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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy’s 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

Support for this project was provided by the Department of Health and Human Services, National Institutes of Health (NIH) Office of Research on Women’s Health (Award No. 1-OD-4-2139), with contributions from the National Institute of Environmental Health Sciences, NIH, the National Institute of Child Health and Human Development, the Office of Women’s Health, the Centers for Disease Control and Prevention, and the Office of Research and Development, Environmental Protection Agency. The views presented in this report are those of the Committee on Gender Differences and are not necessarily those of the funding organizations.

International Standard Book No. 0-309-06423-6

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Copyright 1998 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

First Printing, March 1998

Second Printing, November 1998



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