The Underfunding of Women’s Health Research

The medical sciences have historically prioritized men’s health in both research and funding, often overlooking the specific health needs of women. This gender bias in medical research has significant implications: it not only neglects half of the population but also limits the overall progress in medical science. Women’s health issues, differing substantially from men’s, require dedicated study to develop effective treatments and understanding. 

The underfunding of women’s health research leaves critical questions unanswered and overlooks potential economic benefits. This article explores the consequences of this disparity and the potential gains from refocusing attention and resources on women’s health research.

Dr. Chloe Bird, program director of the Center for Health Equity and Research at Tufts Medical Center, spoke with us about the underfunding of women’s health research, the implications, and how policies and institutions can support the equity of health research moving forward.

The historical trajectory of medical research has been markedly skewed, with a predominant focus on men’s health. This bias stems from outdated notions and logistical challenges, where men were considered the default subjects for study, ostensibly to avoid variables introduced by women’s hormonal cycles. However, this approach has led to a considerable knowledge gap in understanding how different health issues affect women.

“There’s been a history of treating women’s health research as a replication of established knowledge,” began Dr. Bird. ”And as a result, scoring grants proposing to look at the health of women lower because they are not seen as innovative or significant. There are assumptions that, from the perspective of women’s health, can be seen as biases that prioritize the kinds of research that have been done to date.”

For instance, cardiovascular disease, often perceived as a “men’s disease,” is the leading cause of death among women in the United States. Yet, the diagnostic tools and treatment strategies are largely based on male-centric research, leading to misdiagnosis and less effective treatment for women. 

Similarly, the majority of foundational studies on diseases like osteoporosis and autoimmune disorders, which disproportionately affect women, have been conducted primarily on male subjects or without gender-specific analysis.

This imbalance extends to funding as well. A study by JAMA Internal Medicine revealed that diseases primarily affecting women, such as fibromyalgia and migraines, receive significantly less funding compared to those affecting men. This disparity not only hinders the development of effective treatments for these conditions but also reflects a broader issue of gender inequality within the scientific community.

“Traditionally, the main funding avenue has been the National Institutes of Health (NIH), but there are great gaps in the funding and in the priorities,” Dr. Bird explained. “A lot of what I focus on through my research is how we address that. There’s a tremendous opportunity for foundations and donor-based funding to help advance the research on women’s health.”

The consequences of this gender bias in medical research are far-reaching. It has not only impeded the advancement of women’s health care but has also limited our overall understanding of human health. Diseases manifest and progress differently in men and women, and a one-size-fits-all approach to medical research is fundamentally flawed. 

“It’s possible through getting the funding that helps explore the nature of the gaps, to demonstrate that there are differences, for example, in the processes for the development of cardiovascular disease, which we see in some of the animal studies,” Dr. Bird highlighted recent research. “Now, including our work here at Tufts, getting the funding to build on that kind of information can allow researchers to put forward grants that will be far more competitive and overcome some of that bias.”

Recognizing and addressing this bias is a matter of equity, scientific accuracy, and healthcare efficacy.

The underfunding of women’s health research is not only a gap in medical understanding but also a missed economic and social opportunity. 

Women, making up over half of the U.S. population, are disproportionately affected by certain health conditions, yet their representation in medical research is lacking. For instance, as mentioned previously, despite cardiovascular disease being the leading cause of death among women, they are underrepresented in relevant clinical trials. This gap in research leads to less effective treatments and higher healthcare costs.

Economically, prioritizing women’s health research can lead to significant cost savings. Diseases that primarily affect women, like autoimmune diseases, are costly to manage due to the lack of targeted treatments. Enhanced research can lead to more effective therapies, reducing long-term healthcare expenses. 

Additionally, improving women’s health outcomes has broader economic implications. Healthier women can contribute more actively to the workforce, enhancing productivity and economic growth.

From a social perspective, women are often the family’s primary healthcare decision-makers. Improved health outcomes for women have a ripple effect, benefiting families and communities. With this in mind, diseases that disproportionately impact women can place a substantial burden on social systems. For example, conditions like osteoporosis and rheumatoid arthritis, which predominantly affect women, can lead to increased dependency and healthcare costs. Investing in women’s health research can alleviate these burdens, benefiting society as a whole.

Addressing the funding gap in women’s health research is a strategic imperative. Redirecting focus and resources toward this area is not only about correcting a longstanding imbalance but also represents a practical opportunity for significant advancements in medical science. 

Increased investment in women’s health research is expected to lead to more effective medical treatments, reducing healthcare costs and enhancing the quality of life. This approach goes beyond merely balancing research priorities; it’s about tapping into a previously underexplored area of medical research, promising to fill essential knowledge gaps and offer substantial economic and societal benefits.

A compelling case study that underscores the value of increased funding in women’s health research comes from an analysis commissioned by Women’s Health Access Matters. This nonprofit advocacy organization conducted a series of simulations to examine the potential return on investment from doubling the NIH budget for studies specifically assessing women’s health.

