RATAN.
>> A NEW REPORT SAYS WE
COLLECTIVELY UNDERSTAND WOMEN'S
HEALTH FAR LESS THAN MEN'S
HEALTH.
THAT IS BECAUSE A FRACTION OF
RESEARCH FUNDS TO STUDY
ALZHEIMER'S, HEART DISEASE AND
AUTOIMMUNE DISEASE GO TOWARDS
STUDYING WOMEN EVEN THOUGH THEY
DISPROPORTIONATELY FACE THE
DISEASES THE REPORT IS FROM
WOMEN'S HEALTH ACCESS MATTERS
AND FOUND A $300 MILLION FOCUSED
ON WOMEN WOULD YIELD A $13
BILLION RETURN.
IT IS NOT JUST THE FIELD IT'S
HEALTHCARE, AND THE MEDICAL
WORKFORCE.
AND JOINING US TO TALK ABOUT
THESE ISSUES AND WHAT IS BEING
DONE TO ADDRESS THEM ARE Dr.
SHIKHA JAIN OF THE UNIVERSITY OF
ILLINOIS CANCER CENTER AND THE
FOUNDER AND PRESIDENT OF WOMEN
IN MEDICINE.
NICOLE WOITOWICH HOLDS A
DOCTORATE IN CHEMISTRY AND
MOLECULAR BIOLOGY.
AND VINEET ARORA AT THE
UNIVERSITY OF CHICAGO PRITSTER
SCHOOL OF MEDICINE.
NICOLE WOITOWICH I WILL START
WITH YOU.
HOW OVERLOOKED ARE WOMEN WHEN IT
COMES TO BIOMEDICAL RESEARCH AS
SUBJECT STUDIES AND DATA
ANALYSIS?
>> THANK YOU FOR HAVING US
TONIGHT ON THIS PANEL.
YOU KNOW HISTORICALLY WOMEN AND
FEMALES AND I SAY FEMALES
BECAUSE THIS INCLUDES OUR ANIMAL
MODELS WE USE IN BIOMEDICAL
RESEARCH AND OUR CELLS THAT ARE
THE FIRST AREAS WHERE WE DESIGN
AND TEST DRUGS AND THERAPIES
HISTORICALLY THEY HAVE BEEN
MALE.
AND SO THIS HAS BEEN AN ISSUE
OVER THE PAST SEVERAL DECADES
AND MANY PEOPLE DON'T KNOW IT
WAS NOT UNTIL 1993, PER AN ACT
OF CONGRESS THAT WOMEN WERE
REQUIRED TO BE INCLUDED IN
NATIONAL INSTITUTES OF HEALTH
FUNDED CLINICAL RESEARCH
STUDIES.
IN 2016 THE NIH IMPLEMENTED A
POLICY REQUIRING SCIENTISTS TO
CONSIDER SEX AS A BIOLOGICAL
VARIABLE IN THEIR WORK.
IT'S BEEN WITHIN THE LAST DECADE
OR TWO THAT WE'VE SEEN A
PUSHTORS INCLUSION OF WOMEN AND
FEMALES IN RESEARCH.
>> AND Dr. VINEET ARORA THERE
IS AN EXAMPLE WHERE WE DIDN'T
UNDERSTAND MUCH ABOUT WOMEN'S
HEALTH ISSUE AND THIS HAS TO DO
WITH COVID-19 AND PREGNANCY.
SO EXPLAIN THAT?
>> YES, ABSOLUTELY.
WHEN THE COVID-19 VACCINE CAME
OUT, YOU KNOW THERE WERE NO
PRESENTING PREGNANT PEOPLE OR
PEOPLE BREAST-FEEDING IN THE
TRIALS.
SO ONE THING THAT RESULTED FROM
THAT, WAS THIS DISCUSSION OF
SHARED DECISION MAKING BECAUSE
THERE WAS NO DATA TO GUIDE THE
DECISION MAKING FOR
PREDOMINANTLY WOMEN IN THIS
POSITION INCLUDING MYSELF AS A
HEALTHCARE WORKER WHO WAS
BREAST-FEEDING AND DECIDING
WHETHER OR NOT TO TAKE THE
VACCINE.
AND WHILE MANY STUDIES HAVE COME
OUT, HIGHLIGHTING THE IMPORTANCE
OF GETTING COVID-19 VACCINES FOR
PEOPLE WHO ARE PREGNANT OR
BREAST-FEEDING AS WELL AS THE
HEALTH BENEFITS THE EXCLUSION OF
THAT POPULATION GAVE A VOID AND
THAT VOID WAS FILLED WITH
DISINFORMATION AND
MISINFORMATION BUT HAS STILL LED
TO WOMEN PREGNANT PEOPLE AND
PEOPLE WHO ARE BREAST-FEEDING
FROM AVOIDING THE VACCINE WHICH
IS VERY CONCERNING GIVEN THE
HEALTH IMPACT OF COVID ON THE
SEVERITY OF COVID ON THOSE WHO
ARE PREGNANT ESPECIALLY.
>> THERE WAS A LOT OF CONFUSION
IN THAT FIELD FOR A LONGTIME.
