Module Three Study Guide
Leading causes of morbidity and mortality for women in the United
States
o Top causes of death among women are
1. Heart disease
2. Cancer
3. Covid-19
4. Unintentional injuries (accidents/overdose)
o Top contributors to morbidity
hypertension, stroke, COPD, diabetes, osteoporosis,
obesity, arthritis, chronic pain conditions, depression and
anxiety, endometriosis, uterine fibroids, infertility.
o Women live longer than men, but experience more years of
disability and chronic illness.
o AHA/WHO: Target health equity, BP control, and smoking
cessation.
o Black and Native American women → ↑ maternal mortality,
CVD, and chronic disease burden.
o Social determinants: Racism, poverty, and systemic inequities
drive disparities in chronic illness, maternal morbidity, preterm
birth, and stress-related disease.
Socioeconomic factors that affect health among women in vulnerable
populations
o Socioeconomic status (SES) is one of the strongest
predictors of women’s health outcomes.
o Health disparities arise from systemic inequities—not
individual failings. Poverty, racism, and structural oppression
are root causes of vulnerability.
o Key socioeconomic determinants of health
Poverty: Disproportionately affects single mothers,
women of color, older women.
Employment & Pay Gap: Women earn less than men—
especially Black and Hispanic women. Lack of paid leave
and affordable childcare → interrupted employment and
loss of insurance.
Education & Health Literacy: Higher education
improves health behaviors and access, but racial and
immigrant disparities persist.
Housing & Family Structure: Single-parent and same-
sex households face instability in income, housing, and
access to care.
, Insurance & Access to Care: Lower-income women
often rely on Medicaid or are uninsured → decreased
preventive care and medication adherence.
Social Determinants of Health (SDOH):
Neighborhood safety
Transportation
Food security
Environmental exposures
Access to preventive and reproductive services
o Intersectionality and vulnerable populations
Health inequities compound when multiple
disadvantages overlap (gender + race + income +
disability + immigration)
Highest-risk groups: Black, Latina, Indigenous,
immigrant, and disabled women.
Women with disabilities:
~13% of U.S. population; women slightly higher
than men.
Provide ≈ 61% of all caregiving → double burden
(financial + physical strain).
Reliance on SSDI/workers’ comp often depends on
clinician documentation—NPs should provide
clear functional assessments and assist with
forms/referrals.
o Policy and systemic barriers
Benefits capped at < 80% of prior wages; fragmented
systems push women into poverty.
APRNs should advocate for:
Workplace accommodations
Social work/legal referrals
Insurance coverage guidance
Community resource linkage
o COVID-19
Women in low-income or caregiving roles had higher
infection
Women of color had higher infection and mortality rates.
Women with disabilities faced greater exposure risks
due to attendant care and preexisting respiratory
conditions.
o Key info
Always connect intersectionality → “multiple
disadvantages = compounded health risks.”
Understand poverty, structural racism, and gender
inequity as causal, not correlative.
, Expect test questions on policy awareness and NP
advocacy for vulnerable women.
Risks associated with health decline among women with disabilities
o Access & oppression
Structural discrimination, transportation barriers, and
fragmented systems → reduced preventive care and
continuity.
Disability multiplies the effects of social inequities →
poorer physical, mental, and reproductive health
outcomes.
NPs must advocate for accommodations, assist with
documentation (SSDI, adaptive equipment), and ensure
person-centered care.
o Adolescents with disabilities
↑ risk for obesity, seizures, reflux, endocrine issues,
and menstrual irregularities.
3× higher abuse rates; undereducated about sexual
health.
Assess for abuse, provide menstrual management, and
avoid non-consensual sterilization.
Support autonomy and transition to adult care using
multidisciplinary “medical home” teams.
o Midlife and accelerated aging
Early-onset disability + chronic stress = premature
aging and mobility loss.
Midlife = critical inflection point → reassess supports,
roles, and home safety.
Menopause: ↓ muscle mass, ↑ adiposity → harder
transfers, incontinence; update equipment and pelvic-care
plans.
o Musculoskeletal & Mobility Health
Chronic overuse → shoulder impingement in wheelchair
users; re-engineer seating and transfer aids.
