Office of Research On Women's Health, National Institutes of Health, Bethesda, MD, USA.
National Institute On Drug Abuse National Institutes of Health, Bethesda, MD, USA.
BMC Womens Health. 2023 Apr 6;23(1):162. doi: 10.1186/s12905-023-02319-x.
Rising rates of chronic conditions were cited as one of the key public health concerns in the Fiscal Year (FY) 2021 U.S. Senate and House of Representatives appropriations bills, where a review of current National Institutes of Health (NIH) portfolios relevant to research on women's health was requested. Chronic conditions were last defined by the US Department of Health and Human Services (HHS) in 2010. However, existing definitions of chronic conditions do not incorporate sex or gender considerations. Sex and gender influence health, yet significant knowledge gaps exist in the evidence-base for prevention, diagnosis, and treatment of chronic diseases amongst women. The presentation, prevalence, and long-term effects of chronic conditions and multimorbidity differs in women from men. A clinical framework was developed to adequately assess the NIH investment in research related to chronic conditions in women. The public health needs and NIH investment related to conditions included in the framework were measured. By available measures, research within the NIH has not mapped to the burden of chronic conditions among women. Clinical research questions and endpoints centered around women can be developed and implemented; clinical trials networks with expanded or extended eligibility criteria can be created; and data science could be used to extrapolate the effects of overlapping or multiple morbidities on the health of women. Aligning NIH research priorities to address the specific needs of women with chronic diseases is critical to addressing women's health needs from a life course perspective.
慢性疾病发病率上升被认为是 2021 财年美国参议院和众议院拨款法案中主要的公共卫生关注点之一，该法案要求审查与妇女健康研究相关的当前国立卫生研究院（NIH）组合。慢性疾病是由美国卫生与公众服务部（HHS）在 2010 年最后定义的。然而，现有的慢性疾病定义并没有纳入性别因素。性别会影响健康，但在预防、诊断和治疗妇女慢性疾病方面，证据基础中存在重大知识差距。慢性疾病和多种疾病在女性中的表现、流行程度和长期影响与男性不同。为了充分评估 NIH 在妇女慢性疾病相关研究方面的投资，制定了一个临床框架。该框架测量了与框架中包含的疾病相关的公共卫生需求和 NIH 投资。根据现有措施，NIH 内的研究并未与妇女慢性疾病的负担相匹配。可以制定和实施以妇女为中心的临床研究问题和终点；可以创建具有扩大或延长资格标准的临床试验网络；可以利用数据科学推断重叠或多种疾病对妇女健康的影响。使 NIH 研究重点与妇女慢性病的具体需求保持一致，对于从生命全程角度解决妇女健康需求至关重要。
