The government recently appointed Dame Lesley Regan, professor of obstetrics and gynecology at Imperial College London, as England’s first Women’s Health Ambassador. The new role was created to help close the gender gap in health.
Women make up 51% of the population in England and Wales, but persistent gender-based inequalities in health, social protection, living standards and employment mean that women spend more years than unhealthy men. And for the first time in a century, their life expectancy is falling – and women in deprived neighborhoods are the most affected.
Women from underserved and underrepresented racial and ethnic groups face consistently poor outcomes, even after controlling for socioeconomic factors. Black mothers are four times more likely to die during pregnancy and childbirth than white mothers.
Timely, inclusive and relevant research based on woman-centred care is essential to addressing the above issues. Regan stressed the immediate need to focus on areas that affect almost all women – like menopause, menstrual issues and contraception. She also stressed the importance of empowering women to access the health care they need throughout their lives.
Women’s health should be considered across the lifespan. For example, conditions such as polycystic ovary syndrome have different symptoms at different stages of a woman’s life. Menstrual irregularities and facial hair are common in adolescence, but other symptoms – such as infertility, diabetes during pregnancy and even complications such as high blood pressure and type 2 diabetes, accidents strokes and heart attacks – are common in the long term. A single strategy targeting polycystic ovary syndrome throughout a woman’s life will have a positive effect on her health in the short and long term.
Another important area that needs more attention is pregnancy in women with underlying complications, such as epilepsy. Compared to over 200 randomized trials involving the general population with epilepsy, there is only one trial involving pregnant women. Despite improved maternity care, maternal deaths are increasing among women with epilepsy, primarily because the risks of seizures during pregnancy are not properly identified.
Read more: Research on pregnancy, childbirth and infant care is historically underfunded – and women are paying the price
Effective communication of risks, benefits and treatments during pregnancy is an essential component of woman-centred care. The recent Cumberlege review of complications in babies exposed to the drug valproate (an epilepsy drug) during pregnancy highlights the lack of communication with women about the risks. In order for women to make informed decisions about the treatments offered to them, they need reliable information on the long-term effect of the drugs taken during pregnancy.
Pregnancy and lactation should not be grounds for excluding women from drug trials. The recent Safe and Effective Medicines for Use in Pregnancy report outlines how research can be managed to alleviate safety concerns and build confidence in women and their doctors.
Racial and ethnic disparities
To optimize the health of all women, we must address disparities in health outcomes stemming from racial, ethnic and socioeconomic factors. The first step is to really understand the burden of the problem faced by women in different regions and for specific conditions, and to provide targeted funding. We need to identify women at risk of poor health early and target interventions to prevent complications. Additionally, pregnancy complications negatively affect babies in the long run. This intergenerational impact can further aggravate inequalities related to race and ethnicity.
It will also be important to invest more in research that promotes women’s health. This can be achieved by building on UK academic expertise, investing more in these areas, building infrastructure within the NHS and providing training opportunities for early career researchers and clinicians. The seamless integration of academic and health services is essential to successful research.
Any effort to improve women’s health can only be successful if women and their families are involved from start to finish in research. Women must guide, support, direct and disseminate research. We need dedicated, inclusive and representative patient and public groups to promote women’s health research.
The appointment of a dedicated Women’s Health Ambassador is the first step towards achieving the ambitious goal of eliminating health inequalities based on gender, race and income for the benefit of all women and generations. future.