Breast cancer survival in the United States rose from 76% in 1975 to 94% in 2023, demonstrating what sustained investment in research can achieve. Yet many other conditions that affect only or disproportionately affect women remain underfunded and poorly understood, limiting progress in prevention, treatment and quality of life. A new presidential order could help address these gaps, but meaningful change will require congressional funding and structural reform at the National Institutes of Health (NIH).
Improving women’s health and quality of life will require more research into conditions that affect only or disproportionately affect women. Credit: Good Brigade/Getty
The increase in breast-cancer survival was not coincidental. It reflects continued investment in research and shows the progress that can result when women’s health is made a priority.
Women are talking about menopause — the health system needs to listen
NIH funding for breast-cancer research is minuscule compared with the amount spent on other diseases that affect only or disproportionately affect women. The US national research system has not adequately advanced the treatment and prevention of many other conditions that cause premature death, disability or a reduced quality of life in women.
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 an existing institute. This could be a meaningful step, but its impact will depend on what happens next. White House attention and support are important, but lasting progress will require increased funding from the US Congress and structural reform within the NIH.
A history of unfulfilled efforts
The United States has attempted to address these gaps before. In 1993, then-President Bill Clinton signed the NIH Recovery Act, a law intended to address shortcomings in women’s health research and formally establish the Office of Research on Women’s Health (ORWH).
Two years ago, then-President Joe Biden launched a government-wide effort that included an NIH-wide task force to improve women’s health research and direct federal funding towards areas of unmet need. Biden also asked Congress to allocate $12 billion for NIH research on women’s health, but the money was not included in the final budget.
NIH-supported research is undoubtedly improving women’s health, but major 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.
Ignoring sex and gender in research is a public-health risk
Research built around male models
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 still lack a full understanding of fundamental aspects of female physiology, as well as differences between women and men in conditions such as migraines, autoimmune diseases, Alzheimer’s disease and depression. There is also insufficient evidence to guide the safe management of health problems during pregnancy.
As a policy researcher, I have spent much of my career examining barriers that limit 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 first-hand how research gaps affect guidelines and women’s health outcomes.
In 2024, I had the privilege of co-chairing 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