For instance, in the case of Alzheimer’s research, where nearly two-thirds of the 6.2 million Americans affected are women, the study proposed increasing the funding from $288 million to $576 million. The simulations assumed that this increase in budget would yield a minimal health improvement, estimated at just 0.01 percent for Alzheimer’s and coronary artery disease, and 0.1 percent for rheumatoid arthritis, over a 30-year period.

Despite these conservative estimates, the projected returns were remarkable. For coronary artery disease research focused on women, currently funded at $20 million, doubling the budget could potentially lead to a return on investment of 9,500 percent. Similarly, for rheumatoid arthritis research, which receives about $6 million annually, a doubled investment could result in an astonishing 174,000 percent return, adding an estimated $10.5 billion to the economy over three decades.

These projections are not just numbers—they represent real potential improvements in health outcomes and economic gains. For example, rheumatoid arthritis significantly impacts women, often leading to early retirement or reduced work capacity. This affects personal earnings and has broader economic implications. Enhancing research funding in this area could lead to better treatments, potentially enabling millions of women to maintain or return to the workforce, thereby contributing more effectively to the economy.

This case study clearly demonstrates the practical benefits of increased investment in women’s health research. The potential returns, both in terms of health outcomes and economic impact, are too significant to ignore.

The potential benefits of increased funding in women’s health research extend well beyond directly improving health outcomes. The substantial economic return on investment (ROI) from such funding provides a compelling case for policymakers and investors. 

“We did look at what would be the return on investment where we monetize the impacts of increasing funding on the health of women, such that, in the case of coronary artery disease, it was 9,500 percent. This is tremendous,” said Dr. Bird highlighting the research findings.

This is not just a financial figure—it reflects significant advancements in treatment efficacy and healthcare cost savings. Such figures underscore the economic viability of investing in women’s health research, highlighting how even small improvements in disease outcomes can have a large economic impact.

Moreover, the potential ROI goes beyond direct economic gains. Improved health outcomes for women can lead to broader societal benefits, such as increased workforce participation, reduced dependency on healthcare and social services, and enhanced family well-being. With women often being primary caregivers, their improved health directly benefits the wider community.

The projected ROI from increased funding in women’s health research is not merely a financial return but a societal gain. This includes better health outcomes for a significant portion of the population and considerable economic and social benefits. Such projections make a strong case for re-evaluating and increasing investment in women’s health research.

Looking forward, increasing investment in women’s health research could catalyze a paradigm shift in medical science and health policy. A greater focus on women’s health issues would fill existing knowledge gaps and pave the way for innovative treatments and healthcare strategies. This shift could lead to a more inclusive and comprehensive understanding of health issues that affect both women and men.

“My primary recommendation has been increasing funding for NIH and prioritizing women’s health in that increased funding. It will lead to better science,” Dr. Bird explained. “It will lead to answers that tell us more about the population’s health and how else we go about it. I think there’s work underway to assess some rational approaches or alternatives for where we’re to put additional dollars but there’s a cost or trade-off in moving dollars from work that’s working.”

In terms of health research policy, this would necessitate a reevaluation of funding priorities and grant allocations. Encouraging a gender-balanced approach in clinical trials and studies would become a norm, ensuring that medical research and treatments are effective and relevant for everyone. This change could also stimulate a broader interest in women’s health issues among researchers and funding bodies, leading to increased collaboration and innovation.

“There are two approaches that I would take, if I were to start today [to address these issues],” explained Dr. Bird. “One is funding systematic reviews, to look at what we know and don’t know, around specific areas of women’s health, and requiring that it be explicit as to whether a lack of evidence of sex or gender differences is the result of a large body of evidence that does not indicate or consistently support that there are areas of differences versus what we tend to see, the question has not or has rarely been asked. Second, not just calling for or recommending work that assesses for sex and gender differences, but requiring it as part of complete work. We are a decade into the ‘sex as a biological variable’ policy, which requires that you give a reason for not looking at sex as a biological variable. But it is a checkbox approach—it is not required that the work be done. It falls more in the realm of a recommendation.”

With this in mind, the medical sciences need to embrace a more inclusive research approach, one that recognizes the unique health needs of women and leverages them for the benefit of all.

Addressing the funding disparity in women’s health research offers significant opportunities for scientific advancement, economic growth, and societal improvement. By increasing investment in this area, we can develop more effective treatments, reduce healthcare costs, and enhance the quality of life for a significant portion of the population. The potential return on investment is too substantial to be overlooked. 

Ultimately, the increased focus and investment in women’s health research could drive substantial improvements in healthcare quality and effectiveness, benefitting women and the entire population. It represents an opportunity to enhance the health and well-being of society as a whole, making it a priority not just for the medical community but for policymakers and society at large.