A New National Prescription to Improve Women's Health
Women's health was largely ignored in the halls of public policy, at the research bench, and in clinical settings when I was appointed the first Deputy Assistant Secretary for Women's Health and also served as Director of the Office on Women's Health (OWH) at the U.S. Department of Health and Human Services (HHS) more than two decades ago. I had dedicated much of my career to exposing gender inequities in health, so it was an honor to take on this new senior position in HHS dedicated to advancing the health of 51% of the U.S. population. Back then, women were often excluded as subjects in medical research and data were not analyzed for sex differences. Prevention campaigns for HIV/AIDS, heart disease, and smoking did not target women. This was due to the belief that women were just like men — except for differences in their reproductive systems! Additionally, women often paid more for the same insurance plans than men. There were few women's health offices, conferences, or reports, as well as a lack of women leaders in our nation's medical institutions. These oversights put women's health at risk. We saw rising rates of heart disease, lung cancer, mental illness, substance use disorders, and HIV/AIDS in women.
In collaboration with many partners, we wrote a new national prescription to improve women's health. As a result of OWH's work, women's health became a federal health priority with increased funding, infrastructure, research, and prevention and service delivery programs that targeted women's unique needs. The past 25 years have been an exciting time in women's health. We've made many improvements, and here are just a few examples of our key accomplishments during my years directing OWH:
- We established six National Centers of Excellence in Women's Health at academic health centers across the country to serve as models for advancing research and improving the health care of American women. The program also served as a network to share data, determine best practices, provide community outreach, and promote the career development of women in medicine.
- We established the National Women's Health Information Center at womenshealth.gov and 800-994-9662. It was — and is — a resource hub of reliable and accurate women's health information that's accessible online and by phone.
- We created a Women and AIDS Task Force that I chaired, involving more than 60 organizations.
- Violence against women became a critical priority, and we established the National Domestic Violence Hotline (800-799-SAFE).
- The war against breast cancer became a top concern with a presidential initiative that I co-chaired focused on the disease. During this time, we saw federal and private sector funding to fight breast cancer increase. In 1995, I worked with the Central Intelligence Agency, National Aeronautics and Space Administration, and Department of Defense on an initiative called "From Missiles to Mammograms" that used imaging technology from the intelligence, space, and defense agencies to enhance breast cancer detection and helped catalyze computer-assisted diagnostics as well as 3-D imaging.
- We took a "health in all policies" approach by establishing several Federal Coordinating Committees to engage multiple government agencies and their resources to improve women's health.
- We took a global perspective working with other countries to advance women's health.
- We worked to increase women's access to health care and prevention services. Today, as a result of the passage of the Affordable Care Act of 2010, millions more women have health insurance and cannot be charged more for premiums because they're female or denied coverage for a pre-existing condition.
While much progress has been made over the past 25 years since OWH was established, much more work remains to be done including strengthening advocacy to ensure that advancing women's health remains a national priority. We need more research on sex, gender, and racial and ethnic differences in health and on the diseases that affect women across the lifespan. Research data must be analyzed by sex and any differences found must be reported and published. We need to shift from a treatment-oriented society to emphasize prevention and increase the level of preparedness to meet and beat new threats to women's health and safety, like the current Zika epidemic. We also need to close the gap when it comes to health care disparities for women of color and accelerate the translation of science to improve the delivery of services that address women's unique needs. More attention must be paid to the genetic, social, and environmental factors that influence women's health and examine how they interact to influence women's health and the health of future generations. We also must ensure that all women have access to quality health care and strengthen investments in health programs for women worldwide. When we improve women's health, we also improve the health of families, communities, and countries.
The good news is that over the past 25 years, the government and private sectors have mobilized and are working together in partnerships, leveraging their skills and resources, to improve women's health in the United States and globally. If we remain vigilant, the results of these efforts should brighten the health futures for women — and men — in the 21st century.
The statements and opinions in this blog post are those of the author and do not necessarily represent the views of the U.S. Department of Health and Human Services Office on Women's Health.