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Tips to Health & Wellness for Highly Committed Women

Sarah Van Orman, MD

On the never-ending list of priorities, women leaders generally put themselves last. Although they’re the ones colleagues, schools, family and friends rely upon, taking care of their own health is generally an afterthought.

As executive director of University Health Services at the University of Wisconsin-Madison, Sarah Van Orman, MD has seen the results of this in her practice. At the Women and Leadership Symposium held at the University of Wisconsin-Madison in July, she discussed the health and wellness of “high commitment” women from the perspective of a primary care provider, campus administrator and woman leader.

Before earning a medical degree from the Mayo Medical School MN and doing an internal medicine and pediatrics residency at the University of Chicago, Van Orman was a high school teacher.

As head of the University Health Services, she now sees the foundation for a lifetime of health or illness being created every day. “Personal health is made up of personal habits, the environment and genetics,” she said. “College is a time in life when people establish health habits that will affect their health 30 years from now.”

For people ages 10 to 24, the leading causes of death are unintentional injury, homicide, and suicide, with cancer coming in fourth. “As we move through our lives, some of the risk factors change radically and some stay the same,” said Van Orman.

Looking at risks over a lifetime, the big ones relate to heart attacks, stroke and cancer. Many of the habits that increase risks—such as alcohol consumption, diet and smoking—get either started or reinforced in college.

For women in their 20s, primary health issues are building bones, contraception, screening for cervical cancer and substance misuse/abuse. Two decades later, the emphasis changes to maintaining bone health, reproduction and modifying risks for cardiovascular disease and cancer.

As women age, at the forefront are menopause and sexuality, osteoporosis, cardiovascular disease and cancer. Depression and personal violence affect a woman’s health across her lifetime.

Sources of information about risks and prevention may negatively impact women’s health. A 2001 research study compared health articles in women’s magazines with women’s interests, women’s health risks and articles in medical journals. “Information in the magazines may lead women to focus on some aspects of health and health care that don’t reduce risk,” said Van Orman.

Many have turned to the Web for answers. The quality of the online information fluctuates from harmful to good, Van Orman said, recommending getting information from a trusted source and a trusted online site.

Role strain?

What are the effects of work on health? Does working outside the home make women healthier? The answer is complex and related to the concepts of “role strain” and “role enhancement.” Role strain is defined as having lots of responsibilities in a job with little upside. Role enhancement is the prestige and money that comes from work.

Women who work outside the home still handle most household and childcare responsibilities, spending as much as five to 10 hours a week more than men. The greatest discrepancies occur between ages 25 and 34.

Having children increases the risk of physical illness. Early return to work after delivery leads to poorer mental health in women; longer leaves improve mental health.

Overworked?

Administrators tend to have higher workloads. Overwork contributes to cardiovascular disease, as does stress, which can contribute to obesity. Stress hormones increase in women after 6 p.m. while decreasing in men.

Holding professional and managerial positions can affect mental stress. Job overload is tied to increased depression, anxiety and anger, and decreased self esteem.

It’s generally been thought that those with little control over their schedules are more stressed than those with more control. But highly educated women in professional positions experience more guilt than those in less professional positions having less control of their schedule.

“Depression and anxiety are not uncommon among high commitment women,” Van Orman said. Working part-time can be a solution.

 Women don’t want to quit working, so reducing health risks requires an ounce of prevention. Regular screenings for cardiovascular disease, diabetes and cancer can either help prevent disease or lead to more effective care. And screenings for high blood pressure and cholesterol along with the addition of aspirin (if your doctor agrees), weight loss and regular exercise can increase both lifespan and quality of life.

Hypertension or high blood pressure, one of the contributors to cardiovascular disease, is a silent killer of women. “We don’t often think of high blood pressure as a women’s problem,” said Van Orman.

American Heart Association data shows that rates are lower for women until about age 45, when they begin to equal men’s rates. After age 55, women are more likely to have high blood pressure than men are.

Another critical issue is bone health. New research on calcium and Vitamin D finds both useful in preventing osteoporosis, and Vitamin D may also play a role in preventing depression, diabetes, immune system dysfunction and even cancer.

Overweight?

Weight is a volatile issue. Some women expect no benefits unless they hit that “perfect” weight. But just a 10% drop lowers blood pressure, ameliorates fatigue and improves insulin resistance. “Losing only 10% of your weight results in drastic improvements in your health status,” said Van Orman. “Your weight loss goal should be health related, not what you want it to be.”

Weight loss strategies should focus on reducing calories by 500 to 1,000 per day. Control portions by eating four or five small meals to eliminate hunger while reducing caloric intake.

A 2008 report from the Center for Disease Control encourages adults to get at least 150 minutes a week of moderate aerobic exercise or 75 minutes a week of vigorous exercise. Exercise is the key to maintaining weight, but losing weight requires adjusting the diet.

Fasting, eating too much and/or skipping meals are some eating patterns that lead to eating disorders and disordered eating. Eating disorders don’t affect only college age women. High commitment women also experience anorexia and bulimia.

Depression peaks during the fourth decade and while most episodes eventually abate, there is a 90% rate of recurrence. “Some women feel that if you have depression and anxiety, you’re unusual,” said Van Orman. “But these issues are more common than women think.”

Sleep deprived?

When was the last time you slept eight hours in a row? The rate of adults in the United States sleeping less than seven hours per night has increased from 16 to 37% over the past 40 years. The National Sleep Foundation’s 2007 poll found that 52% of women are unable to sleep and 48% are unable to exercise because they’re either too sleepy or they run out of time. And 12% report sleep-related job performance issues.

“Lifestyle compromises are high when women are tired and run out of time,” said Van Orman. You know what gives first: sleep and exercise. Next to go are regular socialization with friends and family. And a whopping 44% report no time for sex.

At the greatest risk of sleep-related problems are married or partnered women who have school-aged children and work full time. These women are fortunate if they sleep six hours per night; 72% report significant incidences of insomnia. This group has the highest rate of drowsy driving at 35%.

No matter our responsibilities, we need eight hours of sleep per night. Less than four hours and more than 10 hours correlate with an increase in mortality.

Studies also link sleep deprivation to obesity, depression and accidents. To improve sleep habits, establish regular bed and wake-up times. Avoid nicotine and caffeine close to bedtime. Don’t rely on alcohol to induce sleep.

Schedule exercise for at least three hours before bedtime. Exercising later can keep you awake. Establish a bedtime routine that winds you down. Create an environment that’s sleep-conducive and use the bedroom only for sex and sleep.

Tips for good health

Van Orman listed 10 tips for better overall health:

10. Practice relaxation techniques.

9. Get recommended health maintenance.

8. Find good sources of health information.

7. Exercise regularly.

6. Mind your mental health.

5. Stop smoking.

4. Maintain a healthy weight.

3. Prioritize seven to eight hours of sleep every day.

2. Wash your hands frequently.

1. Laugh and love regularly.

Contact:
svanorman@uhs.wisc.edu  
or 608.262.1389

Santovec, Mary Lou. (2010, January). Tips to Health & Wellness for Highly Committed Women.Women in Higher Education,19(1), 24-25.