Dr. SHIKHA JAIN IT'S NOT JUST
RESEARCH AND HEALTHCARE THAT
WE'RE TALKING ABOUT BUT ALSO THE
WORKFORCE IN HEALTHCARE.
SO HOW DOES THAT NEED TO CHANGE
TO BE MORE INCLUSIVE?
>> THAT IS A GREAT QUESTION.
IT'S SO IMPORTANT TO REMEMBER
THAT THESE DISPARITIES WE'RE
TALKING ABOUT THEY DIRECTLY
IMPACT THE HEALTHCARE WORKERS
BECAUSE WE'RE SEEING WOMEN IN
MEDICINE NOT BEING SELECTED FOR
AWARDS OR NOT BEING SELECTED FOR
PROMOTION OR ADVANCEMENT.
WE ARE SEEING THEM BEING
OVERLOOKED FOR LEADERSHIP
POSITIONS AND THERE'S STUDY
AFTER STUDY THAT HAS SHOWN WHEN
YOU HAVE A MORE DIVERSE
WORKFORCE AND LEADERSHIP, YOU
ACTUALLY SEE BENEFITS BOTH THE
WAY PATIENTS ARE TREATED AND THE
OUTCOMES OF PATIENTS.
BUT ALSO YOU SEE BENEFITS IN THE
HEALTHCARE SYSTEM WHERE YOU SEE
INCREASED RETENTION AND YOUR
WORKERS ARE HAPPY AND MORE
INNOVATION.
WE SEE HUGE DISPARITIES WHEN IT
COMES TO PAY, PROMOTION, WHEN IT
COMES TO PUBLICATIONS, AWARDS,
THERE'S ALL THESE DISPARITIES
THAT EXIST WITHIN THE HEALTHCARE
WORKFORCE AND THE DIRECT IMPACT
OF THAT IS THAT WE'RE LOSING
BRILLIANT, ACCOMPLISHED WOMEN
FROM THE HEALTH FORCE THEY ARE
NOT ACCELERATING INTO LEADERSHIP
AND THAT HAS A DIRECT IMPACT ON
THE INSTITUTIONS AS WELL AS THE
OVERALL HEALTHCARE SYSTEM AND
THE PATIENTS WHO WE'RE TREATING.
>> AND NICOLE WOITOWICH HOW DOES
IT IMPACT MEN AND WOMEN ALL
PEOPLE WHEN WOMEN AND FEMALES
ARE NOT INCLUDED IN ENOUGH
BIOMEDICAL RESEARCH STUDIES?
>> SO I THINK THIS HAS LED TO A
GAP IN OUR UNDERSTANDING OF
HUMAN HEALTH AND DISEASE BECAUSE
SO MUCH OF OUR RESEARCH HAS BEEN
SOLELY IN MALES, WE'RE LACKING
INFORMATION ABOUT HOW SEX AS A
BIOLOGICAL VARIABLE AFFECTS
HEALTH AND DISEASE ACROSS BODY
SYSTEMS.
ONE EXAMPLE THAT WE MIGHT NOT
THINK OF THERE WAS A STUDY THAT
LOOKED AT TREATMENT FOR GLEE YO
BLASTOMA A BRAIN CANCER AND
ANALYZING THE PATIENTS THEY
FOUND THERE WERE DIFFERENCES IN
PATIENTS' RESPONSES TO TREATMENT
IN MEN VERSUS WOMEN AND BY
ASKING THAT QUESTION THEY ARE
ABLE TO START THINKING ABOUT HOW
CAN WE TAILOR TREATMENTS MORE
EFFECTIVE FOR ALL PEOPLE.
>> Dr. VINEET ARORA WHAT IF WE
ADD IN OTHER VARIABLES, WOMEN OF
COLOR IN TERMS OF RESEARCH AND
QUALITY OF HEALTHCARE, ARE THERE
DISPARITIES HERE, TOO?
>> THERE IS A WEALTH OF
LITERATURE HIGHLIGHTING THE
DISPARITIES IN U.S. HEALTHCARE
PARTICULARLY WITH POOR OUTCOMES
FOR THOSE WHO ARE FROM MINORITY
GROUPS.
WE ALSO KNOW THAT PART OF THAT
REASON IS ACTUALLY OUR
WORKFORCE.
AND SO WE KNOW THAT WHEN WE
ADMIT MEDICAL STUDENTS AND
RESIDENTS TO OUR INSTITUTIONS
THAT THOSE WHO ARE FROM GROUPS
THAT UNDERREPRESENTED IN
MEDICINE OR THOSE THAT ARE FROM
LOWER SOCIOECONOMIC STATUS
COMMUNITIES OR RURAL COMMUNITIES
ARE MORE LIKELY TO GO SERVE
THOSE COMMUNITIES.
AND SO IT IS GETS DOWN TO A
WORKFORCE PROBLEM.
IF YOU DON'T ACTUALLY --
MUCH OF CLINICAL RESEARCH IS
INFORMED BY YOUR PERSONAL
EXPERIENCE.
