Inequality in medicine

Nowogrodzki, Anna

doi:10.1038/550s18a

Cited by 35 publications

(20 citation statements)

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“…Women are underrepresented in drug development trials; many researchers fail to design studies with adequate samples of women, and even fewer analyze results according to gender and sex ( Liu and Mager, 2016 ; Nowogrodzki, 2017 ). For example, women were excluded from all phases of development of a formulation of tenofovir alafenamide/emtricitabine for HIV pre-exposure prophylaxis.…”

Section: Drug Developmentmentioning

confidence: 99%

Health risks and outcomes that disproportionately affect women during the Covid-19 pandemic: A review

Connor

Madhavan

Mokashi

et al. 2020

Social Science & Medicine

454

387

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Background The Covid-19 pandemic is straining healthcare systems in the US and globally, which has wide-reaching implications for health. Women experience unique health risks and outcomes influenced by their gender, and this narrative review aims to outline how these differences are exacerbated in the Covid-19 pandemic. Observations It has been well described that men suffer from greater morbidity and mortality once infected with SARS-CoV-2. This review analyzed the health, economic, and social systems that result in gender-based differences in the areas healthcare workforce, reproductive health, drug development, gender-based violence, and mental health during the Covid-19 pandemic. The increased risk of certain negative health outcomes and reduced healthcare access experienced by many women are typically exacerbated during pandemics. We assess data from previous disease outbreaks coupled with literature from the Covid-19 pandemic to examine the impact of gender on women's SARS-CoV-2 exposure and disease risks and overall health status during the Covid-19 pandemic. Conclusions Gender differences in health risks and implications are likely to be expanded during the Covid-19 pandemic. Efforts to foster equity in health, social, and economic systems during and in the aftermath of Covid-19 may mitigate the inequitable risks posed by pandemics and other times of healthcare stress.

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Section: Drug Developmentmentioning

confidence: 99%

Health risks and outcomes that disproportionately affect women during the Covid-19 pandemic: A review

Connor

Madhavan

Mokashi

et al. 2020

Social Science & Medicine

454

387

View full text Add to dashboard Cite

show abstract

“…Sex differences were once thought to be important mainly for hormonal and reproductive issues, but we are beginning to learn that sex is an important variable for a range of biological functions including cell physiology, metabolism and gene expression (Mank, 2017;Niveditha et al, 2017;Tower, 2017;Clayton, 2018). In humans, poor understanding of sex differences stems in part from the long-standing practice of excluding women from clinical trials, often in the name of their own protection (Nowogrodzki, 2017). The unintended consequences of this practice are now more understood, leading the U.S. National Institutes of Health (NIH) to develop guidelines for including women in clinical research (e.g.…”

Section: Introductionmentioning

confidence: 99%

Sex-specific stress tolerance, proteolysis, and lifespan in the invertebrate Tigriopus californicus

Foley

Sun

Ramirez

et al. 2019

Experimental Gerontology

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Because stress tolerance and longevity are mechanistically and phenotypically linked, the sex with higher acute stress tolerance might be expected to also live longer. On the other hand, the association between stress tolerance and lifespan may be complicated by tradeoffs between acute tolerance and long-term survival. Here we use the copepod Tigriopus californicus to test for sex differences in stress resistance, proteolytic activity and longevity. Unlike many model organisms, this species does not have sex chromosomes. However, substantial sex differences were still observed. Females were found to have superior tolerance to a range of acute stressors (high temperature, high salinity, low salinity, copper and bisphenol A (BPA)) across a variety of treatments including different populations, pure vs. hybrid crosses, and different shading environments. Upregulation of proteolytic capacity-one molecular mechanism for responding to acute stress-was also found to be sexually dimorphic. In the combined stress treatment of chronic copper exposure followed by acute heat exposure, proteolytic capacity was suppressed for males. Females, however, maintained a robust proteolytic stress response. While females *

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“…Historically, biomedical research has neglected this diversity to our detriment. A recent report [64] showed that, of the drugs removed from the U.S. market between 1997 and 2000, 80% were removed due to side effects or fatalities that occurred in women. Another report [65] found that racial factors, although important, do not solely account for the disparities in health care.…”

Section: Commentarymentioning

confidence: 99%

Diversity and inclusion for the All of Us research program: A scoping review

et al. 2020

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The All of Us Research Program (All of Us) is a national effort to accelerate health research by exploring the relationship between lifestyle, environment, and genetics. It is set to become one of the largest research efforts in U.S. history, aiming to build a national resource of data from at least one million participants. All of Us aims to address the need for more diversity in research and set the stage for that diversity to be leveraged in precision medicine research to come. This paper describes how the program assessed demographic characteristics of participants who have enrolled in other U.S. biomedical research cohorts to better understand which groups are traditionally represented or underrepresented in biomedical research. We 1) reviewed the enrollment characteristics of national cohort studies like All of Us, and 2) surveyed the literature, focusing on key diversity categories essential to the program's enrollment aims. Based on these efforts, All of Us emphasizes enrollment of racial and ethnic minorities, and has formally designated the following additional groups as historically underrepresented: individuals-with inadequate access to medical care; under the age of 18 or over 65; with an annual household income at or below 200% of the federal poverty level; who have a cognitive or physical disability; have less than a high school education or equivalent; are intersex; identify as a sexual or gender minority; or live in rural or non-metropolitan areas. Research accounting for wider demographic variability is critical. Only by ensuring diversity and by addressing the very barriers that limit it, can we position All of Us to better understand and tackle health disparities.

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Inequality in medicine

Cited by 35 publications

References 0 publications

Health risks and outcomes that disproportionately affect women during the Covid-19 pandemic: A review

Health risks and outcomes that disproportionately affect women during the Covid-19 pandemic: A review

Sex-specific stress tolerance, proteolysis, and lifespan in the invertebrate Tigriopus californicus

Diversity and inclusion for the All of Us research program: A scoping review

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