AUGUSTA, Maine — When Fatuma Hussein first encouraged fellow Somali women in the Lewiston area to use birth control, she hit a wall.
As Muslims, we can’t, the women said to Hussein. Our religion forbids it.
Today, several years later, many of those same women are using contraception. But their husbands don’t know, they have confided to Hussein.
“We had women who were having children every year,” said Hussein, founder of United Somali Women of Maine. “I’m very proud of my culture, but we have so much that we can take advantage of [in the U.S.]. We come from a culture where a 14-year-old girl can get married. She’s a child. We bring those practices and those cultural norms to this country.”
Birth control is just one aspect of women’s health that Hussein is working to address. Her organization assists refugee and immigrant women living in Maine with transportation, translation, and other services, and has partnered with several health groups in the state.
Hussein, who was born in Mogadishu, Somalia, and relocated to Maine in 2001, spoke Friday at a women’s health conference in Augusta.
The statewide event, dedicated to improving health equity for Maine women, was the first of its kind in Maine in at least a decade, according to Sheila Pinette, director of the Maine Center for Disease Control and Prevention. The event was attended by a few dozen health care advocates, providers, officials, and others.
Women use more medical services than men and make 70 percent of health care decisions in the United States, said keynote speaker Dr. Paula A. Johnson, head of the Mary Horrigan Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital in Boston. Yet women face more challenges when it comes to affording health care — earning less than men on average — and are less likely to keep consistent insurance coverage, she said.
In Maine, more than a quarter of women are obese as they enter pregnancy, Johnson said. That significantly raises a mother’s risk of developing gestational diabetes and high blood pressure, she said.
“Those diseases are not only diseases of pregnancy, but they are diseases that increase the risk of cardiovascular disease and diabetes in women as they age, and it increases the risk of cardiovascular disease in that next generation,” Johnson said. “This is a generational problem that’s truly profound.”
Women’s health issues extend far beyond reproductive health. One in three American women has a chronic health condition that requires ongoing medical care, said Johnson, who is considered a pioneer in the treatment and prevention of cardiovascular disease.
Treating those conditions is made more difficult because of the likelihood of inconsistencies when it comes to women’s health insurance coverage, Johnson said. Women drop in and out of Medicaid and subsidized insurance programs as they enter and leave the workforce, become pregnant, and face other life changes, she said.
“When you transition you frequently drop out,” Johnson said. “That’s a problem in terms of maintaining your health.”
Another hurdle to better understanding women’s health disparities is that medical research and government health agencies often fail to distinguish their data by sex, she said. In Massachusetts, that has complicated efforts to assess the impacts of health reform on women, Johnson said.
She urged Maine’s health care community to get ahead of that data shortcoming in its own march toward health reform. She also encouraged the state to ensure that preventive care, which is mandated under the federal health reform law, including mammograms and prenatal care, is being provided to women at no cost as required.
Insurance is only part of the picture in ensuring that women are taking care of their health, Johnson said.
“An insurance card is absolutely essential, but it’s not the only thing that’s necessary,” she said.