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(The RAND Blog)

March 28, 2014

Assessing and Addressing Women's Health and Health Care

by Chloe E. Bird

Women make up a majority of the U.S. population. Yet research policies and practices often treat women's health and health care as special topics or minority issues. The resulting knowledge gaps hamstring efforts to improve women's health care and outcomes even for cardiovascular disease, the leading cause of death among women. Gender-stratified research can produce more effective decision tools and interventions, and in turn improve both women's and men's health and health care. Until access, quality, and outcomes of care are tracked by gender, inequity in treatment will remain invisible and consequently intractable.

Many of the challenges in women's health research in the United States relate to the lack of requirements for gender-based analyses. Such analyses can determine whether specific findings apply differentially to women and men. The National Institutes of Health Revitalization Act, passed by Congress in 1993, requires that women be included in clinical research. However, the law does not require researchers to include enough women participants to allow gender-based analyses or to carry out such analyses even when they are feasible.

A range of decisionmakers have opportunities to improve research to inform policy and practice on women's health care. One strategy would be to begin funding more gender-based analyses in health research. A second strategy would be to increase the integration of gender considerations across health services research. Since December 2010, the Canadian Institutes of Health Research has required all research funding applicants to indicate how they will examine sex and gender or state why they do not plan to do so. Other countries such as Norway (PDF) consider such requirements for federally funded research essential to assuring state-of-the-art research. Similarly, raising publication standards for analyses and reporting on women's health and outcomes would motivate change. For example, the Gender Policy Committee of the European Association of Science Editors is presently developing a Common Standard for Gender Policies in Scientific Publishing.

Advancing research on women's health is essential to improving women's health care and outcomes. With the implementation of the Affordable Care Act, new ways to assess and track quality of care for the newly insured are being developed and will become routine. This tracking should take gender into account so that disparities in health care and outcomes become visible and get the attention they deserve.

Chloe E. Bird is a senior sociologist at the RAND Corporation.