The Importance of Preventative Care During COVID-19

What's keeping women from getting important health screenings? Surprisingly, there's an even bigger barrier than fear of the novel coronavirus.

shot of two young doctors having a video conference with a laptop in a hospital
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When Prevention, along with HealthyWomen and GCI Health, recently surveyed nearly 3,000 women about health care during the COVID-19 pandemic, we expected to hear that many of you back-burnered preventative care such as annual checkups and cancer screenings during the stay-at-home orders. In fact, in many states, you couldn't get an appointment even if you wanted to, as many hospitals, clinics, and medical and dental offices limited in-person visits during the height of the pandemic.

The results, as it turns out, weren’t quite what we expected. The encouraging news is that 57% of you have seen a health-care provider since March. And while many of you were understandably nervous about being exposed to the virus in a medical setting—and even more worried about passing it on to family members—only 14% of those who canceled appointments said they did so because of the pandemic (an additional 18% had their appointments canceled by their provider).

But the not-so-encouraging news is that the numbers of women who are getting screened regularly for life-threatening diseases are low—with or without a pandemic in the picture, says Wendy Lund, CEO of GCI Health. For example, just 24% of women say they regularly get mammograms, 20% get screened for heart disease, 18% for gynecological cancers, and 13% for skin cancer. Lund calls this the “female prevention knowledge gap,” and it can have serious repercussions for your health.

And even though this low-rate of screening was a problem before anyone ever uttered the phrase “COVID-19,” the pandemic has made it an even thornier issue. First of all, for those who did put off screenings over the last five months, that means there were five more months when a tumor could grow or depression could spiral or arteries could become clogged. Research has already shown that an alarming number of potentially curable cancers may have been missed in the first months of the pandemic: One large study of more than 190 hospitals found that in March, the first month of the shutdown, screenings for breast, colon, and cervical cancer were down as much as 94%; a study in August in the journal Oncology found that there was a 46% decrease in the number of new cancers diagnosed between March and April. “Preventative care matters all the time, not just during the pandemic,” says Lund, whose organization helped found a movement called #BeHealthiHer, to encourage women to prioritize their health and well-being. “You don’t want heart disease and cancer to go unchecked and then progress,” she says.

Fortunately, half of you have already made appointments to see your health care provider, and another 44% plan to go within the next few months (or as soon as you feel comfortable). Just 1.5% plan to wait until there is a vaccine.

Why you should put preventative care first

Whether it’s before, during, or after the current public health crisis, here’s why you should prioritize preventative care:

The earlier you catch disease, the better chance you have to be cured.

“Preventative care is a gift, because when disease is detected early, it minimizes the negative outcomes and gives you more treatment options,” says Marsha B. Henderson, the former associate commissioner for women’s health at the Food and Drug Administration and a board member of HealthyWomen. For example, when breast cancer is caught at its earliest, localized stage, there is a 99% survival rate over 5 years; by the time the cancer has spread to distant parts of the body such as the lungs and bones, however, that number drops to 27%.

It keeps you in fighting form during pandemics and other challenges.

“We know that people with compromised immune systems are at greater risk of more severe complications should they contract COVID-19, so it’s imperative that everyone knows their health status,” says Lund. Some of the conditions that the CDC says put you at higher risk for severe outcomes from COVID include obesity, type-2 diabetes, COPD, and coronary artery disease—so it is crucial to not only do your best to keep these conditions in check, but also to know whether you have them in the first place so you can take extra precautions during the pandemic.

Keeping your mind healthy is as important as keeping your body healthy.

With social isolation, stress over the economy and unemployment, and anger over the state of the world, it should come as no surprise that the mental health problems are on the rise. A recent study of more than 300,000 Americans found that they were three times as likely to have symptoms of depression and anxiety in March and April 2020 as they were at the same time last year. “Mental health screenings are so important," says Lund, who predicts there will be even more stress and anxiety among parents as we head into the new school year. "Women need to get help and support.” Henderson adds that many of the activities that keep our bodies healthy also help to relieve stress: “Whether it’s walking or gardening or wearing a mask, these things relieve stress and improve our mental health by giving us a sense of control at a time when so many other things are out of our control,” she says. "This is what will help get us through this pandemic until we have a vaccine.”

woman using laptop and having video call with her doctor while sitting at home
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      Breaking down the barriers to preventative care

      For the women in the survey who haven’t had any screenings or health visits since March, fear of infection was listed as a factor, but there were many other barriers to care that keep them from seeing a doctor even in the best of (non-pandemic) times. Here's what concerns you and what you can do to get the care you need:

      Lack of money and/or insurance

      The single biggest issue was money: 25% of those surveyed named the high cost of care or a lack of insurance coverage as their reason for skipping screenings—among Black women, the numbers were even higher, with 39% saying there were financial barriers to taking care of their health.

