migraines, sexual dysfunction, stress-related disorders, thyroid disease, and type 2 diabetes—are not discussed here. Because of the volume of literature available, the committee could not discuss the research on all health conditions important to women and on some conditions there was little research to discuss. Absence of discussion does not indicate that the committee thought it unimportant. The committee highlighted conditions to provide examples of successes and examples of less progress on which overarching conclusions and recommendations can be based.

The diseases on which there has been substantial progress are breast cancer, cardiovascular disease, and cervical cancer. Conditions on which there has been some progress are depression, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), and osteoporosis. The committee discusses research on other conditions—unintended pregnancy,2 maternal mortality and morbidity, autoimmune diseases, alcohol and drug addiction, lung cancer, gynecologic cancers other than cervical cancer, non-malignant gynecological disorders, and dementia of the Alzheimer type (Alzheimer’s disease)—on which little progress has been made.

Each condition is discussed with regard to a brief evaluation of advances in research; its relevance to women’s health in terms of current incidence, prevalence, and mortality rates and trends therein; disparities in current incidence, prevalence, and mortality rates and trends therein among groups of women (see Box 3-1 for explanation of data on disparities); advances in research, particularly in relation to women’s health encompassing research on the understanding of the biology, prevention,3 and diagnosis of, screening, and treatment for it; research gaps; and lessons learned from the research and extent of progress. When discussing treatments, the committee focuses on conventional treatments and does not discuss complementary and alternative medicine (CAM) in detail. As discussed in a previous Institute of Medicine (IOM) report (2005), women are more likely than men to seek CAM therapies and, therefore, those therapies are important to consider when looking at women’s health, from the perspective of potential therapies as well as their potential toxicities and interactions with other medications. The reader is referred to the previous IOM report for further details on CAM research (IOM, 2005).

It is important to note that trends in incidence need to be interpreted in the context of changes in diagnostic criteria and technologies, which can result in the appearance of an increased incidence of a condition (see Box 3-2). This chapter addresses questions 2, 3, and 4 from Box 1-4, whether women’s health research is

2

The committee considered whether to discuss unintended pregnancy as a health outcome or a determinant of health. It decided to discuss it as an outcome, along with maternal mortality and morbidity, and discuss the determinants that increase the rate of unintended pregnancies in Chapter 2.

3

Non-biological determinants of health are mentioned only briefly in this chapter. Details of research on them are discussed in Chapter 2.



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