensHealth

Phone number: (888) 275-4772, 

(877) 489-4772 TTY

Indian Health Service

801 Thompson Ave, Suite 400

Rockville, MD 20852-1627

Web site: www.ihs.gov/MedicalPrograms/

MCH/W

MedlinePlus

MedlinePlus provides health information 

from the National Institutes of Health and 

other trusted sources. The Web site also 

has a medical encyclopedia, information 

on prescription and nonprescription drugs, 

and the latest health news.

Web site: www.medlineplus.gov

National Institutes of Health

9000 Rockville Pike

Bethesda, MD 20892

Web site: www.nih.gov

Office of Minority Health Resource 

Center

PO Box 37337

Washington, DC 20013-7337

Web site: www.omhrc.gov

Phone number: (800) 444-6472

Office of Research on Women’s Health, 

NIH

6707 Democracy Blvd, Suite 400

Bethesda, MD 20892-5484 

Web site: http://orwh.od.nih.gov

Phone number: (301) 402-1770
Appendix 425

Office of Women’s Health, CDC

1600 Clifton Rd, MS E-89

Atlanta, GA 30333

Web site: www.cdc.gov/women

Phone number: (800) 232-4636, (888) 

232-6348 TTY

Office of Women’s Health, FDA

5600 Fishers Ln

Rockville, MD 20857

Web site: www.fda.gov/womens

Phone number: (888) 463-6332

American Academy of Family 

Physicians

PO Box 11210

Shawnee Mission, KS 66207-1210

Web site: www.familydoctor.org

American College of Obstetricians and 

Gynecologists

409 12th St SW, PO Box 96920

Washington, DC 20090-6920

Web site: www.acog.org

Phone number: (202) 863-2518 

Resource Center

American Medical Women’s Association

100 N 20th St, 4th Floor

Philadelphia, PA 19103

Web site: www.amwa-doc.org

Black Women’s Health Imperative

1420 K St NW, Suite 1000

Washington, DC 20005

Web site: www.blackwomenshealth.org

National Alliance for Hispanic Health

1501 16th St NW

Washington, DC 20036

Web site: www.hispanichealth.org

National Asian Women’s Health 

Organization

1 Embarcadero Center, Suite 500

San Francisco, CA 94111

Web site: www.nawho.org

National Women’s Health Network

514 10th St NW, Suite 400

Washington, DC 20004

Web site: www.nwhn.org

Phone number: (202) 628-7814

National Women’s Health Resource 

Center

157 Broad St, Suite 106

Red Bank, NJ 07701

Web site: www.healthywomen.org

Phone number: (877) 986-9472

Society for Women’s Health Research

1025 Connecticut Ave NW, Suite 701

Washington, DC 20036

Web site: www.womenshealthresearch.org
426 The Healthy Woman: A Complete Guide for All Ages

Disease Risk Calculators

Heart Attack/Coronary Heart Disease risk assessment tool

On this Web site, find out if you are at risk of having a heart attack or dying of coronary heart disease in the next 10 years. You can also check to see if you may have a 

group of risk factors that increase your chances of developing heart disease, stroke, 

and diabetes.

Web site: www.americanheart.org/presenter.jhtml?identifier=3003499

Your disease risk

This Web site allows you to find out your risk of developing cancer, diabetes, heart 

disease, osteoporosis, and stroke. You can also get personalized tips for preventing 

these diseases.

Web site: www.yourdiseaserisk.wustl.edu

Assess your risk of periodontal disease

Find out on this Web site if you are at risk of developing periodontal, or gum, 

diseases.

