Promoting equity through sex-specific medical research

Abstract

On March 3, the Mary Horrigan Connors Center for Women's Health and Gender Biology at Brigham and Women's Hospital released Sex-Specific Medical Research: Why Women's Health Can't Wait at a women's health summit in Boston, MA, USA. The report aims to assess progress on inclusion of women in clinical research as mandated in the National Institutes of Health (NIH) Revitalization Act of 1993, which sought to make greater representation of women and minorities in health research a US national priority. Recognising that women and men have different risks for the onset, course, and treatment response of many diseases, it is important to integrate sex-specific analysis in all aspects of research—from basic science to clinical trials, and in subsequent translation into practice and evaluation of clinical outcomes. The report acknowledges that notable advances have been made in maternal health, but notes that sex differences are frequently excluded or inadequately addressed, especially in early stage research. Although women are now routinely included in clinical trials, equity is far from being achieved. To address research disparities, the report recommends that US Federal Agencies, including the NIH, should require design, analysis, and reporting of health research by sex; promote transparency and disclosure regarding the absence of sex-specific health research on new drugs and devices; and adopt clinical practices and training curricula that incorporate gender equity in health research. Despite advances in women's health, such as reductions in the burdens of cervical cancer and heart disease in women, there is still much to do; for example, the growing burden of Alzheimer's disease will affect women disproportionately. Greater attention to sex differences in clinical research will be needed to achieve equitable health outcomes and to improve quality of care. The report calls for renewed attention to the ideals of the NIH Revitalization Act to ensure that health research at all levels is planned and undertaken with appropriate sex-specific analyses—ideals that should be embraced internationally.