Excerpts from Ourselves Growing Older
GOVERNMENT RESEARCH IN WOMEN’S HEALTH
Although the federal government has never attempted to direct or plan the entire health system, it does spend funds to study many different aspects of health and disease, and how the system works. Listed on the next two pages (see box) is a selection of federal agencies currently involved in some aspect of health research affecting midlife and older women. Several women’s health groups regularly monitor their activities and decisions.
The federal government spends billions each year on health and medical care. Even with the massive planning efforts that resulted in the publication of Healthy People 2000,3 most actual appropriations and funding decisions are made by a political process in congress. Those with the most powerful voices or influence will dominate that process. The result is that less than 3 percent is spent for research on health care of midlife and older women, and on the aging process itself.
As mentioned, women have succeeded recently in calling attention to our needs and in identifying errors and gaps in women’s health research,4 with the result that almost every federal agency, at long last, is including something of concern to women. Some of the research is excellent. Unfortunately, some of the research is of dubious quality and some may be actually harmful to women.5 Results may be gained at the expense of exposing some women to known risks, for example breast or uterine cancer from hormone therapy. Another research project (not part of the NIH Women’s Health Initiative) that has received nationwide attention is the decision to give tamoxifen, a highly potent anticancer drug, to healthy premenopausal women. The purpose is to test whether this exposure will reduce their chances of developing breast cancer.*
Another danger of so much publicity about women’s health research is that we will be lulled by enthusiastic media reports into assuming everything is going well. We must keep involved in monitoring research quality, determining its relevance for various groups of women, and making sure research reporting includes full disclosure to the public. We must ensure that research results are translated into action. Finally, we must make sure the public realizes that research is only one of a number of tasks necessary to improve health for women.
*Many ethicists and women’s health groups protested this research because it exposes healthy women to substantial risks even after the informed consent materials were improved because of the protester’s pressure. See Susan Rennie, "Tamoxifen: What Are the Risks?" Ms., Vol. III, No. 6 (May/June 1993), p. 46.
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