Web site: www.perio.org/consumer/4a.html
Appendix 427

Health Resources for Men

General health

Men’s Health, womenshealth.gov

200 Independence Ave SW, Room 712E

Washington, DC 20201

Web site: www.womenshealth.gov/mens 

Phone number: (800) 994-9662, 

(888) 220-5446 TDD

U.S. Department of Health and Human 

Services

200 Independence Ave SW

Washington, DC 20201

Web site: www.hhs.gov/

specificpopulations

Divisions of HIV/AIDS Prevention, CDC

1600 Clifton Rd NE

Atlanta, GA 30333

Web site: www.cdc.gov/hiv

Phone number: (800) 232-4636, 

(888) 232-6348 TTY

Healthfinder®

PO Box 1133

Washington, DC 20013-1133

Web site: www.healthfinder.gov/justforyou

MedlinePlus

8600 Rockville Pike

Bethesda, MD 20894

Web site: www.nlm.nih.gov/

medlineplus/men.html

Men’s Health, CDC

1600 Clifton Rd NE 

Atlanta, GA 30333

Web site: www.cdc.gov/men

Phone number: (800) 232-4636, 

(888) 232-6348 TTY

Men’s Health Program, AHRQ

PO Box 8547

Silver Spring, MD 2090

Web site: www.ahrq.gov/path/

menpath.htm 

Phone number: (800) 358-9295, 

(888) 586-6340 TDD

Promoting Responsible Fatherhood, HHS

200 Independence Ave SW

Washington, DC 20201

Web site: www.fatherhood.hhs.gov

Men’s Health Network

PO Box 75972

Washington, DC 20013

Web site: www.menshealthnetwork.org
428 The Healthy Woman: A Complete Guide for All Ages

