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Improving women’s health and care through research

Published: 08 March 2023

Dr Gail Marzetti, Director of Science, Research and Evidence at the Department of Health and Social Care (DHSC), discusses the best ways to address the under-representation of women across health and care research.

Last year, DHSC published its first Women’s Health Strategy for England. The strategy sets out a 10-year ambition to boost health outcomes for all women and girls and radically improve the way in which the health and care system engages and listens to them.

Although women in England live longer than men on average, they spend a significantly greater proportion of their lives in ill health and disability.

I am glad to see research and evidence featured throughout the strategy. In particular, I welcome the long-term focus on addressing the lack of research into women’s health conditions; improving the representation of women of all demographics in research; addressing key evidence gaps; and ensuring that data are broken down by sex.

When I was working in humanitarian aid in Mozambique 30 years ago, I attended a UNICEF conference where we discussed the vital importance of disaggregating research findings by sex and it’s frustrating that this continues to be an issue.

The Strategy highlights that NIHR expects to commission a new Policy Research Unit for Reproductive Health to inform government policy. This is taking a life course approach to reproductive health and is inclusive of groups currently under-represented in research.

I’m proud of this development but I know that more is needed. In particular, it’s important to remember that women’s health needs are not only reproductive. Not enough is known about how conditions that affect both men and women may impact women in different ways.

Since the launch of the strategy, colleagues in DHSC and NIHR have been discussing four priority areas that are vital if we are to realise its ambitions:

  1. How can we improve the representation of women in research, including clinical trials and disaggregation of results?
  2. How can we increase the representation of diverse women across NIHR awards and committees?
  3. How can we ensure research prioritises women’s health, care and wellbeing, and addresses evidence gaps?
  4. How can we more effectively disseminate research to women, practitioners, decision makers, community leaders and the general public

To help answer these questions, Professor Lucy Chappell, DHSC Chief Scientific Adviser and CEO of the NIHR, recently hosted a roundtable meeting with representatives from DHSC, NIHR, NHS England and the Medical Research Council as well as leading academics.

This explored the best ways to address the under-representation of women across health and care research, including in clinical trials. Four key themes emerged from the discussion.

  • Insight: We need to reach people who are persistently under-served by health research. To achieve this, we need to require that results and findings are disaggregated by sex (and other protected characteristics) to understand unmet need.
  • Simplicity: We must address system complexity and break down barriers to inclusion. This will rely on a recognition that women’s health is everybody’s business.
  • Networks: To ensure that we hear a diversity of women’s voices, we need to encourage and enable our research community to build relationships and trust with women’s networks and the voluntary, community and social enterprise sectors.
  • Inclusion: When women - or indeed any other group - are not fully included in health research, their specific needs are not addressed and this ultimately costs the NHS money.

The roundtable marked our first exploratory consultation. There will be opportunities to contribute and we will widen our engagement with other sectors as we proceed.

The consultation for the Women’s Health strategy repeatedly heard from women that our healthcare systems are failing them because NHS services are not designed to meet women’s day-to-day needs. This is echoed in our NIHR Collection about Women’s Health. We are working hard to address this imbalance through research.

As Women’s Health Ambassador Dame Lesley Regan has said, “When we get it right for women, everyone in our society benefits”.

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