Women’s health equity refers to the state in which all individuals who are women[1] and/or were assigned female at birth have a fair and just opportunity to attain their highest level of health.[2] Despite scientific and medical advancements, women continue to be disproportionately affected by many diseases and conditions, including chronic pain, depression, autoimmune diseases (see OADR-ORWH), osteoporosis, and dementia.[3] In addition, common female-specific conditions, such as endometriosis, remain largely understudied and lack effective diagnostics and treatment options.[4] These examples—as well as the rising rates of maternal morbidity and mortality in the United States—underscore the necessity of women’s health research and the importance of women’s health as a public health priority.
As the focal point for women’s health research at NIH, ORWH coordinates, promotes, and supports research to advance women’s health equity and enhance our understanding of intersectionality—the way in which a person’s multiple domains of identity (e.g., their gender identity, race, ethnicity, generation, and sexual orientation), combined with their lived experience, influence their health status and disease risk throughout their life.[5]
To enable a future in which every person receives evidence-based care relevant to their needs, clinical research populations must reflect the diversity of the patient population. Within NIH and beyond, ORWH continues to emphasize the importance of the inclusion of women of all ages, races, and ethnicities in clinical research populations (see NIH Inclusion Policies), including providing support for research specifically focused on populations of women historically understudied, underrepresented, and underreported in clinical research (see U3 Interdisciplinary Research).
Research Programs & Funding Opportunities
The U3 Administrative Supplement Program supports interdisciplinary research focused on intersectionality and health among populations of women that are underrepresented, underserved, and underreported in biomedical research.
Since 2020, ORWH has partnered with the National Institute of General Medical Sciences (NIGMS), along with other participating NIH institutes, centers, and offices, to advance women's health research and women's health equity by expanding research and research capacity in IDeA States. IDeA States are U.S. states and territories that are eligible to receive funding from the IDeA Program.
The GENDER R25 (RFA-OD-22-015) is a funding program to support the development of sex- and gender-focused courses, curricula, and methods that can be widely utilized across disciplines and will be made available along with ORWH’s other online courses and interprofessional resources.
OAR and ORWH launched the joint HIV and Women Signature Program in February 2023. The cornerstone of this new program is an intersectional, equity-informed, data-driven approach to research on HIV and women. The program supports women in scientific careers so they can meet their full professional potential.
In November 2023, the President and First Lady launched the White House Initiative on Women’s Health Research with a clear goal: to fundamentally change how our country approaches and funds research on women’s health.
On March 18, 2024, President Joe Biden signed a new Executive Order (EO) that builds upon the establishment of the White House Initiative on Women’s Health Research. The EO announced new actions to improve women’s health research by prioritizing investments in women’s health research, integrating women’s health across the federal research portfolio, galvanizing new research on women’s midlife health, and assessing the unmet needs to support women’s health research.
As part of the response to the EO, NIH has pledged $200 million to launch an NIH-wide effort to close gaps in women’s health research across the lifespan, such as on the impact of perimenopause and menopause on heart health, brain health, and bone health. ORWH is honored to co-chair this NIH-wide effort alongside the National Institute on Aging (NIA); the National Heart, Lung, and Blood Institute (NHLBI); the National Institute on Drug Abuse (NIDA); the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); and the National Institute on Arthritis and Musculoskeletal and Skin Diseases (NIAMS). This effort will invest in research on a wide range of women’s health issues, call for new proposals to research emerging women’s health issues, and study the effect of environmental factors on women’s health.
Further, NIH has identified a lack of awareness among researchers about federal funding opportunities as a potential barrier to women’s health research. In response, NIH issued a new Notice of Special Interest (NOSI) to identify open funding opportunities related to women’s health research across a wide range of health conditions. ORWH has also created a dedicated, consolidated webpage highlighting funding opportunities related to women’s health across each of NIH’s 27 institutes.
Toolkits & Information Portals
The NIH MMM Web Portal highlights NIH research efforts to understand and combat the maternal health crisis. It hosts a collection of relevant resources for scientists, clinicians, advocates, and the public.