Heart health

National Heart, Lung, and Blood Institute 

Information Center, NIH

PO Box 30105

Bethesda, MD 20824-0105

Web site: www.nhlbi.nih.gov

Phone number: (301) 592-8573, 

(240) 629-3255 TTY

American Heart Association

7272 Greenville Ave

Dallas, TX 75231

Web site: www.americanheart.org

Phone number: (800) 242-8721

Cancer

National Cancer Institute, NIH

6116 Executive Blvd, Room 3036A

Bethesda, MD 20892-8322 

Web site: www.cancer.gov 

Phone number: (800) 422-6237, 

(800) 332-8615 TTY

American Cancer Society

250 Williams St

Atlanta, GA 30303

Web site: www.cancer.org 

Phone number: (800) 227-2345, 

(866) 228-4327 TTY

Mental health

National Clearinghouse for Alcohol and 

Drug Information, SAMHSA

1 Choke Cherry Rd

Rockville, MD 20857

Web site: www.ncadi.samhsa.gov

Phone number: (800) 729-6686, 

(800) 487-4889 TDD

National Institute of Mental Health, NIH

6001 Executive Blvd, Room 8184, 

MSC 9663

Bethesda, MD 20892-9663

Web site: www.nimh.nih.gov 

Phone number: (866) 615-6464, 

(866) 415-8051 TTY

National Mental Health Information 

Center, SAMHSA

PO Box 42557

Washington, DC 20015

Web site: http://mentalhealth.samhsa.gov

Phone number: (800) 789-2647, 

(866) 889-2647 TDD

Urologic and reproductive health

National Kidney and Urologic Diseases 

Information Clearinghouse, NIH

3 Information Way

Bethesda, MD 20892-3580

Web site: www.kidney.niddk.nih.gov 

Phone number: (800) 891-5390
Appendix 429

Health Resources for Children 

General health

girlshealth.gov

200 Independence Ave SW, Room 712E

Washington, DC 20201

Web site: www.girlshealth.gov

Phone number: (800) 994-9662, 

(888) 220-5446 TDD

Building Blocks for a Healthy Future, 

SAMHSA

1 Choke Cherry Rd

Rockville, MD 20857

Web site: www.bblocks.samhsa.gov

Phone number: (800) 694–4747 ext.4820

Child and Adolescent Health, AHRQ

PO Box 8547

Silver Spring, MD 20907

Web site: www.ahrq.gov/child

Phone number: (800) 358-9295, 

(888) 586-6340 TDD

U.S. Department of Health and Human 

Services

200 Independence Ave SW

Washington, DC 20201

Web site: www.hhs.gov/ 

specificpopulations

Family Guide to Keeping Youth Mentally 

Healthy and Drug Free, SAMHSA

1 Choke Cherry Rd

Rockville, MD 20857

Web site: www.family.samhsa.gov 

Food and Drug Administration Kid’s Page

5600 Fishers Ln

Rockville, MD 20857

Web site: www.fda.gov/oc/opacom/kids/

default.htm 

Phone number: (888) 463-6332

Girl Power! Campaign

Web site: www.girlpower.gov 

Phone number: (800) 729-6686

MedlinePlus

8600 Rockville Pike

Bethesda, MD 20894

Web site: www.nlm.nih.gov/ 

medlineplus/childrenandteenagers.html 

My Bright Future: Physical Activity and 

Healthy Eating for Young Women, HRSA

PO Box 2910

Merrifield, VA 22116

Web site: www.hrsa.gov/womenshealth/

mybrightfuture/menu.html 

Phone number: (888) 275-4772, 

(877) 489-4772 TTY
430 The Healthy Woman: A Complete Guide for All Ages

Safe and Healthy Kids, CDC

1600 Clifton Rd, MS E-89 

Atlanta, GA 30333

Web site: www.cdc.gov/women/kids

Phone number: (800) 232-4636, 

(888) 232-6348 TTY

VERBTM It’s What You Do, CDC

1600 Clifton Rd

Atlanta, GA 30333

Web site: www.verbnow.com

Phone number: (800) 232-4636, 

(888) 232-6348 TTY

WISE EARS!®, NIH

1 Communication Ave

Bethesda, MD 20892-3456 

Web site: www.nidcd.nih.gov/health/wise

Phone number: (800) 241-1044, 

(800) 241-1055 TTY

American Academy of Pediatrics

141 Northwest Point Blvd

Elk Grove Village, IL 60007

Web site: www.aap.org 

Kidshealth.org

Web site: www.kidshealth.org 

Child abuse

Prevent Child Abuse America

500 N Michigan Ave, Suite 200 

Chicago, IL 60611

Web site: www.preventchildabuse.org 

Phone number: (800) 244-5373

Cancer

National Cancer Institute, NIH

6116 Executive Blvd, Room 3036A

Bethesda, MD 20892-8322 

Web site: www.cancer.gov 

Phone number: (800) 422-6237, 

(800) 332-8615 TTY

Childhood asthma

American Lung Association 

61 Broadway, 6th Floor

New York, NY 10006

Web site: www.lungusa.org

Phone number: (800) 548-8252

Childhood diabetes

National Diabetes Information 

Clearinghouse, NIH

1 Information Way 

Bethesda, MD 20892-3560

Web site: www.diabetes.niddk.nih.gov 

Phone number: (800) 860-8747

American Diabetes Association

1701 N Beauregard St

Alexandria, VA 22311

Web site: www.diabetes.org 

Phone number: (800) 342-2383

Immunizations

National Center for Immunization and 

Respiratory Diseases, CDC

1600 Clifton Rd NE, MS E-05

Atlanta, GA 30333

Web site: www.cdc.gov/vaccines

Phone number: (800) 232-4636, 

(888) 232-6348 TTY

Childhood Immunization Support 

Program, AAP

141 Northwest Point Blvd

Elk Grove Village, IL 60007

Web site: www.cispimmunize.org 

Immunization Action Coalition

1573 Selby Ave, Suite 234

St Paul, MN 55104

Web site: www.immunize.org 
Appendix 431

Child nutrition

Powerful Bones. Powerful Girls.

200 Independence Ave SW, Room 712E

Washington, DC 20201

Web site: www.girlshealth.gov/bones

Phone number: (800) 994-9662, 

(888) 220-5446 TDD

School Meals, USDA

3101 Park Center Dr

Alexandria, VA 22302

Web site: www.fns.usda.gov/cnd

Safety and injury prevention

U.S. Consumer Product Safety 

Commission 

4330 East West Highway

Bethesda, MD 20814

Web site: www.cpsc.gov

Phone number: (800) 638-2772, (800) 

638-8270 TTY

National Center for Injury Prevention and 

Control, CDC

4770 Buford Highway NE, MS K-63

Atlanta, GA 30341-3717

Web site: www.cdc.gov/ncipc

Phone number: (800) 232-4636, 

(888) 232-6348 TTY

National Highway Traffic Safety 

Administration

1200 New Jersey Ave SE, West Building

Washington, DC 20590

Web site: www.nhtsa.gov 

Phone number: (888) 327-4236, 

(800) 424-9153 TTY

Take A Stand. Lend A Hand. Stop 

Bullying Now!, HRSA

PO Box 2910

Merrifield, VA 22116

Web site: www.stopbullyingnow.hrsa.gov

Phone number: (888) 275-4772, 

(877) 489-4772 TTY

Safe Kids Worldwide 

1301 Pennsylvania Ave NW, Suite 1000

Washington DC 20004

Web site: www.safekids.org
432 The Healthy Woman: A Complete Guide for All Ages

Resources for Health Insurance

Each year, more American families find 

themselves without health insurance. In 

2004, more than 45 million Americans 

didn’t have health insurance. Sixteen 

million of them were women. These programs and resources may be able to help 

you and your family.

