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Women's Health Research: Women's Health Research: A Medical and Policy Primer

Women's Health Research: Women's Health Research: A Medical and Policy Primer In recent years the issue of women's health has become an important item on the national health care agenda. The Society for the Advancement of Women's Health Research, founded in 1990 to address gender inequities in medical research and finding, has articulated five goals: identifying research areas that impact on women's health, promoting/encouraging public and private financial support for such research, effecting changes in policy and behavior based on this research, creating environments for change by improving information to policymakers and the public, and advancing women as leaders in health professions with the intent of increasing women's health research. This primer not only documents the current state of women's health, but also serves as a how-to manual that defines a research and policy agenda for improvement of women's health research and indicates those actions required to institutionalize such an agenda. By illustrating large knowledge gaps in research and treatment, the society hopes to spur organized scientific inquiry into women's health. To this end, the authors recommend a broad series of changes in medical student education and in the way research is funded and conducted. The National Institutes of Health have failed to include women in research studies in the past, a major inequity. Now, with acknowledgment of the discrepancy, many ideas and talents stand ready for action, if opportunity and funding exist for women's health research. Also, the medical profession now appears more willing to accept the value of women's health research and the resultant implications for clinical practice. This book traces the growth of women's health research from its early emphasis on reproduction to a much more sophisticated arena, with a wide variety of women's health issues identified for further study. Several chapters discuss gender differences in diseases and major gaps in research. The chapter "Diseases That Affect Only Women" by Ruth Anne Queenan, MD, and Lynne Beauregard, discusses health problems of the female reproductive system. The next chapter, "Diseases That Are More Prevalent in Women," by the same authors, identifies some diseases that involve an autoimmune factor or female hormones. Such diseases span the body systems and include bone, joint, and rheumatic diseases; endocrine system diseases; migraine, multiple sclerosis, and Alzheimer disease; depression, anxiety, and eating disorders; cholelithiasis, cholecystitis, and irritable bowel syndrome; and urinary tract infections and incontinence. The mechanisms that result in greater frequency of these conditions among women are poorly understood. In "Diseases That Manifest Differently in Women and Men," Nancy Fugate Woods, PhD, RN, and Beverly Greenberg Jacobsen overview several conditions. For example, liver function in females and males differs because of estrogen, which fluctuates. One effect is that women are more susceptible to the effects of alcohol just before menses when liver metabolism is slowest. Later-life estrogen therapy increases high-density lipoprotein cholesterol (HDL); however, women with low HDL are seven times more likely than men to be at risk for heart disease, and it is unclear why this is so. An anatomic difference in females, a shorter urethra, results in more urinary tract infections and glomerulonephritis; research needs to illuminate and enhance female urinary tract health. Another concern is the relationship of ovarian dysfunction in women to kidney dysfunction with resultant osteoporosis, phenomena not well understood. The book provides a sketchy history of the women's health movement. Several of the pioneers, like Edward N. Brandt, Jr, MD, PhD, Ruth L. Kirschstein, MD, and the Honorable Barbara A. Milkowski, to name just a few, should be mentioned in any history of women's health policy and programming. Emphasis on interdisciplinary research is only one way to help ensure that women's health becomes a permanent priority for US policymakers. Substantive change can only occur by looking at structural issues of how research is funded, who sets priorities, and the nature of the power structure making research and funding decisions. By establishing the Office for Women's Health Research in 1990 to focus agency-wide attention on women's health, the National Institutes of Health made a commitment to ensure inclusion of women in clinical trials. The Council on Graduate Medical Education in 1993 made 16 recommendations to improve medical education on women's health. In 1994, the Food and Drug Administration established the Office of Women's Health to provide direction for the FDA in women's health issues and oversight of gender equity in the testing of drugs and products. Women's Health Research describes efforts in the beginning stages, which must be nurtured to thrive and impact significantly the discovery and delivery of sound health care to females. The book is highly recommended for medical educators, clinical researchers, health system planners and program developers, leaders in county medical societies, policy planners, and health legislators. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Women's Health Research: Women's Health Research: A Medical and Policy Primer

