#50 years of progress in women’s health

Debates over women’s health have long been contentious, but have also resulted in significant improvements in areas like equitable access to health care and survivorship. But the overall picture remains far from perfect. For example, the United States still has the highest rate of maternal death among high-income countries, particularly among African American women.

As the United States Supreme Court prepares to hear a Mississippi abortion case challenging the landmark 1973 Roe v. Wade decision, some experts are questioning whether women’s health may be reversing course.

Cynthia A. Stuenkel, MD, clinical professor of medicine at University of California San Diego School of Medicine, and JoAnn E. Manson, MD, DrPH, professor of epidemiology at Harvard T.H. Chan School Of Public Health, review 50 years of progress in women’s health in a perspective article published in the May 29, 2021 online issue of the New England Journal of Medicine.

“Reproductive justice is broader than the pro-choice movement and encompasses equity and accessibility of reproductive health care, as well as enhanced pathways to parenthood,” wrote the authors.

In addition to Roe v. Wade, advances in reproductive health include:

• 1972 US Supreme Court ruling on Eisenstadt vs Baird ensuring unmarried persons equal access to contraception
• 2010 Affordable Care Act made contraceptives an insured preventive health benefit
• Advances in reproductive technologies, including in vitro fertilization, genetic testing and fertility preservation by cancer specialists

Advances in women’s health go beyond reproduction, said the authors. As interest and focus has expanded to all stages of a woman’s life, science has begun to catch up to the specialized needs of women and sex-specific risk factors for chronic diseases that disproportionately affect women’s health, such as autoimmune diseases, mental health, osteoporosis and coronary heart disease.

• Progress in breast cancer care and prevention yielded a five-year overall survival rate of 90 percent
• The human papillomavirus (HPV) vaccine reduced cervical cancer mortality decreased by 50 percent

“Moving forward, it will be essential to recognize and study intersectional health disparities, including disparities based on sex, race, ethnicity, gender identity, sexual orientation, income and disability status. Overcoming these challenges and addressing these inequities will contribute to improved health for everyone,” wrote the authors.