Government resources that can 

help

The Centers for Medicare and Medicaid 

Services (CMS), a federal government 

agency, administers health insurance programs such as Medicare, Medicaid, and 

the State Children’s Health Insurance 

Program. 

Medicare

Medicare is a health insurance program 

funded by the U.S. government. To 

qualify for these benefits, you must be 

65 years old or older, or younger than 65 

with certain disabilities, or a person of 

any age who has end-stage renal disease. 

(A person who has end-stage renal disease has permanent kidney failure that 

requires dialysis or a kidney transplant.)

Medicare has several parts. Your coverage depends on which parts of Medicare 

you have. Medicare Part A typically pays 

for your inpatient hospital expenses. 

Medicare Part B typically pays for your 

outpatient health care expenses, including doctor fees. You usually have to pay 

a monthly premium to be covered by 

Medicare Part B. 

Beginning January 1, 2006, everyone 

who has Medicare is now eligible for 

prescription drug coverage through the 

new Medicare Part D. This coverage is 

available regardless of your income and 

resources, your health status, or how 

much your prescriptions cost. It covers 

both brand-name and generic prescription drugs at participating pharmacies 

in your area. Medicare prescription drug 

coverage provides protection for people 

who have very high drug costs. 

For general information, 24 hours a day, 

7 days a week, 

l Call toll free at (800) MEDICARE 

(800-633-4227) or TTY (877) 486-

2048.

l Web site: www.cms.hhs.gov/home/

medicare.asp

l Web site: The Official U.S. Government Site for People with Medicare: 

www.medicare.gov 

If you have a limited income and resources, you may be eligible for extra 

help with your prescription drug costs. 

Almost 1 in 3 people with Medicare 
Appendix 433

qualify for having almost all of their 

prescription drug costs paid for by the 

program. To find out if you are eligible 

for extra help, contact the Social Security 

Administration.

l Call the U.S. Social Security Administration toll free at (800) 772-1213 

(TTY 800-325-0778).

l Web site: www.socialsecurity.gov

Medicaid 

Medicaid is a health insurance program 

jointly funded by states, counties, and 

the U.S. government. Medicaid provides 

medical benefits to groups of lowincome people that meet certain age, income, and resource requirements. People 

who have certain medical conditions 

such as blindness or who are pregnant 

may also qualify. Whether a person is eligible for Medicaid depends on the state 

where he or she lives.

In general, you should apply for Medicaid if your income is low and you or 

someone in your family needs health 

care. A qualified caseworker in your state 

can give you guidance about your situation. Your child may be eligible for coverage, even if you are not. 

To find out more about Medicaid in 

your state,

l Call the toll free number for your 

state. A list of toll free numbers is on 

the CMS Web site at www.cms.hhs.

gov/medicaid/consumer.asp.

State Children’s Health Insurance Program 

(SCHIP) 

Like Medicaid, the State Children’s 

Health Insurance Program (SCHIP) is a 

partnership between the federal government and the states. SCHIP is designed 

to provide health insurance coverage to 

specific groups of low-income children. 

Families who earn too much money to 

be eligible for Medicaid but not enough 

money to purchase private health insurance may be eligible to get health insurance for their children. 

Each state determines how its program 

is designed, who is eligible, what the 

benefits are, how costs are shared, and 

other features. For little or no cost, this 

insurance pays for children’s doctor visits, immunizations, hospitalizations, and 

emergency room visits.

For more information about SCHIP, go 

to www.cms.hhs.gov/home/schip.asp.

