A new national report card gives Wisconsin poor marks for ensuring the health of women across the state. What’s it going to take to raise the grade? An across-the-board effort statewide. That’s where Sara Finger comes in
By Sarah DeRoo
Photographed by Amber Arnold
Three hundred women together in one room are rarely quiet. But as Lt. Gov. Barbara Lawton stood behind a podium in a banquet room at the Alliant Energy Center last May, the crowd seated in front of her hushed, and the first Wisconsin Women’s Health Policy Summit began.
“This is an extraordinary day today,” Lawton said with excitement, lauding the event as a “very important first” for women in Wisconsin. Then, Lawton set the stage, putting the day—and women’s health care—in historical context. To follow our nation’s history in relation to women’s health care, she said, is to find a list of institutional failures to value the “basic needs” of women.
She reminded the audience of a word in the day’s title: policy.
It was policy, she said, that had brought about important improvements in women’s health both nationally and statewide.
“Think about insurance in Wisconsin,” she said. “Remember that insurance for maternal care—for [when] you had a baby—was not … routinely included in policies until it was mandated by the legislature. And that is true of mammograms. We had to mandate routine coverage of mammograms.”
Mandates like these, she said, were the result of women raising their voices together and demanding change.
“Women must work together,” she said slowly. “We’re like snowflakes. All by ourselves, we melt. Together, we stop traffic.”
With that, the crowd laughed, and began to applaud.
They were a diverse group of women. Some were politicians well versed in policy matters, while others were simply individuals concerned about the issues. Some represented business interests while others represented nonprofits. Some were Republicans. Some were Democrats. They were black, white, gay, straight. And seated in the front row among them all was Sara Finger.
As founder and executive director of the Wisconsin Alliance for Women’s Health, this gathering was her doing. It was a day that, for her, had been five years in the making, and its goal was lofty: To bring disparate groups and interests together in creating a single, comprehensive plan for addressing the full health needs of Wisconsin women.
It also marked a step forward for Finger’s greater mission of changing the way women’s health is approached statewide.
That calling has found new focus after the December release of the National Women’s Law Center’s 2010 Report Card on Women’s Health. In this state-by-state analysis, Wisconsin received an overall grade of “unsatisfactory,” only meeting five of the 26 benchmarks—and receiving a failing grade in a whopping 11 areas.
In a state where hospitals and health care providers consistently rank among the nation’s best for providing quality care to patients, the NWLC report is, to women’s health advocates, a sign that Wisconsin needs to do something differently.
To Finger, it’s a sign she’s on the right track.
Finger is a geek. Yes, those are her words.
“I am a policy geek,” she repeats with a smile. It’s a trait that has served her well since her days as a political science major at the University of Wisconsin-Eau Claire.
In 2004, Finger was a regional director of membership and professional relations for the Wisconsin Medical Society when The Brico Fund, a philanthropic organization based in Milwaukee, began analyzing the way the Wisconsin legislature was approaching women’s health issues.
“At the time we had a state legislature that had introduced over a dozen negative policy initiatives that restricted, rather than increased, access to women’s health care services,” Finger says. “Certain women’s health issues like reproductive health were being targeted and marginalized from women’s general health care. Fortunately, this foundation decided at that point that we needed to invest in a new kind of entity, a new table to sit at to really discuss the full spectrum of women’s health and determine how to move women’s health forward instead of backward.”
Finger was tapped to establish and run this new organization. What it would
ultimately be was up to her—and she approached the process of narrowing her new organization’s mission systematically.
“I took it upon myself to start meeting with different organizations,” Finger says. “I [held] over 60 listening sessions in all corners of the state with a wide variety of women’s health care providers, advocates and individuals. I soon came to appreciate that any effort around women’s health could not be a ‘one-size-fits-all’ effort.”
Statewide organizations were already making positive change around a litany of women’s health issues. From the Wisconsin Coalition Against Domestic Violence and the Wisconsin Cancer Coalition to the Wisconsin Women’s Health Foundation, programs and services aimed at women’s
health needs were being addressed individually around particular issues.
What Finger learned from her meetings was that while each of these organizations was finding successful ways to implement programs to advance their own agendas, one thing was missing for them all.
“There had not been an umbrella-type organization … monitoring policies affecting women’s health care services and information,” Finger explains.
The policy geek had her mission.
Her goal would not be to create new initiatives, provide health care services to women or head to the Capitol to lobby for causes.
“This new entity would serve as a women’s health policy leader in Wisconsin,” she says. “We would work to monitor what was happening … on proposed policies that would impact women’s health care. And then provide the tools for organizations and individuals to raise their voices and speak out at a level appropriate for them.”
To do this, she focused on bringing groups together to emphasize a way of approaching women’s health issues that was all about one thing: Finding common ground.
“After we opened up the conversation and the discussion, we realized how easily we could connect the dots between different women’s health issues,” she adds. “We could connect the dots between mental health and economic security, violence against women and LGBTQ health, chronic disease and environmental health. You can mix and match them any which way you want, [but] they’re all interconnected.”
This holistic approach to health isn’t new. But her ability to gather a wide variety of organizations and individuals together to improve the issues was. They would align their goals to create change together.
The Wisconsin Alliance for Women’s Health was officially launched in 2005. Their mission goes back to Lawton’s snowflake analogy. Alone, each organization was fighting the other for legislative opportunity to pass laws that could improve health outcomes in their area of focus.
