A 5-year initiative slowly takes shape.

Abstract

WOMEN'S HEALTH RESEARCH W omen's health research is moving “away from the insularity” that characterized it during the early 1990s, says cardiovascular specialist Marianne Legato, who spoke last week at a huge planning session on women's health—part of an effort sponsored by the National Institutes of Health (NIH) to draft a 5-year agenda for the field. Research is “moving out of the pelvis,” as she said—focusing less on anatomy and the reproductive system and more on gender-based differences at the cellular and molecular level. This shift in emphasis, Legato and others argue, could broaden support for women's health research. For example, Legato said, researchers are learning how important hormones are in controlling the development of the brain and other organs—insights they have gained partly by examining how women differ from men. But the results are likely to help men as much as women. Legato, who heads a women's health project at Columbia University's College of Physicians and Surgeons in New York, is co-chair of a large task force that's trying to establish priorities for women's health research. The panelists, mostly female leaders of 31 research and advocacy groups, are reviewing presentations given at four meetings sponsored by NIH's Office of Research on Women's Health (ORWH). The results will be passed along to NIH chiefs and members of Congress. Although the report won't be finished for a year, NIH's Donna Dean, Legato's co-chair, said the lessons learned from this advisory process may affect NIH decisions before then. For example, she said NIH may be ready to fund an initiative on autoimmune disorders inspired in part by pressure to act on lupus, which is far more likely to strike women than men. And one institute is planning to fund new obstetrics and gynecology research centers. Last week's review was the final session in a yearlong series of meetings held around the country by ORWH director Vivian Pinn. At a press conference on 19 November, Pinn said the aim is to examine what's been accomplished in the 7 years since ORWH was created and to consider “priorities and scientific directives … as we move toward the year 2000.” The gathering also served to raise the visibility of Pinn's office: It drew one Cabinet member—Health and Human Services Secretary Donna Shalala—and three members of Congress. Writing up the recommendations from this exercise won't be easy. A draft list of top priorities discussed at last week's meeting was so long the items were categorized under 25 major headings. The job of sifting wheat from chaff now falls to Legato and Dean.