To learn whom you should contact in 

your state or to read specific information 

about eligibility in your state, go to Insure 

Kids Now at www.insurekidsnow.gov.
434 The Healthy Woman: A Complete Guide for All Ages

Other government programs and benefits

To learn about the government benefits 

you may be entitled to,

l Call toll free (800) FED-INFO 

(800-333-4636). Calls are answered 

Monday through Friday, 8 am to 8 pm, 

Eastern Standard Time.

l Web site: www.govbenefits.gov

Other public government and 

private resources that can help

For women who make too much money 

to qualify for these federal and state 

programs but who can’t afford to pay for 

health insurance or costly health services, 

the choices are limited and difficult. 

Public and private resources may be able 

to help.

l “Safety-net” facilities. Community health centers, public hospitals, 

school-based centers, public housing 

primary care, and special-need facilities. Contact your local or state health 

department for more information or 

go to ask.hrsa.gov/pc.

l Free clinics. Free clinics provide 

health care services for the uninsured. 

l Prescription drug assistance. Some 

states provide prescription drug 

assistance to women who cannot 

get Medicaid. Many drug companies 

will work with your doctor to provide 

free medicines to those in need. A 

list of resources can be found at 

www.disabilityresources.org/RX.html.

l Women with cancer. Women with 

cancer can find help through a variety of government-sponsored and 

volunteer organizations. For accurate, 

up-to-date information on cancer and 

resources for people dealing with cancer, go to the Web site of the National 

Cancer Institute (www.cancer.gov). 

You can also visit the Cancer Information Service of the National Cancer 

Institute on the Internet (http://cis.

nci.nih.gov). To get answers to specific 

questions about cancer, call (800) 4-

CANCER (800-422-6237), Monday 

through Friday, 9:00 am to 4:30 pm

to speak with a cancer information 

specialist. Deaf and hard-of-hearing 

callers with TTY equipment can call 

(800) 332-8615. 

l Women with HIV. The federal Ryan 

White CARE Act funds health care 

services for women with HIV/AIDS 

who do not have health insurance or 

the financial resources to pay for care. 

To locate a CARE provider, contact 
Appendix 435

your local or state health department 

or call (800) 994-9662.

l Group health insurance. Some 

states and localities, labor unions, 

professional clubs, associations, and 

organizations offer low-cost group 

health insurance to their members. 

These plans usually cost less than individual insurance and can be worth 

considering.

l Temporary insurance. Some individuals who have been denied health 

insurance because of a medical condition may be able to obtain coverage 

through their state’s “risk pools.” More 

than 30 states provide this temporary 

insurance assistance. For more information, go to the Web site of the 

Health Insurance Resource Center at 

www.healthinsurance.org/risk_pools.

Protect your health insurance 

coverage

If you have health insurance, you should 

know how to protect that insurance 

coverage. If you are losing your health 

insurance because you have lost your job, 

have reduced hours at work, have gotten 

a divorce, or have had your spouse die, 

you have certain rights and protections. 

These rights are described in the Health 

Insurance Portability and Accountability 

Act of 1996, or HIPAA. 

Tips: What to do 

l Obtain proof that you had previous 

health insurance coverage from your 

employer.

l Apply for COBRA, which stands for 

the Consolidated Omnibus Budget 

Reconciliation Act of 1985. COBRA 

requires most employers that have 

20 or more employees to allow you 

to continue your health insurance for 

18 months, but you must pay the full 

premium cost of the insurance. Ask 

your employer’s human resources office 

about when and how you should apply 

for these benefits. 

l Consider your health insurance 

situation carefully before agreeing 

to certain terms and conditions. It is 

especially important to think about 

your health care needs when you are 

separated from your spouse, divorced, 

or are a retiree with annuities. 

l In a legal separation or divorce proceeding, you can get a court order 

to provide your children with health 

insurance under the health plan of the 

noncustodial parent. This act is called a 

qualified medical child support order.

l Act quickly to get the right information to protect you and your family. 

File any required forms promptly. 

Strict time limits often apply. 

For more information about HIPAA, 

l Call (866) 627-7748

l Web site: www.cms.hhs.gov/

HIPAAGenInfo

For more information on health insurance choices, go to the Web site of the 

Agency for Healthcare Research and 

Quality at www.ahrq.gov/consumer. n