However, several health issues important to women have seen little progress, including unintended pregnancy, autoimmune diseases, alcohol and drug addiction, lung cancer, and dementia. Overall, fewer gains have been made on chronic and debilitating conditions that cause significant suffering but have lower death rates, pointing to the need for researchers to give quality of life similar consideration as mortality for research attention. Moreover, barriers such as socio-economic and cultural influences still limit the potential reach and impact of research developments, especially among disadvantaged women.
The gains that have been made reflect the effects of requirements for researchers to include women in studies, an influx of resources from public and private stakeholders, and multifaceted research approaches that tackled the conditions from several fronts for a fuller understanding of each condition, the committee concluded.
"There is good news and bad news on the state of women's health research," said committee chair Nancy E. Adler, professor of medical psychology and director of the Center for Health and Community, University of California, San Francisco. "Significant boosts in research on women's health issues have yielded measurable progress in reducing the toll of several serious disorders. Unfortunately, less progress has been made on conditions that are not major killers but still profoundly affect women's quality of life. These issues require similar attention and resources if we are to see better prevention and treatment in more areas. And across all areas, researchers need to take into account the effects of both biologically determined sex differences and socially determined gender differences as a routine part of conducting research."
Historically, researchers recruited women to clinical studies less often than men in part because of ethical concerns about potential fetal exposure to experimental substances; the flux of hormones in women's bodies, which could complicate studies; and the assumption that results of studies on men could be extrapolated to women. However, trial results were not necessarily applicable or consistently applied to women, as demonstrated by the unequal use of stents, beta blockers, and cholesterol-lowering drugs to treat heart disease in women. Moreover, the symptoms and courses of diseases in males do not always correspond to what happens in females. Inadequate research focus on women's health issues was first comprehensively documented in 1985, which led to a transformation in government and public support of women's health research and in related policies and regulations.
Requirements for researchers to enroll women in clinical trials have enabled many advances. Yet the full benefit of increased participation by women has not been realized because researchers do not routinely analyze and report results separately for women and men, the committee observed. This limits the breadth and depth of clinical information that could facilitate more effective interventions and treatments for women. Journal editors should adopt a guideline that all papers reporting outcomes of clinical trials must present data on men and women separately unless a trial focuses on a sex-specific condition such as prostate cancer, the report says. In addition, the U.S. Food and Drug Administration should enforce companies' compliance with requirements to provide sex-specific data on the efficacy and safety of new drugs and devices and should take this information into account when it considers approval, dosing, and labeling of products.
Although the dramatic increase in women's health research has generated an abundance of new information of interest to women, the course of scientific study sometimes yields conflicting findings and opposing recommendations that can cause confusion among the public. The committee recommended that the U.S. Department of Health and Human Services appoint a task force to develop strategies to communicate and market health messages about research results to women. The task force should include experts on mass media and marketing.
The sheer number of health conditions relevant to women and volume of information available on many of them precluded analysis of all conditions in the report. Lack of discussion should not suggest that the committee considered a specific condition unimportant. By necessity, the committee focused on those that are specific to or more common or serious in women or that have distinct causes, manifestations, outcomes, or treatments in women. And it selected conditions that could provide broadly applicable conclusions.
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The report was sponsored by the U.S. Department of Health and Human Services. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies. A committee roster follows.
Copies of WOMEN'S HEALTH RESEARCH: PROGRESS, PITFALLS, AND PROMISE are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at HTTP://WWW.NAP.EDU. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above). In addition, video of the public briefing will be available at HTTP://NATIONAL-ACADEMIES.ORG/PODCAST. (contacts listed below)
Date: Sept. 23, 2010
Contacts: Christine Stencel, Senior Media Relations Officer
Luwam Yeibio, Media Relations Assistant
Office of News and Public Information
202-334-2138; e-mail
[ This news release and report are available at HTTP://NATIONAL-ACADEMIES.ORG ]
INSTITUTE OF MEDICINE
Board on Population Health and Public Health Practice
COMMITTEE ON WOMEN'S HEALTH RESEARCH
NANCY E. ADLER, PH.D. (CHAIR)
Professor of Medical Psychology
Departments of Psychiatry and Pediatrics, and
Director
Center for Health and Community
University of California
San Francisco
ELI Y. ADASHI, M.D.
Professor of Medical Sciences
Division of Biology and Medicine
Brown University
Providence, R.I.
SERGIO A. AGUILAR-GAXIOLA, PH.D., M.D.
Director
Center for Reducing Health
Disparities, and
Professor of Internal Medicine
School of Medicine
Health Disparities and Clinical Internal
Medicine
University of California
Davis
HORTENSIA AMARO, PH.D.
Distinguished Professor of Health Sciences
Institute on Urban Health Research
Bouve College of Health Sciences
Northeastern University
Boston
MARIETTA ANTHONY, PH.D.
Associate Director of Women's Health Programs
Arizona Center for Education and Research on Therapeutics, and
Director of Women's Health
Critical Path Institute
Rockville, Md.
DIANE BROWN, PH.D., M.P.H.
Executive Director
Institute for the Elimination of Health Disparities
School of Public Health
University of Medicine and Dentistry of New Jersey
Newark
NANANDA COL, M.D., M.P.H.
Director
Center for Outcomes Research and Evaluation
Maine Medical Center
Portland
SUSAN CU-UVIN, M.D.
Professor of Obstetrics and Gynecology and Medicine
Miriam Hospital
Brown University
Providence, R.I.
DENISE L. FAUSTMAN, M.D., PH.D.
Director
Immunology Lab
Massachusetts General Hospital
Charlestown
JOHN R. FINNEGAN JR., PH.D.
Dean and Professor
School of Public Health
University of Minnesota
Minneapolis
WILLIAM R. HAZZARD, M.D.
Professor of Medicine
Division of Gerontology and Geriatric Medicine
University of Washington
Seattle
JAYE E. HEFNER, M.D., M.P.H., PH.D.
Associate Medical Director of Consult and Primary Care Services
Department of Internal Medicine and Physical Medicine and Rehabilitation
Spaulding Rehabilitation Hospital
Boston
M. JEANNE MIRANDA, PH.D.
Professor
Department of Psychiatry and Biobehavioral Sciences
University of California
Los Angeles
LORI MOSCA, M.D., M.P.H., PH.D.
Professor of Medicine and Director of Preventive Cardiology
New York Presbyterian Hospital
New York City
HERBERT B. PETERSON, M.D.
Professor and Chair
Department of Maternal and Child Health
School of Public Health
University of North Carolina
Chapel Hill
ETTA D. PISANO, M.D.
Vice President for Medical Affairs, and Dean
College of Medicine
Medical University of South Carolina
Charleston
ALINA SALGANICOFF
Vice President and Director
Women's Health Policy and KaiserEDU.org
Kaiser Family Foundation
Menlo Park, Calif.
LINDA G. SNETSELAAR, PH.D.
Associate Professor and Chair
Department of Preventive Medicine and Environmental Health
University of Iowa
Iowa City
STAFF
MICHELLE CATLIN, PH.D.
Study Director
END
