@article{8903605629154cb08af47a81cbb35203,
title = "Quality and Equitable Health Care Gaps for Women: Attributions to Sex Differences in Cardiovascular Medicine",
abstract = "The present review synthesizes evidence and discusses issues related to health care quality and equity for women, including minority population subgroups. The principle of “sameness” or women and men receiving equitable, high-quality care is a near-term target, but optimal population health cannot be achieved without consideration of the unique, gendered structural determinants of health and the development of unique care pathways optimized for women. The aim of this review is to promote enhanced awareness, develop critical thinking in sex and gender science, and identify strategic pathways to improve the cardiovascular health of women. Delineation of the components of high-quality health care, including a women-specific research agenda, remains a vital part of strategic planning to improve the lives of women at risk for or living with cardiovascular disease.",
keywords = "disparities, health care quality, sex differences",
author = "Shaw, {Leslee J.} and Pepine, {Carl J.} and Joe Xie and Mehta, {Puja K.} and Morris, {Alanna A.} and Dickert, {Neal W.} and Ferdinand, {Keith C.} and Martha Gulati and Harmony Reynolds and Hayes, {Sharonne N.} and Dipti Itchhaporia and Mieres, {Jennifer H.} and Elizabeth Ofili and Wenger, {Nanette K.} and {Bairey Merz}, {C. Noel}",
note = "Funding Information: The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Pepine has received grant support from the Gatorade Trust through funds distributed by the University of Florida, Department of Medicine; NIH NCATS—University of Florida Clinical and Translational Science UL1TR001427; and PCORnet-OneFlorida Clinical Research Consortium, CDRN-1501-26692, Adelphi Values, AMGEN, AstraZeneca, Athersys, Boehringer Ingelheim, Brigham and Women{\textquoteright}s Hospital, Capricor Inc., Cytori Therapeutics, Daiichi-Sankyo, Duke University, Gilead Sciences, Inc., inVentive Health Clinical LLC, Merck & Co., National Institutes of Health/National Heart, Lung, and Blood Institute, Minocycline HTN, Microbiota HTN, Microbiota, Relypsa, and Sanofi. Dr. Morris has been a consultant for Novartis. Dr. Ferdinand has received grant and/or research support from Boehringer Ingleheim; and has been a consultant for Amgen, Sanofi, Boehringer Ingleheim, Eli Lilly, and Quantum Genomics. Dr. Reynolds has received in-kind support for research from St. Jude Medical. Dr. Ofili has received research support from the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Numbers U54MD008149 and 8 U54 MD007588; and from the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR000454. Dr. Bairey-Merz has been a consultant for and has received honoraria from the Annenberg Center for Health Science, American Diabetes Association, DCCT/EDIC, Expert Exchange, Japanese Circulation Society, Kaiser, Mayo, Northwestern, Pacific Medical Center, Practice Point Communications, Pri-Med, Sanofi, University of Colorado, University of California-San Francisco, University of Utah, Women{\textquoteright}s Health Congress, WomenHeart, ACRWH, New York University, San Bernardino, University of California-San Diego, NIH-CASE, and the Research Triangle Institute. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Funding Information: Within CVD research, limited funds have been available to examine sex differences. Research funding (from the American Heart Association, foundations, or governmental) targeted for CVD in women is one-tenth of what is spent on breast cancer (113) . The NIH tracks spending on women{\textquoteright}s health largely through enrollment reports by sex and not on focused research initiatives (113) . Women{\textquoteright}s health has been a part of the vision of the NIH, and has focused on advancing knowledge on sex and gender science, particularly in basic and translational research (114) . Although there have been calls for a greater attention to sex and gender science, there has yet to be targeted funding announcements, such as WISE, which played a transformative role in stable ischemic heart disease. Moreover, in 2015, the NIH added requirements that sex be considered in all research applications (115) . Based on this, proposals must not examine “only one sex” without strong evidentiary justification (115) . However, because of the limited resources of NIH-funded grants and our limited knowledge regarding CVD in women, there are many instances when the comparator (men) has established evidence, and what is missing are data on women. Accordingly, this new NIH regulation may be policy driven, but may lack the comprehensiveness required to grow our knowledge in sex and gender science. Publisher Copyright: {\textcopyright} 2017 American College of Cardiology Foundation",
year = "2017",
month = jul,
day = "18",
doi = "10.1016/j.jacc.2017.05.051",
language = "English (US)",
volume = "70",
pages = "373--388",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "3",
}