      What you can do: Beth Battaglino, R.N., the CEO of HealthyWomen, points out that the Affordable Care Act covers all the major preventative screenings, including mammograms every 1 to 2 years for women over 40, Pap smears every 3 years for women 21 to 65, HIV screenings for everyone 15 to 65, vaccines, depression screenings, recommended vaccines, and annual well-woman visits. (HealthyWomen is another founding supporter of the #BeHealthiHer campaign.) And Henderson encourages everyone with financial concerns to find their nearest Community or Migrant Health Center (type “find a health center” and then your zip code into Google, or call 877-464-4772). “These health centers are all over the country, in urban, suburban, and rural areas," she says. "They provide free or low-cost services on a sliding scale for preventative care—and your taxes have already paid for them.”

      Lack of time

      Finding a free morning to drive to the doctor’s office, sit in the waiting room paging through old magazines, and then get your mammogram, Pap smear, or even an eye or dental exam has always been a challenge, but now many of us are working longer hours at home while we simultaneously supervise our children’s virtual learning, and there just may not be enough hours in the day. Around 23% of women surveyed said they couldn’t find the time to see a doctor because they had other obligations, such as work and caring for family members.

      What you can do: There are certain health screenings you must do in person—mammogram, colonoscopy, and Pap smear, for example. But there are also many services and screenings that can be done via telemedicine, says Battaglino, who says the platform works particularly well for those managing chronic diseases or who need to update prescriptions. There are are even some added benefit to not being face-to-face, says Henderson. “One of my favorite things about telehealth is that it provides privacy,” she says. “Especially if you have problems with addiction, mental illness, or STDs, you may feel uncomfortable talking to a doctor in person, and telehealth can address a lot of those concerns.” The survey found that 42% of all women took advantage of telehealth services during the last four months (mainly for primary care consultations, mental health, and pregnancy or postpartum care), and not surprisingly, the younger they were, the more comfortable they were using a screen to talk to their doctor. For women under 24, 57% said they used telehealth during the pandemic, and 65% of those felt their care was as good as it would have been in person. Only 35% of women over 65 age took advantage of virtual medicine, with only 31% giving it the thumbs up. “The younger generation is high-tech, and the older generation is high-touch,” says Lund.

      Fear of getting COVID-19

      For the 14% who canceled appointments because of the pandemic, the fear of getting infected was very real. But women were not so much worried for themselves: Only 16% listed “I’m worried about getting the virus and getting sick” as one of their top mental health concerns; however, 17% said they were concerned about getting the virus and transmitting it to others, and 23% were up at night worrying about family members getting sick.

      What you can do: The greatest antidote to fear is knowledge. All three experts urged women to call the doctor’s office and ask whoever answers the phone to give a rundown of all the safety measures they are putting in place (and don’t worry about being called a “Karen”—politely asking for more information is always appropriate). “An aunt of mine who is high-risk recently had to go to the hospital for a screening, and I told her, ‘There’s no safer time to go into a hospital than right now,” says Battaglino. “The cleaning that’s going on is impeccable, everything is very stringent. They’re practicing social distancing, taking your temperature before you even walk in the door, you’re not going to be sitting in a waiting room with many other other people.”

      Fear of getting bad results

      Fear of COVID may be a new concern, but fear of the unknown has long kept may women from seeking out preventative screenings, says Henderson. “Often, something might be bothering you, but you think, If I don’t pursue this, maybe it will just go away, right? But the best thing to do is investigate it, because it’s an opportunity to calm your fears and minimize any potential negative outcomes.” And indeed, 9% of the women surveyed said they skipped screenings because “I’m scared what the results will be.”

      What you can do: Of course, the main incentive to check those screenings off your to-do list is to catch disease at the earliest stage possible so you can treat it and go on to to enjoy your life and take care of your family. But if it takes a little extra nudge to get you going, there's nothing wrong with that. Henderson is a firm believer in rewards—whether it’s getting extra whipped cream on your latte or treating yourself to a small gift. “I just made appointments for my physical, my eye exam, and my mammography in the next three weeks,” she explains. “I am always anxious about my mammogram, because I have a history of breast cancer in my family. I’ve found that I need something to motivate me, so I’ve already spotted the pair of earrings I’m going to buy to congratulate myself.”

      The BeHealthiHer Now campaign is encouraging women to focus on their immediate health and act now to make those important health appointments and screenings. Share when you’ve made yours on the #BeHealthiHer facebook page and challenge the women in your lives to do the same.


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