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Women’s Health Research: Progress, Pitfalls, and Promise
that create a significant burden in women’s lives. The committee focused on health conditions that are specific to women, are more common or more serious in women, have distinct causes or manifestations in women, have different outcomes or treatments in women, or have high morbidity or mortality in women. Numerous conditions could be included in such a list. The committee could not review all such conditions and, therefore, highlights a number of such conditions as examples that are specific to women; that have differences in prevalence, severity, preferred treatment, or understanding for women; or that the condition is prominent in women or there is a research need regarding women, whether or not there are sex-differences. Searches included research on factors that are determinants of health (biologic, psychologic, environmental, and sociocultural factors), especially factors that might affect women disproportionately or uniquely, and on the translation of research findings into practice and the communication of research findings to the public.
When considering health end points, the committee did not present a comprehensive review of findings of all research on all diseases, disorders, and conditions that are women’s health issues. The committee identified a number of conditions that have a large impact on women, reviewed the literature related to them, and categorized them as conditions in relation to which there has been major, some, or little improvement in women’s health.
The committee developed a series of questions to focus deliberations and ensure appropriate response to the charge. Those questions and the committee’s responses to them are presented below.
IS WOMEN’S HEALTH RESEARCH STUDYING THE MOSTAPPROPRIATE AND RELEVANT DETERMINANTS OF HEALTH?
Determinants can range from a woman’s genetic makeup to her behaviors to the social, cultural, and environmental context in which genetic vulnerabilities and individual traits and behaviors are developed and expressed. Over the last 20 years, much has been learned about what the determinants of women’s health are.
The committee found that many behavioral determinants (such as smoking, eating habits, and lack of physical activity) are risk factors for most of the conditions under consideration. Those behavioral factors, in turn, are shaped by cultural, social, and societal contexts. Marked differences in the prevalence of and mortality from various conditions in women who experience social disadvantage due to race and ethnicity, lack of education, low income, and other factors have been documented. The differences stem from a variety of social determinants, including differential exposure to stressors and violence, which are more common in more disadvantaged communities. Such exposures are related to wide-ranging outcomes, including injury and trauma, depression, arthritis, asthma, heart disease, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and other sexually transmitted infections.