Diabetes has been a serious public health problem for many years. Currently an estimated 16 million Americans have diabetes, more than half of them women. Why, then, has so little progress been made in reducing the burden of this disabling disease? This provocative question is explored by the authors of Diabetes and Women's Health Across the Life Stages: A Public Health Perspective. Throughout its pages, editors Gloria L.A. Beckles and Patricia E. Thompson-Reid and their collaborators introduce us to some eye-opening issues and some serious, sobering implications for the health of women. There is no better time for this in-depth look at diabetes as a women's health issue than now, as we begin a technologically advanced new century. Old or young, one third of American women are overweight, and more than one-fourth do not participate in any leisure-time physical activity, according to the Third National Health and Nutrition Examination Survey (NHANES III 1988-1994). As a group, American women are aging and growing more obese and less physically active; each of these factors increases their risk for type 2 diabetes. Currently, about 20 million are over age 65. By the year 2030, that number is expected to double to 40 million, or roughly 1 in 4 American women. Astonishingly, more than 7 million women will be past the age of 85, compared with 4 million men. The face of the American population is also changing: by the year 2050, 1 in 4 American women will be of Hispanic heritage, 1 in 8 African American, 1 in 11 Asian American, and 1 in 100 American Indian. Non-Hispanic whites will represent barely half of the population of women. Currently, the prevalence of diabetes is at least 2-4 times higher among women of color, and if this trend continues, the burden of diabetes could reach unimaginable dimensions. The intent of this monograph is: To describe the diversity within the population of American women as a context for the discussion of women's health issues; To present a situational analysis of the epidemiological, social, and environmental circumstances in which American women develop and live with diabetes; To synthesize and present in a single document the health status of women with diabetes; To suggest ways in which public health agencies can contribute to improved access and quality of care for women with diabetes; To serve as a general reference document for public health professionals, advocacy groups, and all persons in the diabetes community; and To increase awareness of the general population that diabetes is a serious health problem.