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Providers Must Engage Many Middle-Aged Female Patients Differently


Two years ago, a Harvard University study based on three decades of government data revealed that Americans are enjoying longer, healthier lives than ever before. Why, then, do current data show an increase in mortality among middle-aged white Americans, particularly among women?

Middle-Aged Women Are at Risk

Healthcare providers have been diligent in communicating with women about breast cancer, heart disease and a range of other health concerns. Unfortunately, patient engagement strategies appear to be missing—or perhaps missing the mark—when it comes to two major contributors to the growth in death rates among white, middle-aged women.

A Health Affairs blog reports that its own research, in 2013 and again this year, concur with the recently published Case and Deaton study: Suicides and accidental deaths due to abuse of prescribed opiates and their illegal counterpart, heroine, are pushing mortality higher within the middle-aged white demographic. “Furthermore,” Health Affairs says, “our own analysis of the same data used by Case and Deaton shows that the average increase in age-specific mortality rates for whites age 45-54 was more than three times higher for women than men.” In addition to suicide and addiction-related deaths, chronic diseases related to obesity and smoking have also been contributing factors in high mortality rates among white, middle aged women.

Pregnancy and Childbirth-Related Deaths Are on the Rise, Too

The analysis also noted increases in the death rate among “women of reproductive and childrearing ages, a finding that has huge implications for children, families and communities.” CNN reported on this issue just days ago, saying, “It's hard to comprehend how the United States, one of the wealthiest nations in the world, is now one of only eight countries—including Afghanistan and South Sudan—where the number of women dying as a result of pregnancy and childbirth is going up.” In fact, the rate has doubled since 1990. And the rising mortality rate due to pregnancy or childbirth complications isn’t just affecting white women. According to the latest data, black women are three times as likely to die from such complications. What are the root causes?

  • Obesity-related complications like hypertension and diabetes. Dr. Michael Brodman, chairman of the department of obstetrics, gynecology and reproductive science at the Mount Sinai Health System believes the problem may lie with improper protocols.  “We didn't treat [women with obesity-related health complications] differently,” said Brodman, “and in reality, you have to treat them differently.”
  • High numbers of cesarean section births. While the number of cesarean section births are going down, they reached an all-time high of 32.9 percent in 2009, and current statistics are still high. Hospitals need to continue to work on reducing the number of C-sections that are performed annually. 
  • Women choosing to have children later in life. While CDC data indicates that fewer than 15 percent of all births in the U.S. are to women aged 35 or older, they represent close to 30 percent of pregnancy-related deaths. According to a CDC spokesperson, studies have shown that an increasing number of these middle-aged women have chronic health conditions—hypertension, diabetes, chronic heart disease—and, noted the same spokesperson, “all these conditions can put a pregnant woman at higher risk of pregnancy complications.”

When interviewed by CNN, Dr. Brodman explained that looking deeper into the maternity mortality trend in New York, revealed variations in care for women that also contributed to the problem.

It’s a Wakeup Call for Healthcare Professionals

Findings such as these are a sharp reminder that healthcare providers must do more to provide women with better education and intervention to address mental health, misuse of legal and illegal drugs and health risks related to obesity. To develop effective patient engagement strategies that move the needle back down on mortality rates for women, however, hospitals and other healthcare providers need to look deeper than demographic factors like race, gender and age.

Psychographic segmentation is a powerful way for healthcare providers to deeply understand their patients and tailor interactions in a more productive way.  Psychographics pertain to patients’ beliefs, attitudes, values, personalities and lifestyles; segmenting patients according to these shared traits increases the likelihood of effective engagement and impact on population health, since it is not a one-size-fits-all approach.

Psychographic segmentation allows healthcare providers to create more relevant patient engagement tactics by clearly identifying unique barriers to behavior change, and to capitalize on motivation factors and communication preferences shared by distinct segments of the target audience.  While many female patients face the same health issues, what it takes to activate these patients towards positive health behaviors and better outcomes will differ.

Psychographic Segmentation and its Practical Application in Patient Engagement and Behavior Change


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