JAMA , Volume 280 (4) – Jul 22, 1998
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Publisher
American Medical Association
Copyright
Copyright © 1998 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.280.4.387
Publisher site
See Article on Publisher Site

Abstract

In recent years the issue of women's health has become an important item on the national health care agenda. The Society for the Advancement of Women's Health Research, founded in 1990 to address gender inequities in medical research and finding, has articulated five goals: identifying research areas that impact on women's health, promoting/encouraging public and private financial support for such research, effecting changes in policy and behavior based on this research, creating environments for change by improving information to policymakers and the public, and advancing women as leaders in health professions with the intent of increasing women's health research. This primer not only documents the current state of women's health, but also serves as a how-to manual that defines a research and policy agenda for improvement of women's health research and indicates those actions required to institutionalize such an agenda. By illustrating large knowledge gaps in research and treatment, the society hopes to spur organized scientific inquiry into women's health. To this end, the authors recommend a broad series of changes in medical student education and in the way research is funded and conducted. The National Institutes of Health have failed to include women in research studies in the past, a major inequity. Now, with acknowledgment of the discrepancy, many ideas and talents stand ready for action, if opportunity and funding exist for women's health research. Also, the medical profession now appears more willing to accept the value of women's health research and the resultant implications for clinical practice. This book traces the growth of women's health research from its early emphasis on reproduction to a much more sophisticated arena, with a wide variety of women's health issues identified for further study. Several chapters discuss gender differences in diseases and major gaps in research. The chapter "Diseases That Affect Only Women" by Ruth Anne Queenan, MD, and Lynne Beauregard, discusses health problems of the female reproductive system. The next chapter, "Diseases That Are More Prevalent in Women," by the same authors, identifies some diseases that involve an autoimmune factor or female hormones. Such diseases span the body systems and include bone, joint, and rheumatic diseases; endocrine system diseases; migraine, multiple sclerosis, and Alzheimer disease; depression, anxiety, and eating disorders; cholelithiasis, cholecystitis, and irritable bowel syndrome; and urinary tract infections and incontinence. The mechanisms that result in greater frequency of these conditions among women are poorly understood. In "Diseases That Manifest Differently in Women and Men," Nancy Fugate Woods, PhD, RN, and Beverly Greenberg Jacobsen overview several conditions. For example, liver function in females and males differs because of estrogen, which fluctuates. One effect is that women are more susceptible to the effects of alcohol just before menses when liver metabolism is slowest. Later-life estrogen therapy increases high-density lipoprotein cholesterol (HDL); however, women with low HDL are seven times more likely than men to be at risk for heart disease, and it is unclear why this is so. An anatomic difference in females, a shorter urethra, results in more urinary tract infections and glomerulonephritis; research needs to illuminate and enhance female urinary tract health. Another concern is the relationship of ovarian dysfunction in women to kidney dysfunction with resultant osteoporosis, phenomena not well understood. The book provides a sketchy history of the women's health movement. Several of the pioneers, like Edward N. Brandt, Jr, MD, PhD, Ruth L. Kirschstein, MD, and the Honorable Barbara A. Milkowski, to name just a few, should be mentioned in any history of women's health policy and programming. Emphasis on interdisciplinary research is only one way to help ensure that women's health becomes a permanent priority for US policymakers. Substantive change can only occur by looking at structural issues of how research is funded, who sets priorities, and the nature of the power structure making research and funding decisions. By establishing the Office for Women's Health Research in 1990 to focus agency-wide attention on women's health, the National Institutes of Health made a commitment to ensure inclusion of women in clinical trials. The Council on Graduate Medical Education in 1993 made 16 recommendations to improve medical education on women's health. In 1994, the Food and Drug Administration established the Office of Women's Health to provide direction for the FDA in women's health issues and oversight of gender equity in the testing of drugs and products. Women's Health Research describes efforts in the beginning stages, which must be nurtured to thrive and impact significantly the discovery and delivery of sound health care to females. The book is highly recommended for medical educators, clinical researchers, health system planners and program developers, leaders in county medical societies, policy planners, and health legislators.

Journal

JAMA – American Medical Association

Published: Jul 22, 1998

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