Previously, at The Nuzzo Letter, I explained that the White House’s Initiative on Women’s Health Research would be allocating 100 million dollars to work being done by women’s health researchers and startup companies. Now, we know more details of where that money will go.
The Office for Research on Women’s Health, in coordination with the National Institutes of Health (NIH), issued a Notice of Special Interest to inform researchers of the organization’s interest in receiving applications for research studies that are focused on diseases and health conditions that predominantly impact women, including, but not limited to, autoimmune diseases, depressive disorders, Alzheimer’s disease, and “gender-based violence.” The organization also announced its interest in receiving applications for diseases and conditions that are specific to women, such as endometriosis and menopause, as well as diseases and conditions that present or progress differently in women, including, but not limited to, cardiovascular disease, human immunodeficiency virus (HIV), and reproductive aging.
Addressing women’s health is important. However, as explained previously at The Nuzzo Letter, the NIH already shells out more money for research trials that enrol only female participants compared to research trials that enrol only male participants. In financial year 2020, the NIH invested 4.47 billion dollars into women’s health research (see Table 1 below). Interestingly, unlike reports from the Office for Research on Women’s Health in previous years, this latest report does not include a comparison of how much the NIH invested into men’s health in 2020, 2021, or 2022. However, a previous report from the Office of Research on Women’s Health reveals that the NIH invests about 2 billion dollars per year in men’s health – less than half of what it invests into women’s health (see Table 8 below).
With approximately 4.5 billion dollars per year already dedicated to women’s health, you might be thinking that it seems strange that the health conditions to be targeted by the White Houses’ Women’s Health Research Initiative were not already within the purview of the 4.5 billion dollars already being spent. I wondered the same thing and consequently did some digging around. What I found will probably not surprise you.
The NIH has been investing hundreds of millions of dollars into these areas of women’s health for many years. The table below shows the NIH’s research budget for women’s health for the 2020, 2021, and 2022 financial years. In 2022, the NIH spent 55 million dollars on research into violence against women, 27 million dollars on research into endometriosis, 189 million dollars on research into sexually transmitted infections, which will include HIV, 298 million dollars on research into autoimmune conditions, 954 million dollars on research into mental health conditions, which will include depressive disorders, and 586 million dollars into research on cardiovascular disease.
As I have discussed before, the greater funding into women’s health research than men’s health research then helps to explain why women make up a greater proportion of participants NIH-funded research trials. Between 1995 and 2022, women made up 58% of participants in NIH-funded trials (figure below). All other things held constant, the new lot of 100 million dollars can only cause an increase in women’s representation as research participants and a decrease in men’s representation as participants – odd outcomes to have considering that male life expectancy is 5.4 years shorter than female life expectancy in the United States.
Given that the extra 100 million dollars into women’s health research will inevitably increase female participant representation beyond its current levels, here, I pose the question as to how the NIH and the Office for Research on Women’s Health will present and discuss these data in future reports. I see two possibilities.
The first possibility is that these national health offices report the data in a way that makes it hard to know the exact percentages of male and female participants. This could involve reporting the data in an ambiguous way or simply not including it, similar to how the overall budget for men’s health research was oddly absent from the latest report from the Office for Research on Women’s Health.
A second possibility – the one that I think is more likely – is that the NIH and the Office for Research on Women’s Health simply will not give a damn. They will not care that male participant representation decreases to 35-40%, while female representation increases to 60-65%. In this scenario, the data would be publicly available, and the agencies would celebrate their achievements in women’s health research. They would justify their celebration by rehashing the same old talking points such as the supposed historical exclusion of women from research trials, suggesting that current disproportions in representations are merely recompense for years of lost knowledge about women’s health. And, of course, any celebration would be coupled with imprecise phrases that would rationalize the continued existence of the Office for Research on Women’s Health, such as, “more research is necessary on women’s unique health needs” and that there is “still a long way to go until gender equality is achieved.”
Sceptics might question whether the NIH and the Office for Research on Women’s Health would be so brazened as to increase the number of female participants as high as possible, particularly with the sex difference in life expectancy looming in the background. The answer is: probably.
In other domains, we see the goal is never 50/50 representation. In the academic world, when outcomes, such as numbers of degrees earned or numbers of staff positions filled in certain fields, surpass 50% female representation, there are no subsequent initiatives to try to increase male representation, such that the ratio stabilizes at 50/50. I have personally been on the receiving end of university emails that brag about the fact that over 70% of winners of internal research grants are women. The goal, therefore, does not seem to be parity. It seems to be something akin to matriarchy.
So, if government research funding does indeed improve health outcomes, and the NIH already invests more money into women’s health than men’s health, and the health conditions to be targeted by the 100 million dollars from Jill Biden and the White House are conditions already being funded under the NIH’s 4.5 billion dollar budget for women’s health, then perhaps Jill should have considered directing the money toward men’s health.
One might think that Jill Biden would have a personal interest in seeing more funds directed toward certain areas of boys’ and men’s health. Topics such as cocaine-use disorder, dementia, and falls risk prevention should hit close to home for the First Lady. Or, if Biden were to have a moment of deep and solemn reflection, she might encourage investment into research that explores mental health outcomes in boys who lose their mothers and husbands who lose their wives and daughters via tragic circumstances.
But in my opinion, the best place for the 100 million dollars is back in the hands of American taxpayers. With it, each individual man and woman, in consultation with friends, family, and health professionals, can determine how they might best spend the few extra bucks in their pockets to optimize their health. Perhaps they could use the money to help pay for a health screening, more nutritious food, or a gym membership. The decision should be up to them not to the gynocentrists in government.
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