Advancing Research on Chronic Conditions in Women (2024) / Chapter Skim
Currently Skimming:
1 Introduction
1 Introduction
Pages 16-31
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From page 16... ...
. Women experience chronic conditions differently than men; some are specifically influenced by women's biology and hormonal makeup, and others are influenced by gender differences related to how women access health services, their life roles, environmental exposures, and other factors.
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. The report discusses basic biochemical sex differences in cells and health variability between the sexes over the life course.
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, considered five options for enhancing the research and resulting outcomes and recommended creating such an office within the NIH Office of the Director. The report pointed to several gaps this office would fill, such as facilitating cross-NIH multidisciplinary collaboration to stimulate autoimmune research innovation; offering priority setting, strategic planning, and implementation; and providing visible leadership on autoimmune disease research.
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NIH held a conference titled Advancing NIH Research on the Health of Women, with chronic debilitating conditions as one of its three focus areas (NIH, 2021a) , that identified important knowledge gaps related to chronic conditions in women, including an understanding of the effect of sex and gender influences on the outcomes that individuals experience.
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The resulting report, Perspectives on Advancing NIH Research to Inform and Improve the Health of Women (NIH, 2021b) , also emphasized the lack of clear definitions of chronic debilitating conditions specific to women and of an NIH Research, Condition, and Disease Categorization (RCDC)
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The review will consider: • The epidemiology of chronic debilitating conditions including gender and racial and ethnic differences in clinical presentation and outcomes • How the development and accumulation of chronic debilitating conditions in women are influenced by factors such as menopause, aging-related skeletal muscle dysfunction (loss of muscle mass, muscle strength, and muscle function) , and frailty • Prevention, diagnosis, and treatment of female-specific gynecologic conditions • To the extent possible, the social and economic impact of chronic debilitating conditions.
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, and an infectious disease. The conditions also reflect the four NIH framework chronic debilitating conditions categories (see Table 1-1)
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Pain Disorders Migraine/headache More common or greater morbidity in women Chronic pain Potentially understudied in women Fibromyalgia More common or greater morbidity in women Myalgic encephalomyelitis/chronic fatigue syndrome More common or greater morbidity in women Conditions Affecting Musculoskeletal System Osteoporosis More common or greater morbidity in women Sarcopenia Not included in NIH Framework Conditions Related to Mental Health 10 Depression More common or greater morbidity in women Substance use disorder Higher morbidity in women Conditions Affecting Neurocognitive System Alzheimer's disease Potentially understudied in women Conditions Related to Cardiometabolic Disease Cardiovascular disease Higher morbidity in women Stroke Higher morbidity in women Metabolic (Type 2 diabetes, metabolic syndrome, obesity) Higher morbidity in women Autoimmune Diseases Systemic lupus erythematosus More common or greater morbidity in women Multiple sclerosis (also affects neurocognitive system)
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• What structural and social determinants play a role in the occurrence and experience of chronic conditions and MCC in women? Throughout its review, the committee considered the progress made and research gaps across the translational science spectrum, which "represents each stage of disease to interventions that improve the health of individuals and the public" (NCATS, 2023)
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This inclusive definition recognizes individuals who have been affected by a set of biological and social variables that influence women differently than men. Throughout the report, when citing research findings and study results, the committee used "female" to refer to biological factors related to animal research and "women" in human research that describes sex and gender differences.
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. A conceptualization of SDOH by the NIH-wide Social Determinants of Health Research Coordinating Committee explicitly included sexism as a structural factor (NINR, n.d.)
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Chapter 5 discusses the evidence base on prevention, diagnosis, treatment, management, and disparities of female-specific and gynecologic conditions, including vulvodynia, endometriosis (including dysmenorrhea and chronic pelvic pain) , uterine fibroids, infertility, chronic conditions related to pregnancy, and menopausal symptoms and transition.
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2021. The WHAM report: The case to fund women's health research, an economic and societal impact analysis.
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n.d. NIH-wide Social Determinants of Health Research Coordinating Committee.
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