ORWH, ACRWH Host Conference
NIH’s Office of Research on Women’s Health and the advisory committee on research on women’s health (ACRWH) recently cohosted “Advancing NIH Research on the Health of Women: A 2021 Conference” in response to a congressional request to address efforts related to women’s health research. Key topics identified by Congress included clinical practices related to rising maternal morbidity and mortality (MMM) rates; increasing rates of chronic debilitating conditions in women; and stagnant cervical cancer survival rates.
MMM is a public health crisis in the United States, with an estimated 6 in 10 maternal deaths being preventable. In 2011–2015, the U.S. had nearly twice the live birth maternal mortality rate as peer nations. This rise in maternal mortality has been even more pronounced among women of color, including Black, American Indian/Alaska Native and Hispanic women. These racial and ethnic inequities stem, in large part, from structural racism, implicit bias and racially biased policies and practices, with neither educational attainment nor higher socioeconomic status mitigating the elevated risks.
Rates of chronic debilitating conditions, such as chronic obstructive pulmonary disease, affecting women in the U.S. are on the rise, and chronic diseases are more common in women than men. However, understanding of the impact of sex and gender influences on the outcomes of individuals with chronic diseases remains limited.
Current challenges include a lack of research on rare diseases more prevalent in women and the lower specificity, sensitivity and efficacy of diagnostic tests for women. Also, disparities exist among underserved racial and ethnic groups. For example, Black women are 20 percent more likely to die from heart disease than White women.
In the U.S., there are approximately 12,000 new cases of cervical cancer per year. Despite increased prevention efforts through human papillomavirus vaccination and cervical cancer screening, the incidence of and mortality rate from cervical cancer have remained stable over the past two decades.
Significant racial and ethnic disparities related to cervical cancer persist. For example, in the U.S., Black and Hispanic women are diagnosed more frequently than women of other races and ethnicities and are less likely to survive.
Several suggestions emerged from participants:
- Investigators can expand implementation research to ensure that the effective, evidence-based practices and preventive interventions that have already been developed—notably for MMM and cervical cancer—benefit all women in all clinical settings.
- Research and clinical communities can integrate diversity, equity and inclusion concerns into all aspects of the medical enterprise to account for implicit biases and health disparities associated with race, ethnicity, geographical location, socioeconomic status, age, sex, gender and other demographic factors as well as the intersection of these factors. Equity science must inform all aspects of the research process—from the development of funding opportunities, to study design, to recruitment practices, to data collection and analysis, to reporting—for everyone to benefit equitably from investment in medical discovery.
- Funding agencies can realign priorities better to address the diverse populations in the U.S. and abroad, to support a broader and more diverse group of universities and research institutions and to enhance research on understudied diseases and on the health problems of women and individuals from underrepresented populations.
ORWH will collect specific recommendations from the conference in a forthcoming report.
Watch a recording of the conference at https://videocast.nih.gov/watch=42584.