Together, Finger thought, they could advocate for legislation that would raise the status of women’s health as a whole.
This vision has attracted new attention thanks to the 2010 Report Card on Women’s Health.
The fifth released since 2000 by the National Women’s Law Center and Oregon Health and Science University, it offers a state-by-state analysis of how each of the 50 states and the District of Columbia fare in meeting 26 health-status benchmarks set by the U.S. Department of Health and Human Services.
Wisconsin was one of 27 states to receive an unsatisfactory grade, ranking 23rd overall—a drop from 21st place in 2007.
The state only met five of the 26 benchmarks: The percentage of women receiving mammograms, colorectal cancer screening and cholesterol screening, the percentage of women having yearly dental visits, and the percentage of women graduating from high school.
On the other end of the spectrum, Wisconsin missed a total of 21 benchmarks—including the percentage of women with health insurance—and received a failing grade for 11 indicators that range from having a high wage gap between men and women to high obesity and diabetes rates, and a low percentage of women receiving pap smears, among others.
“You [see] from the NWLC report that we’ve made some progress,” Finger says. “Cholesterol screenings are up, smoking is down, heart disease deaths are down, stroke deaths are down.”
But solely focusing on those successes, she says, hides the full truth.
“[We’ve] barely maintained the status quo,” she says. “And in some ways [we’ve] lost ground.”
To Finger, the report card emphatically reinforces the idea that in order to raise the status of women’s health, a collaborative approach is required.
“It’s important for us to capitalize on the interconnectedness of women’s health issues,” she says. “It’s going to become more and more challenging for us to be heard and our issues prioritized if we stand alone. And there’s a wonderful opportunity that exists within the policy arena [to make this happen].”
Eight months have passed since the Wisconsin Women’s Health Policy Summit, and Finger has been hard at work.
There hasn’t been much time to reflect on past successes, though in the last two years, there have been some, including a history-making moment.
In 2008, the Wisconsin state legislature passed the Compassionate Care for Rape Victims Act. When it was signed into law by Gov. Jim Doyle, it marked the first proactive piece of women’s health legislation to be passed in the state in over a decade.
In the two years since, the WAWH and its allies have worked together to make their voices heard on a range of issues they see as key to ensuring women’s health. Today, that’s where their work from the Women’s Health Policy Summit comes in. For months, Finger and her team have been combing over the topics presented at the summit.
“There were over 100 women’s health issues brought up. And we can’t possibly take on all of them,” she adds. “But [we asked ourselves], ‘Which issues could be prioritized to help us raise the collective status of women’s health the most? And realistically, which of these issues will possibly be taken up in this next [legislative] session?”
The answers to her questions will appear in the first Women’s Health Policy Agenda, which will be released by Finger and her team this month. For many women’s health advocates, the agenda couldn’t be coming at a better time.
As a new administration and legislature are sworn in at the Capitol, and as these lawmakers start to grapple with a budget deficit that could top $3 billion in the next two years, there is a battle brewing.
“In a tight economic situation, in a tight budget situation, everybody is going to be competing for scarce dollars and political attention,” she says. “As women’s health advocates, we can’t afford to function in silos—our potential is in collaborating
together.
“We’re ready to send a really strong message that, if our state legislators want to truly help raise the status of women’s health in Wisconsin, we, as a collective women’s health community are ready to provide the tools and resources to help them do this,” she adds.
The issues selected by the WAWH and its collaborators are over-arching themes they view as critical to women’s health: Economic security, nutrition, access and affordability, protection and support, prevention and maintaining state health programs such as BadgerCare—the insurance program providing coverage to low-income families—and the First Breath Program that helps pregnant women quit smoking.
These themes, Finger says, will lead to specific policy goals, and act as a proposed roadmap for policy makers, organizations and individuals on how to raise the status of women’s health. This first agenda, she says, is about the basics.
“For instance, our collective women’s health community came together and recognized that, ‘We really need to support pay equity in the state of Wisconsin,’”
Finger explains, pointing to a statistic from the NWLC report card that shows a Wisconsin woman only earns 75 cents for every dollar a man makes. “You may not naturally see this as a women’s health issue, but the economic security of women and their families directly impacts their access [to health care] and level of health.”
She continues, emphasizing the how each theme on the agenda connects to others to begin solving the puzzle of women’s health.
It’s a long list of needs. And Finger is aware that in a tight budget situation, negotiations will have to be made. But for her, women’s health, and Wisconsin’s health in general, should be non-negotiable.
“It’s the smartest investment we can make in the long run,” she says. “By investing in the health, safety and wellness of our communities now, it’s going to result in tremendous cost savings in the near future and in the long term.”
Finger acknowledges the pay-off may take time.
“You don’t just raise the status of women’s health, or Wisconsin’s health, overnight,” she adds.
As she plans for the 2011 Women’s Health Policy Summit, Finger will have her ear to the ground, alerting the groups that rely on her about the happenings under the State Capitol dome. And when legislation affecting the wide range of women’s health issues is presented, she’ll be ready to sound the alarm and bring organizations together to make their voices heard.
“We have this vision of reaching this point where we’ve raised the status of women’s health in Wisconsin, where we’ve reduced these poor health outcomes, where we’ve raised our grade with the NWLC report,” Finger says.
“If we could meet our vision and raise the status of women’s health … I would be fine searching for another job,” she adds. “Until then, my work is not done.”