Charting the Course: A National Summit on the Future of Women's Health (2014 Event)

Disease is known as the great equalizer, indiscriminately occurring regardless of gender, race or economic status. But the science that informs medicine, including the diagnostics and treatment of disease, is alarmingly unequal in that it has failed to adequately acknowledge how sex and gender differences in diseases impact who remains healthy and who becomes ill.

Biomedical research that is either gender neutral or skewed to male physiology is putting women in the United States and around the world at risk for missed diagnosis, misinformed treatment, sickness, and death.

The consequences of these practices are staggering:

  • Cardiovascular disease is the leading cause of death for women in the U.S yet only one-third (35%) of clinical trial subjects in cardiovascular research are female and just 31% of studies that include women report outcomes by sex. This is particularly disturbing given research has proven that women and men can present differently, and have different risks and different outcomes for heart disease, factors that ought to be considered in research and clinical practice.i
  • Lung cancer is the leading cause of cancer death among women in the U.S., with increased rates particularly among young, female non­ smokers. While many complex factors contribute to this prevalence, the lack of gender-specific research findings means that prevention, diagnosis and treatment of lung cancer for women does not consider what role gender biology may play in its occurrence.
  • Depression is the leading cause of disease burden worldwide with women disproportionately impacted; women are 70% more likely than men to suffer from depression over the course of their lifetimes, though the causes of this remain largely a mystery. The social and economic burden of this disease on our nation is enormous and increasing worldwide.

Perhaps most concerning is the fact that a majority of people are unaware that the gender gap in science and medicine continues to exist. Others believe that advances in research and clinical care in breast and ovarian cancer mean that women’s health is adequately stewarded.

This lack of awareness, together with insufficient research in understanding sex and gender differences and the problem of underrepresentation in medical research have made this health care policy issue a national and global imperative.

At stake is not only the overall health of women but the integrity of medical research and the health of the economy already overburdened by the enormous cost of fighting disease.

The National Summit: A Place and Time that will Change Women's Health

Believing that “what we don’t know, will hurt us,” a growing number of women and men, researchers and lay people, advocates and elected officials are determined to shine light on this disparity in biomedical research and work to correct its consequences. The Mary Horrigan Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital (BWH) has been leading the way in changing the course of women’s health by advocating for the application of a gender-based lens to all diseases as a way of improving health for both women and men. As the only academic medical center with a nonpartisan policy and advocacy program, the Connors Center is uniquely positioned to articulate and inform an enlightened policy framework to enable research and clinical innovation.

In 2014, the Connors Center at Brigham and Women’s Hospital, together with the Henry J. Kaiser Family Foundation and the Jacob’s Institute for Women’s Health at the George Washington School of Public Health, hosted the first national summit dedicated to this aspect of women’s health.

Organized around the 20th anniversary of the landmark National Institute of Health (NIH) Revitalization Act that required all NIH-funded medical research to include women and minorities, the Summit was an unprecedented opportunity to improve medical research policies, empower stakeholders, and adopt a more precise and gender-specific approach to treating disease. The half-day Summit in Boston was the rallying point behind a legislative, regulatory and advocacy campaign aimed at closing the gender data gap that persists in biomedical research.  

Seizing the Moment: Celebrating History, Charting A New Course

The Revitalization Act of 1993, passed by Congress and signed into law by President Clinton, set the stage for major advances in women’s health. Yet, despite the expanded inclusion, disparities remain regarding women and minorities, including: a dearth of research on sex and gender differences in disease and on health problems that disproportionately impact women; the insufficient inclusion of women and minorities in research and clinical trials; and the failure to report outcomes of research by sex.  

Twenty years later, it is alarmingly apparent that The Revitalization Act only began to solve a major deficit in research.

  • Women are still not included in clinical research in numbers reflecting the prevalence and impact of disease in women. This means that clinical practices including treatment guidelines and medication dosages are derived largely from the male physiological perspective. In spite of including both women and men in clinical research, 66% of studies including both sexes fail to analyze the data by sex.ii
  • Even at the very early stages of scientific discovery, sex is not considered. For example, the majority of studies using laboratory animals to study neuroscience pharmacology and physiology, where findings are more likely to translate to humans, only use male mice.iii
  • Women face safety concerns when it comes to prescription drugs. Eight of the ten drugs withdrawn from the market between 1997 and 2000 had higher risks for women compared with men.iv A lack of research focused on sex differences in disease and therapeutics may contribute to these disparities.

Twenty years of experience since the Revitalization Act, along with major changes in science and technology, and our current knowledge of gaps in implementation, demand an examination of the legislation’s sphere of impact, a reexamination of its components, and the consideration of new strategies. Of particular focus are the opportunities that exist with the implementation of The Affordable Care Act, which has been designed to eliminate gender discrimination in health coverage, mandate the coverage of crucial women’s health services such as maternity care and preventive services, and insure as many as 11 million currently uninsured women in the US.  

The National Summit on Women’s Health celebrated the 20th Anniversary of this watershed legislation by honoring its pioneering authors while charting a course for future action. The landmark event provided a national stage, as well as a major convening of the minds, to mobilize, inspire and launch a movement for change in this area. 

Going Forward: Amplifying the Issue and Moving an Agenda

The Summit was the centerpiece of a larger public affairs effort to amplify the issues of disparity in science and medicine and its consequences, unite key stakeholders, and engender the public concern needed to address the problem. 

The effort included:

  • Convening a diverse set of policymakers, advocates, businesses and opinion leaders who have a stake in addressing these disparities; mobilizing this constituency through the National Summit and through continued communication and follow-through strategies.
  • The release of the 20th Anniversary Progress Report and recommendations on the state of women’s health that documents where our nation has fallen short in fulfilling the goals of the law and setting policy recommendations to spark a legislative agenda.   
  • An external communications strategy that utilizes social and traditional media to disseminate the facts and consequences of our current practices as well as the opportunities that exist in moving ahead to the next level of inclusion.

Women's Health Summit Policy Report

The Mary Horrigan Connors Center for Women’s Health at Brigham and Women’s Hospital is proud to present "Sex-Specific Medical Research: Why Women’s Health Can’t Wait." The report provides compelling evidence that the science that informs medicine—including the prevention, diagnosis, and treatment of disease—routinely fails to consider the crucial impact of sex and gender.

About the Connors Center at Brigham and Women's Hospital

BWH is a natural convener for this event given our historic commitment to improving the health of women and transforming their medical care for the past 100 years. Created as the country's first maternity hospital and provider of free care to women in need, BWH continues to be recognized as one of the top hospitals in the world. BWH has led the nation in sex and gender-specific clinical research and is responsible for landmark research that revolutionized prevention of cardiovascular disease in women. The first hospital in the nation to focus on gender-based medicine in a comprehensive way, BWH opened The Connors Center for Women's Health in 1993. The Center now has 10 years of expertise translating scientific discovery into tangible policy and advocacy achievements that improve health care for women everywhere. 

[1] Melloni  C, Berger JS, Wang TY, Gunes F, Stebbins A, Pieper KS, Rowena DJ, Douglas PS, Mark DB, Newby LK (2010). Representation of women in randomized clinical trials of cardiovascular disease prevention. Circulation: Cardiovascular Quality and Outcomes, 3(2), 135-142.

[1] Wald C., & Wu C. (2010). Of mice and women: the bias in animal models. Science, 327(5973), 1571-1572.

[1] Wald C., & Wu C. (2010). Of mice and women: the bias in animal models. Science, 327(5973), 1571-1572.

[1] Simon V. Wanted: women in clinical trials. Science 2005; 308: 1517.


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