Osteoarthritis, osteoporosis, sarcopenia post-
menopause → periodic MSK reassessment and adaptive-
equipment updates.
o Cognitive & Sensory Function
Early cognitive decline predicts ADL loss; use OT and
compensatory routines early.
New hearing/vision loss → falls, cognitive decline,
institutionalization; urgent low-vision/audio referral and
home modification.
o Oral Health
, Not cosmetic—edentulism (<9 teeth) correlates with
later disability and mortality.
Prioritize annual dental visits and pre-op dental
clearance for major procedures.
o Mental Health
In older women, depression and PTSD are top
predictors of ADL decline and mortality.
Screen aggressively, treat promptly, and coordinate with
pain/migraine management.
o Physical Activity
Exercise ≥3 days/week improves psychosocial health,
body awareness, and independence.
Encourage adaptive or disability sports; include
relapse/exacerbation plans.
TSH levels: 0.5-5.0
T3 levels: 2.3-4.2
T4 levels: 0.8-1.8
Evidence-based health promotion and disease prevention practices for
lesbian, gay, bisexual, and transgender individuals
o LGBTQ+ health disparities stem not from orientation or
identity, but from stigma, discrimination, and lack of
affirming care.
o Anti-oppressive, inclusive, culturally competent care
improves prevention, trust, and health outcomes.
o Use inclusive language: Ask name, pronouns, sex assigned at
birth, and anatomy inventory.
o Screen by anatomy, not gender marker.
o Never assume orientation, identity, or body parts.
o Create visible inclusion: Posters, intake forms, EMR pronoun
options.
o Address minority stress: Recognize discrimination, family
rejection, and unsafe environments as health determinants.
o Protective factors include supportive families, affirming
school and workplaces, access to inclusive mental health
and primary care and safe clinical environments that
validate identity
o Mental health
↑ depression, anxiety, suicidality (47% LGBTQ youth
consider suicide annually); ↑ homelessness
PHQ-9 or GAD-7 screening (not validated but still used);
connect to affirming therapy and crisis resources
o Violence/ipv
2–9× higher risk of hate crimes and IPV
Leading causes of morbidity and mortality for women in the United
States
o Top causes of death among women are
1. Heart disease
2. Cancer
3. Covid-19
4. Unintentional injuries (accidents/overdose)
o Top contributors to morbidity
hypertension, stroke, COPD, diabetes, osteoporosis,
obesity, arthritis, chronic pain conditions, depression and
anxiety, endometriosis, uterine fibroids, infertility.
o Women live longer than men, but experience more years of
disability and chronic illness.
o AHA/WHO: Target health equity, BP control, and smoking
cessation.
o Black and Native American women → ↑ maternal mortality,
CVD, and chronic disease burden.
o Social determinants: Racism, poverty, and systemic inequities
drive disparities in chronic illness, maternal morbidity, preterm
birth, and stress-related disease.
Socioeconomic factors that affect health among women in vulnerable
populations
o Socioeconomic status (SES) is one of the strongest
predictors of women’s health outcomes.
o Health disparities arise from systemic inequities—not
individual failings. Poverty, racism, and structural oppression
are root causes of vulnerability.
o Key socioeconomic determinants of health
Poverty: Disproportionately affects single mothers,
women of color, older women.
Employment & Pay Gap: Women earn less than men—
especially Black and Hispanic women. Lack of paid leave
and affordable childcare → interrupted employment and
loss of insurance.
Education & Health Literacy: Higher education
improves health behaviors and access, but racial and
immigrant disparities persist.
Housing & Family Structure: Single-parent and same-
sex households face instability in income, housing, and
access to care.
, Insurance & Access to Care: Lower-income women
often rely on Medicaid or are uninsured → decreased
preventive care and medication adherence.
Social Determinants of Health (SDOH):
Neighborhood safety
Transportation
Food security
Environmental exposures
Access to preventive and reproductive services
o Intersectionality and vulnerable populations
Health inequities compound when multiple
disadvantages overlap (gender + race + income +
disability + immigration)
Highest-risk groups: Black, Latina, Indigenous,
immigrant, and disabled women.
Women with disabilities:
~13% of U.S. population; women slightly higher
than men.
