Addressing Women's Health

Abstract

Disparities in women's health and health care increasingly fuel concerns, prompt studies, and advance international policies. The World Medical Association has consistently highlighted the need to address inequities in women's health care, and the World Health Organization continues to include improvements to women and children's health prominently among its goals (World Health Organization, 2009 2018; World Medical Association, 2002, 2008). Until recently, women's health suffered from a void in knowledge to appropriately inform practice and medical policies (Institute of Medicine, 2010), despite the fact that women represent the largest segment of the world population. Until the post-World War II era, male subjects were exclusively used in animal or human biomedical experiments and drug trials. The results of these studies were extrapolated to female, elderly, and child patients. For example, common medications used in men were administered to children, but in smaller doses, and aspirin was administered to women to prevent heart attacks. does not now have appropriate management systems to monitor how many women are in clinical trials, to be assured that NDAs and IND annual reports are in compliance with pertinent regulations for presenting outcome data by sex and tabulating the number of women included in ongoing trials, or to confirm that its medical officers have adequately addressed sex-related issues in their reviews. While FDA has taken some promising initial steps to address these deficiencies, it is important that the agency finalize the pilot programs it has underway and give sustained attention to these management issues. (U.S. Government Accountability Office, 2001, pp. 19–20) The figure below highlights further global socioeconomic, physical, and medical obstacles to delivering adequate health care to women. For centuries, the focus on women's health was limited to “reproductive health.” Women of all ages have also historically been disproportionately subjected to abuse and neglect. Providing preventive care to women, and reducing disparities and violence (including human trafficking) will contribute a long way to ensuring healthy and productive life spans for women. A major policy objective to achieve this goal is an aggressive literacy program for women (including health literacy). These considerations are included in the WHO millennium goals. Health-care funding and access are, of course, influenced by politics. An evidence-based approach to health-care delivery for all men, women, and children, without the influence of prejudice or personal convictions, is a major driver to ensure effective patient care and disease prevention. Continued debates over rationing health-care services, ensuring universal access, reproductive rights, and social justice in medicine are political discussions that influence policy. Acknowledging and addressing the difference between opinions and evidence in these debates is essential to appropriately informing and educating individuals on risks and outcomes in health care. Health literacy and education of the public are essential for better health care, lifestyle choices, and family security, particularly for women. Cultural, societal, and ethical values play a significant role in the formulation of policies dealing with health and medical practice and should be all inclusive of race, age, and sex. No individual should be excluded from participation in informed health-care decisions or access. The WHO charter for health promotion produced in 1986 in Ottawa defined health as, “a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities” (World Health Organization, 1986). Sex, female or male, matters in health and disease. Male and female bodies react differently to the same stimuli. Sex differences manifest in the function of many bodily organs, beyond the reproductive and genitourinary systems, including the brain, musculo-skeletal system, heart, and lungs. Additional interdisciplinary research is required to recognize these differences. More information is needed in the areas of pain and pharmacodynamics of medications, central nervous system (CNS) functioning, digestive tract, and immune system responses to environmental stresses and challenges. World Medical & Health Policy is committed to addressing health issues related to sex and gender. Under the leadership of Professor Stabile, co-editor of World Medical & Health Policy, The Schar School of Policy and Government at George Mason University, along with the Policy Studies Organization, is supporting a biennial workshop dedicated to Women's Health in Global Perspective. Many of the participants have the opportunity to publish excellent papers in World Medical & Health Policy (Stabile & Nicogossian, 2016, 2017). The second successful workshop was held in March 2018, and the editors look forward to receiving additional manuscripts to advance knowledge and thought, and improve policy, with regard to women's health.