Women in the United States experience a higher prevalence of many chronic conditions, including Alzheimer’s disease, depression, and osteoporosis, than men; they also experience female-specific conditions, such as endometriosis and pelvic floor disorders. A lack of research into both the biological and social factors that influence these conditions greatly hinders diagnosis, treatment, and prevention efforts, thus contributing to poorer health outcomes for women and substantial costs to individuals and for society.

The National Institutes of Health’s Office of Research on Women’s Health asked the National Academies of Sciences, Engineering, and Medicine to convene an expert committee to identify gaps in the science on chronic conditions that are specific to or predominantly impact women, or affect women differently, and propose a research agenda. The committee’s report presents their conclusions and recommendations.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON A FRAMEWORK FOR THE CONSIDERATION OF CHRONIC DEBILITATING CONDITIONS IN WOMEN
• Reviewers
• Acknowledgments
• Preface
• Acronyms and Abbreviations
• Key Terms Related to Sex, Gender, Race, and Ethnicity
• Summary
  • CHARGE TO THE COMMITTEE AND APPROACH
  • COMMITTEE’S APPROACH TO ADDRESSING ITS CHARGE
  • A RESEARCH AGENDA FOR THE FUTURE
• 1. Introduction
  • REPORTS ON WOMEN’S HEALTH
  • CURRENT LANDSCAPE AND BACKGROUND
  • CHARGE TO THE COMMITTEE AND APPROACH
  • REFERENCES
• 2. Why Women Develop Chronic Conditions Differently than Men
  • BIOLOGICAL FACTORS
  • EPIGENETICS: ENVIRONMENTAL REGULATION OF GENE EXPRESSION
  • STRUCTURAL AND SOCIAL DETERMINANTS OF HEALTH
  • SUMMARY
  • REFERENCES
• 3. Methodological Considerations for Studies of Chronic Conditions in Women
  • POPULATION AND NON-POPULATION BASED STUDIES
  • STUDIES OF FREQUENCY AND DISTRIBUTION (DISEASE)
  • OBSERVATIONAL STUDIES
  • EXPERIMENTAL STUDIES OF INTERVENTIONS
  • SUMMARY
  • REFERENCES
• 4. Impact of Select Chronic Conditions in Women
  • IMPACT OF FEMALE-SPECIFIC AND GYNECOLOGIC CONDITIONS
  • IMPACT OF CHRONIC CONDITIONS THAT PREDOMINANTLY IMPACT WOMEN OR AFFECT WOMEN DIFFERENTLY
  • ECONOMIC BURDEN
  • QUALITY OF LIFE
  • SUMMARY
  • REFERENCES
• 5. Female-Specific and Gynecologic Conditions
  • INTRODUCTION
  • ENDOMETRIOSIS
  • UTERINE FIBROIDS
  • FEMALE INFERTILITY
  • VULVODYNIA
  • PELVIC FLOOR DISORDERS
  • PREGNANCY AND CHRONIC CONDITIONS
  • MENOPAUSAL SYMPTOMS AND TRANSITION
  • SUMMARY
  • REFERENCES
• 6. Chronic Conditions That Predominantly Impact or Affect Women Differently
  • DEPRESSION
  • SUBSTANCE USE DISORDER
  • HIV/AIDS
  • MIGRAINES/HEADACHES
  • CARDIOMETABOLIC CONDITIONS
  • MULTIPLE SCLEROSIS
  • CHRONIC PAIN
  • FIBROMYALGIA
  • MYALGIC ENCEPHALOMYELITIS/CHRONIC FATIGUE SYNDROME
  • ALZHEIMER’S DISEASE
  • OSTEOPOROSIS
  • SARCOPENIA
  • SUMMARY
  • REFERENCES
• 7. Chronic Conditions in Women and the Structural and Social Determinants of Health
  • STRUCTURAL AND SOCIAL DETERMINANTS OF HEALTH
  • RESEARCH GAPS
  • REFERENCES
• 8. Multiple Chronic Conditions
  • DEFINITION OF MULTIPLE CHRONIC CONDITIONS
  • MEASUREMENT TOOLS
  • PREVALENCE OF MULTIPLE CHRONIC CONDITIONS
  • GENDER DIFFERENCES IN MULTIPLE CHRONIC CONDITIONS
  • ECONOMIC EFFECT OF MULTIPLE CHRONIC CONDITIONS IN THE UNITED STATES
  • MULTIPLE CHRONIC CONDITIONS ACROSS THE LIFE COURSE
  • BIOLOGICAL MECHANISMS OF MULTIPLE CHRONIC CONDITIONS
  • EXAMPLES OF MULTIPLE CHRONIC CONDITIONS CLUSTERS
  • BIOMARKERS FOR MULTIPLE CHRONIC CONDITIONS
  • DISPARITIES AND STRUCTURAL/SOCIAL CONTEXTS
  • TREATMENT AND MANAGEMENT OF MULTIPLE CHRONIC CONDITIONS
  • RESEARCH GAPS
  • SUMMARY
  • REFERENCES
• 9. Improving Prevention and Care for Chronic Conditions in Women
  • TRANSLATING RESEARCH: OPPORTUNITIES AND CHALLENGES
  • ADDITIONAL OPPORTUNITIES TO ENHANCE THE TRANSLATION OF RESEARCH TO CLINICAL PRACTICE
  • SUMMARY
  • REFERENCES
• 10. An Agenda to Advance Research on Chronic Conditions in Women
  • A RESEARCH AGENDA FOR THE FUTURE
• Appendix A. Committee Member and Staff Biographies
• Appendix B. Open Session Agendas
• Appendix C. Patient Perspectives and the Lived Experience

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2024. Advancing research on chronic conditions in women. Washington, DC: The National Academies Press. https://doi.org/10.17226/27757.

Digital Object Identifier: https://doi.org/10.17226/27757

This publication is available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

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