This Q&A is a response to the Editorial published in the journal Biology of Sex Differences. SWHR is the journal's official co-partnering Society.
Poster image courtesy of SWHR: Irene O. Aninye (right) and Mala Adiga (left).
What does the Society for Women’s Health Research do, and what are the main goals of the organisation?
The Society for Women’s Health Research is a national non-profit based in Washington, DC (USA) that is dedicated to advancing women’s health through science, policy, and education while promoting research on sex differences to optimize women’s health. Our vision is to make women’s health mainstream.
How do the goals of SWHR relate to the SDGs?
SWHR works to increase awareness and research investment in diseases and health conditions that exclusively, disproportionately, or differently, affect women. The roles of biological sex, hormones, and gender have been documented in various disease states and life stages that impact individuals from every race, ethnic group, geographic location, and socioeconomic status. A comprehensive strategy to improve the lives and health of women, in particular, must take into account these sex and gender differences if we are to sustainably close global gender health gaps. SWHR’s approach promotes interdisciplinary and cross-sector collaborations across the healthcare ecosystem. For every knowledge gap or unmet need, there are research questions that must be answered, clinical care interventions that must delivered, public health strategies that must be developed for diverse populations, and policy solutions that must ensure equitable access for all women.
How do SDG3 (good health and wellbeing) and SDG5 (gender equality) contribute to better health outcomes for women?
Women face unique challenges over the course of their lifespans, due to biological sex differences in health and disease, as well as sociocultural influences related to gender. Women also take on the responsibility of making up to 80% of the health decisions for their families and serve as the caregivers for up to 60% of loved ones with debilitating health conditions: the health of society relies heavily on the health and wellbeing of the mothers, sisters, daughters, and wives that it has so often overworked and undervalued. Appropriately recognizing structural and social determinants that perpetuate gender inequality and health disparities can begin to illuminate the most problematic areas. Further, key stakeholders and influencers in the health care and policy communities must commit to address these inequities at every iteration. A research framework proposed by the National Institute on Minority Health and Health Disparities outlines the need at four levels – individual, interpersonal, community, and societal – across five domains over the life-course – biological, behavioural, physical environment, sociocultural environment, and health care system.
In your Editorial in Biology of Sex Differences you say: “women’s unique health needs influence and are influenced by other goals, such as zero hunger, quality education, reduced inequalities, and partnerships for the goals (Goals 2, 4, 10, and 17 respectively).” Can you tell us how?
Food security is foundational health and wellbeing. What a person consumes provides the nutrient basis for every function throughout the body. Without access to enough food, and the right types of food, the health of women cannot be optimally attained. Education – not just formal schooling, but also general knowledge building and health literacy – supports the ability for women to make informed decisions that promote their own health, as well as the health of those for which they provide care. Partnerships are essential for women’s health, as mentioned before, because health is not achieved in silo. Diverse stakeholders must collaborate to generate solutions and deliver them to the very audiences that inspired the innovation. Without committed partners who have a shared goal to address disparities for women, vulnerable populations will receive minimal or even no benefit from the advancements that could save their lives.
What are the key challenges women face in achieving good health under the SDGs?
Historically, women have been left behind in scientific endeavours, including the systematic and systemic exclusion from participating in clinical trials. Just 30 years ago, the United States Congress passed the NIH Revitalization Act of 1993, mandating the inclusion and reporting of women and underrepresented minorities in clinical research funded by the National Institutes of Health. Health care across the globe is still playing catch-up in women’s health, having to make up for years of lost knowledge. Preventive care, treatment guidelines, and interventions for many health conditions insufficiently account for sex and gender differences, resulting in gender health gaps that exacerbate disparities in women’s health and slow progress toward achieving good health and wellbeing for women worldwide.
How important is it to SWHR that the United Nations recognise the importance of incorporating women’s health in global health and international policy?
Since SWHR’s founding 35 years ago, we have advocated for the national prioritization of women’s health in the United States through federal funding of research and health care policies that promote science-based, patient-centred care. The United Nations incorporating women’s health on the global platform of the UNGA79 Science Summit underscores their commitment to increasing awareness of sex and gender differences in health and disease and supporting the representation of women in leadership across research, health care, and policy decision-making spaces. These are important steps towards ensuring that future best practices and outcomes are produced by more diverse and inclusive perspectives than previous times.
How can we address the social and cultural barriers that affect women's health and hinder the achievement of the SDGs?
Taking a page out of my classroom teaching toolkit, I would offer what may seem like a simplistic suggestion but is quite useful if adapted to address women’s health gaps at a foundational level: Think, Pair, Share.
THINK about one or two social or cultural barriers that have hindered you from achieving your optimal health. Does this barrier cause you to hesitate speaking with a medical professional about an ailment? Does it present an obstacle for you when trying to implement a recommended healthy behaviour like regular exercise, enough sleep, or eating healthy? Does it introduce a challenge or hardship related to accessing resources or health care?
PAIR with a woman in your family, friend circle, or community and discuss this prompt. Allow them to share their perspective first. Listen to understand their experience, and not to point out their errors or solve their problem. Repeat this pairing exercise with different women from different ages, backgrounds, and settings.
SHARE what you have learned with others. Help to spread an appreciation for the unique health needs of women. Advocate for addressing the challenges that arose as common themes in your conversations. As you empathetically share what you learn from the women in your life, ask others to try the exercise and pay it forward for women’s health. Consider sharing your personal health story with SWHR directly at www.swhr.org/shareyourstory.
For each person that engages in this Think-Pair-Share exercise, the awareness building will begin to exponentially increase, and as understanding grows, stigma begins to wear away. We can slowly start normalizing conversations and advocacy for women’s health and begin addressing the unique health needs of women from the ground up.