More research is needed into conditions that affect only or disproportionately affect women to improve women’s health and quality of life. Credit: Good Brigade/Getty
Research has produced major gains in women’s health, including an increase in the five-year breast-cancer survival rate in the United States from 76% in 1975 to 94% in 2023. But many conditions that affect only or disproportionately affect women remain underfunded and poorly understood. A new presidential order could bring greater attention to the issue, although sustained progress will require increased congressional funding and structural changes at the US National Institutes of Health (NIH).
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The improvement in breast-cancer survival was not accidental. It resulted from sustained investment in research and demonstrates the progress that can be achieved when women’s health is made a priority.
However, NIH funding for breast-cancer research is minuscule compared with spending on other diseases that affect only or disproportionately affect women. The US national research enterprise has not adequately advanced the treatment and prevention of many other conditions that can cause premature death, disability or a reduced quality of life.
A new push for women’s health research
In October, US President Donald Trump signed a presidential order directing the NIH to create a task force on women’s health and establish a division of women’s health within its existing institute.
The order could be a meaningful step, but its impact will depend on what happens next. White House attention and support are important; lasting progress will require increased funding from the US Congress and structural reform at the NIH.
The United States has pursued similar initiatives before. In 1993, then-President Bill Clinton signed the NIH Recovery Act, legislation intended to address gaps in women’s health research and to formally establish the Office of Research on Women’s Health (ORWH).
Two years ago, then-President Joe Biden launched a government-wide effort that created an NIH-wide task force to improve women’s health research and direct federal funding towards areas of need. Biden also asked Congress to allocate $12 billion for NIH research on women’s health, but that funding was not included in the final budget.
Persistent gaps in research
NIH-supported research is undoubtedly improving women’s health, but substantial gaps remain. Endometriosis, polyendocrine-metabolic ovarian syndrome, uterine fibroids, menopause, and ovarian and endometrial cancers are examples of conditions affecting women that remain underfunded and low priorities.
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Human biology and disease have also historically been studied through male models, both in laboratory animals and among human participants. Even when women are included in clinical trials, pregnant and breastfeeding women are usually excluded, and analyses specific to sex and gender remain uncommon.
Researchers also lack a full understanding of fundamental aspects of female physiology, differences between women and men in conditions such as migraines, autoimmune diseases, Alzheimer’s disease and depression, and how to manage health issues safely during pregnancy.
From research gaps to health-care outcomes
As a policy researcher, I have spent much of my career examining barriers that restrict women’s access to care. I also served on a committee that developed recommendations for shaping insurance coverage in the United States, where I saw firsthand how gaps in research affect guidelines and women’s health outcomes.
In 2024, I co-chaired a consensus committee mandated by Congress at the National Academies of Sciences, Engineering, and Medicine. The committee assessed the state of women’s health research at the NIH and developed recommendations for improving it.
Source: www.nature.com