Doctor checking a woman's heart rate

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Women's Heart Disease Awareness

February 5, 2014

Friday is National Wear Red Day, when people are asked to wear red to raise awareness about the health risks women face from heart disease.

Chloe E. Bird, a senior sociologist at RAND, a professor at the Pardee RAND Graduate School and the editor-in-chief of Women's Health Issues, has authored several publications dealing with a range of women's health issues, including cardiovascular health.

Bird led a RAND study entitled Mapping Gender Differences in Cardiovascular Disease and Diabetes Care and a study funded by the National Heart, Lung, and Blood Institute of neighborhood effects on the incidence of cardiovascular disease among women based on data from the Women's Health Initiative (WHI).

Too little attention is devoted to preventing heart disease in women and improving the quality and outcomes of their care, Bird wrote in an op-ed titled Making Heart Disease a Women's Issue that was published last year in Ms. Magazine. Her latest commentary was published this month in Women's Health Issues and is summarized below.

Will extending the Women's Health Initiative lead to better research and policy?

The longitudinal follow-up of the WHI cohort has already yielded hundreds of breakthrough findings on women's health and health care, including the effects of estrogen and progestin on a large range of outcomes, from cardiovascular disease to dementia. An increasingly large and diverse group of researchers are using WHI data to assess an expanding array of women's health behavior and conditions. Follow-up of the WHI cohort can inform health care and policy decisions and research in countless ways:

  • The geographic diversity of the cohort offers a unique opportunity to assess how variations in women's lives and circumstances contribute to their health and longevity as they age. For example, what household and community factors are associated with physical activity and exercise, and can these factors be supported through local policies and programs? WHI data, collected nationwide, can inform healthy aging policy and community programs in a way that smaller studies, particularly those confined to a particular geographic area, cannot.

  • Social and economic costs are growing rapidly as our population ages, with the corresponding decline in health and physical functioning. These factors are particularly relevant to research on women, who outnumber men in the oldest cohorts. Key policy questions, such as what individual and community factors and policies facilitate older women's ability to “age in place,” may be answered by following WHI women into older age. The WHI is unique in providing the longitudinal health data needed to assess how health trajectories play into decisions about living arrangements and whether particular health behaviors or factors can potentially prevent decline and enable women to continue to live on their own.

  • Continued follow-up of the WHI cohort can help answer questions regarding which types of programs and medical care are most effective for maintaining health and health-related quality of life throughout the aging process. These national data provide a unique opportunity to inform a wide range of state and federal policy decisions with potentially substantial economic benefits to both women and taxpayers; conversely, the costs of failing to fund the continued follow-up of this unique cohort may represent an irrecoverable loss.

WHI is important because of the lack of an institute devoted to either women's health or to sex/gender and health at the National Institutes of Health. While some will argue that research and an institute specific to women's health is not necessary, differences in men's and women's biology and the social and biological pathways that lead to their health trajectories substantiate the need for a more systematic evaluation of whether research findings apply similarly to women's and men's health.

Scott Orr