Sex-Specific Medical Research: Why Women's Health Can't Wait - Mary Horrigan Connors Center for Women's Health & Gender Biology

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Sex-Specific
Medical
Research
Why
Women’s
Health
Can’t Wait
A Report of the
Mary Horrigan Connors Center
for Women’s Health
& Gender Biology
at Brigham and Women’s Hospital
Sex-Specific
Medical
Research
Why
Women’s
Health
Can’t Wait
A Report of the
Mary Horrigan Connors Center
for Women’s Health
& Gender Biology
at Brigham and Women’s Hospital
The Connors Center for Women’s Health and Gender Biology and the
Division of Women’s Health at Brigham and Women’s Hospital, led
by Paula A. Johnson, MD, MPH, are committed to improving the health
of women and transforming their medical care through the discovery,
dissemination and integration of knowledge of women’s health and sex-
and gender-based differences and the application of this knowledge
to the delivery of care. We are committed to building awareness of
issues related to women’s health and gender biology among clinicians,
patients and the general public, advocating for changes in public policy
to improve the health of women, and advancing the field of women’s
health globally by developing leaders with the experience and skills to
have a major impact on improving the health of women. For more infor-
mation, please see www.brighamandwomens.org/connorscenter.
© 2014, Brigham and Women’s Hospital
Sex-Specific
Medical Research
Why Women’s Health
Can’t Wait
A Report of the
Mary Horrigan Connors Center
for Women’s Health & Gender Biology
at Brigham and Women’s Hospital
AUTHORS
Paula A. Johnson, MD, MPH
Chief, Division of Women’s Health and Executive Director, Connors Center
for Women’s Health and Gender Biology, Brigham and Women’s Hospital;
Professor of Medicine, Harvard Medical School
Therese Fitzgerald, PhD, MSW
Director, Women’s Health Policy and Advocacy Program, Connors Center
for Women’s Health and Gender Biology, Brigham and Women’s Hospital
Alina Salganicoff, PhD
Vice President and Director, Women’s Health Policy, Kaiser Family Foundation
Susan F. Wood, PhD
Director, Jacobs Institute of Women’s Health, Associate Professor of Health Policy,
George Washington University, School of Public Health and Health Services
Jill M. Goldstein, PhD, MPH
Director of Research, Connors Center for Women’s Health and Gender Biology,
Brigham and Women’s Hospital;
Professor of Psychiatry and Medicine, Harvard Medical School
CONTRIBUTING AUTHORS
Yolonda L. Colson, MD, PhD
Professor of Surgery, Harvard Medical School;
Director, Women’s Lung Cancer Program, Brigham and Women’s Hospital
Laura Cohen, JD
Senior Health Policy Analyst, Women’s Health Policy and Advocacy Program, Connors Center
for Women’s Health and Gender Biology, Brigham and Women’s Hospital
Usha Ranji, MS
Associate Director, Women’s Health Policy, Kaiser Family Foundation
Andrea Camp
Senior Policy Advisor, Communications Consortium Media Center
Carolyn Luk
Research Assistant, Women’s Health Policy and Advocacy Program, Connors Center
for Women’s Health and Gender Biology, Brigham and Women’s Hospital
D. Richard Mauery, MS, MPH
Managing Director, Jacobs Institute of Women’s Health, George Washington University
Janet Rich-Edwards, ScD
Associate Professor, Harvard Medical School (Department of Medicine) and
Harvard School of Public Health (Department of Epidemiology);
Director of Developmental Epidemiology, Connors Center for Women’s Health
2
and Gender Biology, Brigham and Women’s Hospital
ACKNOWLEDGMENTS
We would like to acknowledge the generous contribution of the Boston Foundation in publishing and disseminating
the report and for editing and designing the final product. In particular, we would like to thank Mary Jo Meisner,
Barbara Hindley, and Kathleen Clute of the Boston Foundation and Katherine Canfield of Canfield Design.
Special thanks are due to our reviewers, particularly Ruth J. Katz, Director of the Health, Medicine and Society
Program at the Aspen Institute and Chloe E. Bird, PhD, senior sociologist at RAND and professor of sociology and
policy analysis at the Pardee RAND Graduate School, for their valuable comments, suggestions and ongoing support.
We would also like to thank Nisha Kurani, Program Associate at the Kaiser Family Foundation for her invaluable
assistance.
Finally, we want to express our deep appreciation to the members of Congress, pioneers and advocates whose tireless
dedication and force of action made the historic NIH Revitalization Act a reality. They are true champions who
ushered in a new era of federal policy focused on gender equity in medical research.
FOREWORD
T
wenty years ago, a bipartisan group of legislators worked with patients, providers, policy makers, and
advocates to create and pass the 1993 National Institutes of Health Revitalization Act, a law mandating that
women and minorities be included in clinical trials funded by the NIH. In many ways the law has been a success.
Women are now routinely included in clinical trials, and we have learned how certain diseases present differently
in men and women.
Yet, despite some progress, medical research is too often flawed by its failure to examine sex differences. It is now
clear that men and women experience illness differently and this report looks closely at four diseases where this
is especially true: cardiovascular disease, lung cancer, depression and Alzheimer’s disease. The past two decades
have shown not only that sex differences exist, but have produced scientific advancements that enhance our ability
to discover why they occur and how we might adapt prevention, detection and treatment strategies for the benefit
of women and men alike. Therefore, to ignore these differences challenges the quality and integrity of science and
medicine.
While this report focuses on women, understanding health differences is valuable to all who want to understand
the impact of different conditions and treatments on men and communities of color as well. Our hope is that this
document will fill a void in our collective conscience by highlighting the challenges ahead and inspiring men and
3
women alike to care about the inequities that now exist. Researchers around the world have worked tirelessly on these
issues, and many of their studies are cited in these pages. We gratefully acknowledge their important contributions.
In addition to documenting the problem, this report also offers a realistic, concrete action plan for a path forward.
We hope this plan will inspire all stakeholders to work together to gain a recommitment to research in which the study
of sex differences is the norm, not the exception.
Now is the time for us to act so that we can realize the promise of the NIH Revitalization Act. Embracing the study of
sex differences can improve the lives of women and men in the United States and around the globe, for this generation
and for generations to come.

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