The NIH Inclusion Outreach Toolkit serves as a resource for researchers to learn about the history and importance of including women in clinical research. It also contains information about related policies and case studies, as well as tools and best practices for advancing the inclusion of women in research.
Webinars & Conferences
ORWH’s quarterly lecture series, “Diverse Voices: Intersectionality and the Health of Women,” amplifies research that incorporates an intersectional framework, and it addresses the breadth of topics relevant to the health of women.
In recognition of the significant health impacts of gender as a social and cultural variable, ORWH and the Eunice Kennedy Shriver National Institute of Child Health and Human Development hosted a scientific workshop in October 2022, titled “Gender and Health: Impacts of Structural Sexism, Gender Norms, Relational Power Dynamics, and Gender Inequities.” Participants discussed the landscape of NIH-supported research on gender roles, gender norms, and gender inequity and identified opportunities in this space. The workshop included discussions on methods and best practices for health research on gender roles, gender norms, and gender inequity.
In response to a congressional request to address NIH efforts related to women’s health research, ORWH, on behalf of the Advisory Committee on Research on Women’s Health, hosted “Advancing NIH Research on the Health of Women: A 2021 Conference” on October 20, 2021. The key topics discussed, as identified by Congress, were (1) clinical practices related to rising maternal morbidity and mortality rates; (2) increasing rates of chronic debilitating conditions in women; and (3) stagnant cervical cancer survival rates. Read the full report here.
The Vivian W. Pinn Symposium honors the first full-time Director of ORWH, Vivian W. Pinn, M.D., and is hosted each year in recognition of National Women’s Health Week. In line with ORWH’s mission to put science to work for the health of women, this public-facing event serves as a critical forum for experts across sectors to communicate and collaborate for the advancement of women’s health.
Reports & Strategic Planning
The NIH-Wide Strategic Plan for Research on the Health of Women 2024-2028 outlines strategic goals to guide and inform NIH-supported research on the various diseases and health conditions that affect women.
Developed in collaboration with the NIH institutes, centers, and offices, this report established NIH’s plan, strategic goals, and vision for women’s health research for 2019 through 2023.
The Report of the Advisory Committee on Research on Women’s Health: Office of Research on Women’s Health and NIH Support for Research on Women’s Health is a biennial report by the Advisory Committee on Research on Women’s Health detailing programs and accomplishments from across NIH in the area of women’s health and sex differences research. This report also includes data on the inclusion of women in clinical trials funded by NIH.
References
[1] Note: We use the term “women” to include all individuals who identify as women, including cisgender, transgender, and gender-diverse women.
[2] National Institute on Minority Health and Health Disparities (n.d.). What is health equity?. U.S. Department of Health and Human Services, National Institutes of Health. https://www.nimhd.nih.gov/resources/understanding-health-disparities/health-equity.html. Accessed 5-Jul-2023
Centers for Disease Control and Prevention. (n.d.). Health equity. U.S. Department of Health and Human Services. https://www.cdc.gov/healthequity. Accessed 5-Jul-2023
[3] Office of Research on Women’s Health. (2020). Perspectives on advancing NIH research to inform and improve the health of women. U.S. Department of Health and Human Services, National Institutes of Health. Perspectives on advancing NIH research to inform and improve the health of women.
Centers for Medicare & Medicaid Services. (2020). Chronic conditions among Medicare beneficiaries: A methodological overview. U.S. Department of Health and Human Services. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/Downloads/Methods_Overview.pdf
Angum, F., et al. (2020) Cureus. PMID: 32542149
International Association for the Study of Pain. (n.d.). Pain in women. https://www.iasp-pain.org/advocacy/global-year/pain-in-women/. Accessed 19-Jan-2023.
[4] Mirin, A. A. (2021). Journal of Women’s Health. PMID: 33232627
As-Sanie, S., et al. (2019). American Journal of Obstetrics & Gynecology. PMID: 30790565
[5] Alvidrez, J., et al. (2021) American Journal of Public Health. PMID: 33326274