THE NEW ENGLAND JOURNAL OF MEDICINE June 3, 2021 pp 2073-2076|Perspective| A HALF-CENTURY OF PROGRESS IN HEALTH:THE NATIONAL ACADEMY OF MEDICINE AT 50|”Women’s Health-Traversing Medicine and Public Policy” by Cynthia A. Stuenkel, M.D., and JoAnn E. Manson, M.D., Dr. Ph.H.
Read The New England Journal Medicine of article and hear the audio interview of Dr. Stuenkel at NEJM.org
Key Milestones in Women's Health. Table from N ENGL J MED 384;22 NEJM.ORG June 3, 2021 pp 2075
Summary provided by 2244
“Women’s health extends far beyond reproductive health. It is now recognized to encompass physical, mental and emotional well-being, as well. Women do, however, have specific health needs related to pregnancy, and other life stages.”
Selected Key Milestones in Women’s Health are presented below
Eisenstadt v. Baird 1972 ruled in favor of “women’s use of contraception irrespective of their marital status.”
Roe v. Wade 1973 ruled that “women have a right to legalized abortion.”
The Affordable Care Act of 2010 mandated “coverage of contraceptives as a preventive health benefit.”
1978 with the first “test tube” baby ushered in “enhanced pathways to parenthood.” Besides in vitro fertilization (test tube baby) “fertility-related advances include…less invasive prenatal genetic testing, the use of donor eggs or embryos, and fertility preservation by oncofertility specialists.”
Although not readily or practically accessible everywhere new “interventions [have reduced] pre-eclampsia and postpartum hemorrhage” reducing “maternal death rate…by 57% since 2006” in California as example of progress.
By 1986 the NIH pushed for “increased participation in women in clinical trials.”
“Progress in preventing and managing breast cancer has included the development of enhance imaging techniques for early detection, genetic testing with recommended prophylactic measures, and medications to prevent disease.
“Cervical cancer screening (including Pap testing)” and the elucidation of HPV in the 1980s as the etiological agent causing cervical cancer. In 2006 HPV vaccine was approved and since the combined effect of testing and vaccine have “contributed to a reduction of greater than 50% in cervical cancer mortality” in America. Today “endometrial cancer” linked in part to rising obesity and type 2 diabetes is “four times as prevalent as cervical cancer." Today lung cancer kills more women than “breast, ovarian and cervical cancers combined.”
Other women’s health insights
Women remain more likely to have autoimmune diseases, mental health disorders, diabetes, osteoporosis and dementia that “affect women’s health and impair women’s quality of life as they age.” Cardiovascular disease presents differently in women and men and consequently remains for women “overlooked and underrecognized" but trends with “increasing rates of hypertension, dyslipidemia, and diabetes in women" Coronary Heart Disease ..."events in younger women, may reflect increasing rates obesity.”
Still remaining is a need to “recognize and study intersectional health disparities, including disparities based on sex, race, ethnicity, gender identity, sexual orientation, income and, disability status.”
All future successes in women’s health need be based on science to enable “new discoveries.”
