By: Gabriella Watson, MS, Science Programs Coordinator.
From autoimmune and cardiovascular diseases to dementias, cancer and mental health – certain diseases and conditions disproportionately, differently, or exclusively affect women. A lifespan approach to women’s health research investigates various issues across the different stages of a woman’s life in order to preserve health and to prevent, diagnose, and treat these very diseases and conditions. It also recognizes the influences of biological sex, gender, age, race/ethnicity, geography, health insurance coverage, and access to care – among other factors – that contribute to and influence women’s health.
In an effort to highlight and address disparities in women’s health across the lifespan, the Society for Women’s Health Research (SWHR) launched the Women’s Health Dashboard. The dashboard serves as a resource and centralized platform for SWHR and other stakeholders in the women’s health space to explore the latest national and state data on health conditions and diseases that have significant impacts on women’s health.
Assessing Priority Issues in Women’s Health
According to data from the Centers for Disease Control and Prevention (CDC), in 2018, the leading causes of death for people in the United States included homicide, diabetes, Alzheimer’s disease, chronic obstructive pulmonary disease, and malignant neoplasms (cancerous tumors) of the trachea, bronchus, and lung. After further analyses that included disease burden and stratification by sex, the data revealed five diseases and conditions that had the most disproportionate effects on women. These became the initial focus areas for the dashboard:
- Alzheimer’s disease
- Breast cancer
- Chronic obstructive pulmonary disease
- Depressive disorders
- Ischemic heart disease
*Source: CDC Wonder [1]
**Source: WHO Global Health Estimates [2]
Alzheimer’s disease, a type of dementia, is a progressive neurological disorder that affects memory, thinking, and behavior. In 2018, of the 5.5 million people ages 65 and older living with Alzheimer’s in the United States, two-thirds were women. Alzheimer’s disease was the second leading cause of death for women, with women of color and women living in Southern states facing a particularly high burden of disease. Given the rapidly growing population of older adults in the United States, the impacts of Alzheimer’s disease, including financial costs and caregiving burdens, are of great public health concern. It is reported that over one-third of dementia caregivers are women, and that women who are caregivers have higher levels of depression and worse health when compared to men. Despite its disproportionate impacts on women, less than 1.0% of Alzheimer’s research grants funded by the National Institutes of Health (NIH) are focused on women’s health. Learn more about Alzheimer’s Disease and Women’s Health on the SWHR Dashboard.
Breast Cancer
Breast cancer is a disease of uncontrolled cell growth in the breast tissue, caused by genetic abnormalities or mutations. While breast cancer can occur in both men and women, women account for the majority of breast cancer cases and deaths in the United States each year. An estimated one in eight women are predicted to develop invasive breast cancer during their lifetime, with women of Ashkenazi (Eastern European) Jewish descent at increased risk. While overall mortality has steadily decreased since 2013, in 2018, breast cancer was the seventh leading cause of death for women. Breast cancer treatments can incur exorbitant costs, especially for patients at the end-of-life phase. Health insurance access and coverage are essential for assisting with this financial burden – though in Oklahoma, for example, a state with the second highest mortality rate attributed to breast cancer, up to 15.6% of the population is uninsured. Learn more about Breast Cancer and Women’s Health on the SWHR Dashboard.
Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease (COPD) refers to a group of progressive lung diseases, such as chronic bronchitis or emphysema, that cause damage to the lungs and airflow blockage, resulting in difficulty breathing. Exposure to tobacco smoke and air pollutants in the home and workplace are associated with increased risk of COPD, with research suggesting that women may be even more vulnerable to the effects of such exposures. In 2018, over 57% of people with COPD in the United States were women. While the mortality rates for men have decreased over the last two decades, the rates remain relatively unchanged for women. Women are also diagnosed with COPD later than men, and thus afforded fewer treatment options due to more advanced disease progression. Moreover, female smokers are one-third less likely to be diagnosed with COPD by a physician or be referred to a pulmonologist for spirometry testing (a simple lung test that measures how much air you can breathe out in one forced breath). Learn more about COPD and Women’s Health on the SWHR Dashboard.
Depressive Disorders
Depressive disorders, including major depressive disorder (MDD) and persistent depressive disorder, are common but serious mood disorders which can affect a person’s thoughts, feelings, and ability to function. Depressive disorders can be caused by a multitude of factors, including biology, environment, genetics, and psychology. In the United States, women experience higher rates of depression, and from 2015 to 2018, the rates of major depressive episodes among both adolescent girls (ages 12-17) and young adult women (ages 18-25) increased significantly. Women can also experience perinatal depression, a mood disorder that can occur during a pregnancy, or postpartum depression, which can occur after giving birth. Depressive disorders are one of the leading contributors to disability, and MDD cost the United States an estimated $121 billion in 2018. Researchers have also found significant suicide-related costs attributable to depression, totaling $13 billion in 2018. Learn more about Depression and Women’s Health on the SWHR Dashboard.
Ischemic Heart Disease
Ischemic heart disease (IHD), also known as coronary heart disease or coronary artery disease, refers to the reduced blood flow and oxygen supply to the heart, usually caused by plaque buildup in the arteries surrounding the heart. IHD affects both men and women, and in 2018, was the leading cause of death in the United States for men and women, despite a 28% decline in the annual death rate attributable to IHD the decade prior. American Indian and Alaska Native populations are affected by IHD at disproportionate rates, though these rates are likely underreported by up to 20%. Women with gestational diabetes are also at increased risk (1.5x) of developing IHD, and women with diabetes are at increased risk (6x) of dying from IHD. Research has shown that there are significant sex differences in the pathophysiology (abnormal changes in the body related to a disease), symptom presentation, efficacy of diagnostic tests and pharmacological therapies, and clinical outcomes for IHD. In fact, women are more likely to be diagnosed with IHD at older ages and, on average, women experience their first heart attack 10 years later than men. Learn more about Ischemic Heart Disease and Women’s Health on the SWHR Dashboard.
Future of the Dashboard
Through the dashboard, SWHR aims to identify notable trends, bring attention to priority issues, and highlight opportunities to address disparities in women’s health. The work of addressing these diseases and conditions that disproportionately affect women requires dedicated participation of stakeholders across the health care ecosystem. The information presented in the dashboard has been curated from 2018 data, unless otherwise stated. Moving forward, SWHR intends to track and update this data in areas that are influential to women’s health – including public health data, research investment, health insurance coverage, and relevant policy implications and actions.
SWHR is proud to build on its efforts to end women’s health disparities through the Women’s Health Dashboard, and looks forward to continuing work with our partners to make women’s health mainstream.