Provide ≈ 61% of all caregiving → double burden
(financial + physical strain).
Reliance on SSDI/workers’ comp often depends on
clinician documentation—NPs should provide
clear functional assessments and assist with
forms/referrals.
o Policy and systemic barriers
Benefits capped at < 80% of prior wages; fragmented
systems push women into poverty.
APRNs should advocate for:
Workplace accommodations
Social work/legal referrals
Insurance coverage guidance
Community resource linkage
o COVID-19
Women in low-income or caregiving roles had higher
infection
Women of color had higher infection and mortality rates.
Women with disabilities faced greater exposure risks
due to attendant care and preexisting respiratory
conditions.
o Key info
Always connect intersectionality → “multiple
disadvantages = compounded health risks.”
Understand poverty, structural racism, and gender
inequity as causal, not correlative.
, Expect test questions on policy awareness and NP
advocacy for vulnerable women.
Risks associated with health decline among women with disabilities
o Access & oppression
Structural discrimination, transportation barriers, and
fragmented systems → reduced preventive care and
continuity.
Disability multiplies the effects of social inequities →
poorer physical, mental, and reproductive health
outcomes.
NPs must advocate for accommodations, assist with
documentation (SSDI, adaptive equipment), and ensure
person-centered care.
o Adolescents with disabilities
↑ risk for obesity, seizures, reflux, endocrine issues,
and menstrual irregularities.
3× higher abuse rates; undereducated about sexual
health.
Assess for abuse, provide menstrual management, and
avoid non-consensual sterilization.
Support autonomy and transition to adult care using
multidisciplinary “medical home” teams.
o Midlife and accelerated aging
Early-onset disability + chronic stress = premature
aging and mobility loss.
Midlife = critical inflection point → reassess supports,
roles, and home safety.
Menopause: ↓ muscle mass, ↑ adiposity → harder
transfers, incontinence; update equipment and pelvic-care
plans.
o Musculoskeletal & Mobility Health
Chronic overuse → shoulder impingement in wheelchair
users; re-engineer seating and transfer aids.
Osteoarthritis, osteoporosis, sarcopenia post-
menopause → periodic MSK reassessment and adaptive-
equipment updates.
o Cognitive & Sensory Function
Early cognitive decline predicts ADL loss; use OT and
compensatory routines early.
New hearing/vision loss → falls, cognitive decline,
institutionalization; urgent low-vision/audio referral and
home modification.
o Oral Health
, Not cosmetic—edentulism (<9 teeth) correlates with
later disability and mortality.
Prioritize annual dental visits and pre-op dental
clearance for major procedures.
o Mental Health
In older women, depression and PTSD are top
predictors of ADL decline and mortality.
Screen aggressively, treat promptly, and coordinate with
pain/migraine management.
o Physical Activity
Exercise ≥3 days/week improves psychosocial health,
body awareness, and independence.
Encourage adaptive or disability sports; include
relapse/exacerbation plans.
TSH levels: 0.5-5.0
T3 levels: 2.3-4.2
T4 levels: 0.8-1.8
Evidence-based health promotion and disease prevention practices for
lesbian, gay, bisexual, and transgender individuals
o LGBTQ+ health disparities stem not from orientation or
identity, but from stigma, discrimination, and lack of
affirming care.
o Anti-oppressive, inclusive, culturally competent care
improves prevention, trust, and health outcomes.
o Use inclusive language: Ask name, pronouns, sex assigned at
birth, and anatomy inventory.
o Screen by anatomy, not gender marker.
o Never assume orientation, identity, or body parts.
o Create visible inclusion: Posters, intake forms, EMR pronoun
options.
o Address minority stress: Recognize discrimination, family
rejection, and unsafe environments as health determinants.
o Protective factors include supportive families, affirming
school and workplaces, access to inclusive mental health
and primary care and safe clinical environments that
validate identity
o Mental health
↑ depression, anxiety, suicidality (47% LGBTQ youth
consider suicide annually); ↑ homelessness
PHQ-9 or GAD-7 screening (not validated but still used);
connect to affirming therapy and crisis resources
o Violence/ipv
2–9× higher risk of hate crimes and IPV
