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[–] 1 point 2 months ago* (9 children)

At the risk of infuriating people, it's complicated. Most of the article focuses on cardiovascular disease. It is the number one killer of women, as it for men. But men have an elevated risk over women, and develop CVD 10 years earlier.

Lumping CVD research into a single bucket isn't super helpful. A lot of it will be done in vitro and focused on molecular mechanisms. These studies are essentially sexless and it's not clear to me if the funding calculations were limited to human, whole organism, or anything at all. Were they comparing funding targeted specifically to women against a denominator that included test tube research? I can't tell, but maybe I missed it on a quick read.

Research also covers different areas: mechanisms, treatment options and outcomes, cost, patient factors such as access to treatment, acceptability of treatment, impact of disease on life factors and a million other things. Some of these require a sex or gender segmentation. Some don't. Some studies will use a convenience sample i.e. everyone who showed up to a hospital, some will have screening criteria. This not a case of comparing apples to oranges, but rather comparing apples to poodles and a growing sense of doom for an upcoming exam. They are just not relatable in the aggregate.

No discussion of this sort can take place without a reference to Simpson's Paradox .

So I completely agree that women need to be included in CVD research. I think the article is being deliberately inflammatory and ignoring critical details on how it is already being done, and where improvement is most needed.

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  • [–] 5 points 2 months ago* (8 children)

    Most of the article focuses on cardiovascular disease.

    Just 2 of the 8 facts they listed tackled cardiovascular disease. I wouldn't call that most.

    The second of the two specifically talks about the research gap for black women:

    Nearly 60% of Black women ages 20 and older have cardiovascular disease, and they face the highest prevalence — and highest risk of dying from it — among women of other racial and ethnic groups, according to the American Heart Association.

    Yet a 2022 review of representation in research revealed Black women made up just 3.2% of women enrolled in global cardiovascular drug trials.

    So while it is talking about studying women's health in regard to cardiovascular health, the point was that black women face a greater risk but are not included at rates they should be in clinical studies.

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  • [–] 2 points 2 months ago (7 children)

    These are valid points, and I must stress that CVD is nowhere close to being in my wheelhouse - I can overstep here easily. From the bit that I know about prospective trials of those sorts, participation is often driven by a single factor; physician links to the study which biases towards university affiliated clinics. I have no doubt that impacts patient recruitment.

    As the article states there has been a directive since the 1990s for clinical trials to reflect the racial and ethnic proportions of the real-world populations impacted by the condition. That has met with some (limited?) success. The guidance has strengthened in the last few years.

    These issues are well worth discussing. My point was that the article seems to be focused on awareness raising with a confrontational edge. The research field is well aware of these biases and has been taking steps to correct them. I didn't see that sort of nuance in the article.

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  • [–] 3 points 2 months ago (6 children)

    A congressionally mandated National Academies analysis found that just 8.8% of NIH grant spending from 2013 through 2023 focused on women’s health research.

    And that sliver got even smaller: It fell from 9.7% in 2013 to 7.9% in 2023 — even as the NIH’s overall grant funding grew.

    Is it getting better?

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  • [–] 1 point 2 months ago (5 children)

    I don't know what's captured in the category. I'm not in the USA anymore so I've been out of touch with NIH for more than a decade.

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  • [–] 3 points 2 months ago (4 children)

    I was simply pointing out that this article that we’re discussing specifically mentions that funding has been going down, not increasing.

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  • [–] 1 point 2 months ago (3 children)

    Funding for everything at NIH has been going down. It is not a great time to be in medical research, particularly in public health.

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  • [–] 4 points 2 months ago (2 children)

    If you read the article, you'll know that the NIH's overall grant funding grew while women's health research funding shrank.

    It's in the quoted section in my comment above.

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  • [–] 1 point 2 months ago (1 child)

    I read the article and missed that part. I'll give it another look.

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  • [–] 2 points 2 months ago

    A congressionally mandated National Academies analysis found that just 8.8% of NIH grant spending from 2013 through 2023 focused on women’s health research.

    And that sliver got even smaller: It fell from 9.7% in 2013 to 7.9% in 2023 — even as the NIH’s overall grant funding grew.

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