Women's Health Chose Me

OWH 25th Anniversary LogoAs part of our 25th Anniversary celebration, we are inviting past and present OWH staff to share their experiences working in women's health, what progress they've seen, and their hopes for the future. Our first guest blogger is Dr. Wanda K. Jones, director of OWH from 1998 to 2009 and current Senior Advisor to the Assistant Secretary for Health, on detail to the Office of the Assistant Secretary for Preparedness and Response, at the Department of Health and Human Services.

I didn't choose to work in women's health. It chose me. I saw women marginalized early in the HIV/AIDS epidemic. I heard them referred to as liars because most women with AIDS back then didn't fit neat stereotypes about who gets HIV and because of the rampant denial that HIV could be transmitted through heterosexual sex. In general, women's health is too easily marginalized and not considered part of the mainstream healthcare system. There is a tendency to revert to "bikini medicine" — focusing only on breasts and reproductive organs — when, in fact, women's hormones influence other systems in their bodies as well. Without robust and honest data on women, the will to address the real gaps in knowledge about health status, access to culturally competent and patient-focused care, and outcomes that hold the system (not the patients) accountable, women's health will continue to be marginalized. In turn, this will limit the entire health care system's ability to lower costs and improve care.

So when I was given the opportunity to lead HHS OWH, I saw it as a chance to press for stronger national policies for and integration of women into HHS-wide efforts.

During my time, I personally focused on several issues, including how data are collected, analyzed, and reported on women and how violence and abuse affect women's health. And we made exciting progress. I'm particularly proud of the way we reached out to girls with age-appropriate health messages, our incredible and still-evolving website and social media presence (with the first-ever-for-HHS men's health section and a resource section for women with disabilities), our role as a founding partner in the Heart Truth campaign, and our examination of whether gender-focused (not just "women's health-focused") strategies would improve outcomes and help highlight opportunities to address conditions that often aren't considered part of "women's health," such as diabetes and obesity.

We have made huge strides in women's health in the last 25 years, but they each have also come with disappointments. One of the most exciting things that has happened is the progress we've made in non-invasive imaging procedures like magnetic resonance imaging (MRI) and ultrasound. But these procedures have also replaced good medical history-taking and led to over diagnosis of conditions in women that won't necessarily kill them prematurely.

And we keep getting in our own way. For instance, we now have better genetic tools for risk assessment and diagnosis, but most clinical providers aren't equipped to use them. Even as we make advances in recognizing and treating depression, systemic and social stigmas persist. The vaccines for human papillomavirus could eradicate virtually all cervical cancer, yet they're tangled in the battle over quality reproductive health care that allows the United States to lead almost all developed countries in unplanned pregnancies. We are not where we should be, especially considering that we have the most expensive health care system in the world.

The fact is that gender has a huge effect on people's lives. It should not be ignored. I think OWH should be at the table for every single discussion of policy and programmatic approaches in HHS, whether or not the subject is considered "women's health." It should use its resources to explore and evaluate different approaches with the goal of changing the system. Otherwise, the results will always be the same.

In the next 25 years, I'd like the topic of "women's health" to be on the bookshelves in the History of Medicine section. It should be a relic. People should look back in amazement that there was once a time when studies weren't done on women because they might become pregnant or when data weren't collected and analyzed by sex. It should be shocking that we once thought that only breasts and reproductive organs defined a woman. We should marvel that there was ever a time when complexity — whether in hormonal changes over the course of a woman's lifespan, social determinants such as gender, or brain-biology interdependency — was considered just too difficult to factor into intervention. I hope in 25 years, we'll know better.

Wanda JonesDr. Wanda Jones is the Senior Advisor to the Assistant Secretary for Health in the Office of the Assistant Secretary for Health (OASH), U.S. Department of Health and Human Services. She is on detail to the Office of Policy and Planning, in the Office of the Assistant Secretary for Preparedness and Response (ASPR). Before accepting the detail in early 2016, she served as Principal Deputy Assistant Secretary for Health in OASH. Dr. Jones actively participates in the Department's efforts concerning global health, continuity of operations, strategic planning, and a range of other issues managed within OASH and ASPR.

From February 1998 until December 2009, Dr. Jones was the Deputy Assistant Secretary for Health — Women's Health and the Director of the Office on Women's Health. In that capacity, Dr. Jones emphasized the elimination of health disparities, addressing HIV and AIDS and violence against women, supporting women with disabilities, and helping women have better access to healthcare services and programs.

Having joined HHS in 1987, Dr. Jones has been recognized for her leadership in and contributions to the Federal and state public health communities. She received the Presidential Rank Award as a Meritorious Executive of the Senior Executive Service in 2011.