THERE'S BEEN LITERATURE SHOWING
THERE IS A HUGE GAP IN RESEARCH
AS WELL TO STUDY CONDITIONS THAT
PREDOMINANTLY AFFECT BLACK
PEOPLE LIKELY DUE TO THE
INADEQUATE FUNDING AND PROMOTION
OF INVESTIGATORS WHO ARE FROM
THOSE UNDERSTAND REPRESENTED IN
REPRESENTED INMEDICINE GROUPS.
>> YOU HAVE A NONPROFIT CALLED
WOMEN IN MEDICINE YOU ORGANIZE
CONFERENCES AND TRAINING
PROGRAMS WHAT ARE THE THINGS
BEING DONE TO CLOSE THE GAPS
RIGHT NOW?
>> THERE ARE A LOT OF AMAZING
ORGANIZATIONS THAT ARE WORKING
TO CLOSE THE GAPS.
SOME OF THE THINGS WE DO WE HAVE
AN ANNUAL CONFERENCE THAT IS
LEADERSHIP TRAINING AND
EMPOWERMENT OF WOMEN AND ALSO OF
MEN.
BECAUSE NONE OF THESE CHANGES
ARE GOING TO HAPPEN WITHOUT MEN
AT THE TABLE AS WELL.
WE'VE CREATED LEADERSHIP
PROGRAMS TO HELP WOMEN BECOME
MORE EMPOWERED AND LEARN HOW TO
NEGOTIATE FOR THEMSELVES AND
CHANGE THE SYSTEMS WITHIN WHICH
THEY WORK AND CREATED LEADERSHIP
PROGRAMMING FOR MEN AS WELL.
BECAUSE THERE IS A LOT OF MEN
WHO WANT TO HELP CLOSE THE GAP
AND ADDRESS THE INEQUITIES BUT
THEY DON'T ALWAYS HAVE THE TOOLS
BECAUSE IT ISN'T SOMETHING THAT
HAS BEEN TAUGHT IN MEDICAL
SCHOOL EDUCATION AND NOT
SOMETHING INTENTIONALLY LOOKED
AT FOR A LONGTIME.
WE'RE STARTING TO CREATE THE
PROGRAMMING TO HELP PEOPLE
UNDERSTAND THAT THE PROBLEM
EXISTS AND EMPOWER MEN AND WOMEN
TO CREATE STRUCTURES THAT ARE
GOING TO ADDRESS THE BARRIERS
THAT HAVE RESULTED IN THIS
REALLY PROBLEMATIC INEQUITY THAT
EXISTS IN HEALTHCARE IMPACTING
PEOPLE IN THE HEALTHCARE
WORKFORCE OR NOT.
>> IT IMPACTS EVERYBODY.
NICOLE WOITOWICH WE MENTIONED
THE STUDY THAT SAID WITH A $300
MILLION INVESTMENT YOU GET A $13
BILLION RETURN.
CAN YOU EXPLAIN THAT FOR US?
>> SO I THINK WHAT THE ISSUE IS
IS THAT WOMEN'S HEALTH RESEARCH
IS UNDERFUNDED AND UNDER STUDIED
AND IF WE MAKE AN ECONOMIC
DECISION TO FUND RESEARCH THAT
SUPPORTS WOMEN AND OTHER
UNDERREPRESENTED GROUPS.
IT HAS A TRICKLE-DOWN EFFECT.
CLINICIANS WILL BE AGE TO
PROVIDE FOR GRANTS.
AND ONCE THAT IS INTEGRATED INTO
OUR BIOMEDICAL ENTERPRISE WE
WILL THEN BE ABLE TO SEE THE
OUTCOMES OF THAT RESEARCH
TRANSLATING FROM THE BENCH TO
THE BEDSIDE.
>> AND Dr. VINEET ARORA WHAT
ABOUT PAY GAP?
THERE IS A HUGE SALARY GAP IN
HEALTHCARE BETWEEN MEN AND
WOMEN?
>> ABSOLUTELY.
SO WHILE WE HAVE EQUAL NUMBERS
OF WOMEN AND MEN ENTERING THE
WORKFORCE IN HEALTHCARE, WE DO
NOT HAVE EQUAL NUMBERS AT THE
LEADERSHIP LEVEL.
AND WE ALSO SUFFER A HUGE PAY
GAP.
EVEN WHEN TRYING TO CONTROL FOR
A VARIETY OF FACTORS SUCH AS
NUMBER OF PATIENTS SEEN OR THE
TYPES OF MEDICAL PRACTICE THAT
YOU HAVE, WE STILL SEE A 20,000
DOLLAR PAY GAP AND A REPORT FROM
THE ASSOCIATION OF AMERICAN
MEDICAL COLLEGES CLEARLY
OUTLINES THAT THE PAY GAP
PERSISTED.
WE WILL NEED A LOT OF SOLUTIONS
AND LIKE TRANSPARENCY, AND
GREATER PAY EQUITY.
FROM THE LEADERSHIP LEVEL FOR
INSTITUTIONS TO IMPLEMENT.
>> A LOT OF ISSUES BROUGHT TO
LIGHT WITH THIS REPORT AND WE'RE
GLAD ARE YOU ILLUMINATING THIS