An Overview: Expanding the Women's Health Research Frontier
Davenport, Marsha G., Health Care Financing Review
The health of women of all ages is a priority for the Nation. With the release of the Department of Health and Human Services' (DHHS) Healthy People 2010 report (U.S. Department of Health and Human Services, 2000), there is a national focus on (1) increasing the quality and years of healthy life and (2) eliminating health disparities. The emphasis for goal two of Healthy People 2010, eliminating health disparities, is to target factors such as sex, race/ethnicity, poverty, and disability, for example, to conquer differences in health status across the population in the United States. Thus, the Federal Government, in partnership with State and local governments, community organizations, and advocacy groups is engaged in efforts to eliminate health disparities.
Historically, health disparities have existed for a number of individuals or groups who have been considered vulnerable populations. Women of all ages are one such group. In 1983, the United States Public Health Service Task Force on Women's Health was convened. This Task Force was charged with reviewing and evaluating the role of DHHS in women's health (U.S. Department of Health and Human Services, 1985). A major recommendation put forth by the Task Force was to increase women's participation in research studies, especially in clinical trials, that were funded by the Federal Government. Further, the Task Force recommended expanding women's health research in the biomedical and behavioral health arenas.
In 1987, in response to these recommendations, the National Institutes of Health (NIH) developed a policy for including women in clinical trials. However, it was not until 1990, that NIH established the Office of Research on Women's Health (ORWH) (Pinn and Chunko, 1999). Recognizing the importance of the Federal Government to address the health needs of women and other vulnerable populations, ORWH was challenged with three mandates. First, ORWH was asked to identify the gaps in knowledge for diseases and conditions for women and to increase research in these particular areas. As part of this effort, ORWH was to develop a women's health research agenda for NIH. Secondly, ORWH was to ensure that clinical trials, as well as all other NIH-funded research, included appropriate representation of women. This was and still is a key role for ORWH. Prior to this time, women had not been included routinely in studies, therefore, little was known about diseases, conditions, and medications affecting women outside of their reproductive health. ORWH's third mandate was to develop and direct appropriate research and academic initiatives resulting in an increase in the number of women pursuing biomedical careers (Pinn and Chunko, 1999).
Following the creation of ORWH, other Federal agencies developed a focus on women's health issues, including CMS. In 1998, CMS established the Women's Health Workgroup to assist in the coordination of the agency's women's health programs and policies, educational and outreach efforts, and research and demonstration projects (Davenport et al., 2000). Today, almost every Federal agency has staff who are dedicated to improving the health of women of all ages. Various Federal agencies work closely with the DHHS' Office on Women's Health to provide leadership and coordination of women's health activities (Jones, 1999).
Women's health is an important aspect of every program administered by CMS, including Medicare, Medicaid, and the State Children's Health Insurance Program (SCHIP). For the Medicare program alone, women comprise over 50 percent of beneficiaries (Health Care Financing Administration, 2000). The Medicare, Medicaid, and SCHIP programs are critical for providing access to quality health care for all of the beneficiaries and for women, in particular. Moreover, research studies identifying areas where new coverage policies and benefits are needed are crucial for CMS to do its job.
Policy and coverage decisions frequently require the support of evidence-based studies. …