WASHINGTON — The federal government said Friday that it plans to conduct the most sweeping study of women's health problems ever attempted, with hundreds of thousands of women participating in a research effort expected to cost $500 million over 10 years.
The project is the brainchild of the new director of the National Institutes of Health, Dr. Bernadine Healy, who said that it would be "the most definitive, far-reaching study of women's health ever undertaken in the United States, if not the world."
The study intends to examine the major causes of illness and death in women, including cancer, heart disease and osteoporosis--a condition characterized by deterioration of the bones--and the impact of several preventive and therapeutic approaches.
Healy, who announced the study at a hearing of the Senate Labor and Human Resources subcommittee on aging, said that recent years have brought "an important awakening to a simple fact, namely, women have unique medical problems that need greater attention.
"Women have a right to know how they can prevent and ameliorate the health problems attendant to growing older," she added. The new study "will go far toward providing these answers," she said.
NIH, considered the world's premier biomedical research facility, has come under fire in recent years for its failure to include more women in federally funded medical research. During the last year, the agency has made an increased effort to ensure that women are better represented in research. The study announced Friday "is in the spirit" of that response, one NIH official said.
"The good news is that women live longer; the bad news is that their quality of life, from a medical and behavioral perspective, is not what it could be," Healy said during a subcommittee hearing that focused on the health of older women and the effects of menopause.
An estimated 35 million women--about one-third of the female population in this country--have gone through menopause. For every 2,000 menopausal women, 20 will develop cardiovascular disease, the leading cause of death among women; 11 will develop osteoporosis; six will be diagnosed with breast cancer, and three will develop endometrial cancer, according to data presented at the hearing.
NIH said in a statement that the study would examine the effects of menopause and the accompanying loss of ovarian hormones on these diseases, and whether diet modification, exercise, hormone replacement therapy and smoking cessation can reduce their toll.
"Such regimens, however, may not be reinforcing and may even work at cross purposes to one another," the agency said.
NIH said that the study will address each of these approaches individually as well as their effects in combination.
The study is expected to track the health of hundreds of thousands of women and will include several different components, among them a large prospective surveillance program, a nationwide community prevention and intervention study and random clinical trials examining different preventive and therapeutic strategies.
Detailed plans for the study are to be prepared over the next six to nine months.
The agency said that it hopes the study findings will result in recommendations that "are couched in practical terms and are generalizable to all the nation's women, including all racial and socioeconomic groups.
"Research and development of preventive strategies must consider the whole person and should not result in confusing or incompatible recommendations to women and their physicians," the statement said.
Rep. Patricia Schroeder (D-Colo.), a leading Capitol Hill advocate for increased research into women's health, told the subcommittee that menopause has never been taken seriously as a health concern.
"We have never really looked at menopause as a health issue fully and it's been treated as something that one should not discuss in polite company," she said. "Finally, we see menopause come out as a legitimate health care issue instead of a joke."
Unfortunately, Schroeder said, "there's still a notion in our society that men age and women rot."
Sen. Brock Adams (D-Wash.), chairman of the subcommittee, agreed. "Women will continue to be at unnecessary risk until the study of the health concerns of midlife and older women become a top priority in the United States," he said.
"Many of the health problems women face . . . begin in midlife but little attention or resources have been directed to menopause where it is believed women's susceptibility to many of these diseases begins," he added. "Women pay the price for this inattention. As a result of the lack of research, particularly on gender differences in aging and the development of disease, women receive second-class health care."
Healy told the subcommittee that one "unfortunate side effect" of the feminist movement of the 1970s and 1980s was to emphasize the "sameness in men and women," including in medical studies, where research has been performed almost exclusively on men.
The study will be coordinated by the NIH office of research on women's health and will involve the National Cancer Institute; the National Heart, Lung and Blood Institute; the National Institute on Aging, and the National Institute of Child Health and Human Development.
"The study will have an ecumenical approach," NIH said. "One that allows all of the categorical institutes to contribute their knowledge, expertise and wisdom to a coordinated research program."
The National Institutes of Health is the major federal agency supporting medical research in the United States. A branch of the Department of Health and Human Services, it provides funds for training medical researchers, conducts programs for prevention and treatment of mental illness and classifies and distributes a wide range of medical information. About 40% of all medical research conducted in the United Sates is financed by the agency.