WASHINGTON, USA – The Department of Defense (DoD) is working to ensure that research conducted across the department addresses health disparities faced by women, including conditions that affect women uniquely, disproportionately, or differently.
As part of the department’s broader efforts to support the health of women Service members, veterans, and beneficiaries (such as spouses and dependents) to enhance the medical readiness of the force and consistent with the president’s executive order on Advancing Women’s Health Research and Innovation – DoD is publicly announcing a series of new actions and commitments to advance women’s health research by:
Spending half a billion dollars each year on women’s health research, primarily through the Congressionally Directed Medical Research Programs (CDMRP);
Adopting a new research policy to ensure that women’s health is considered during every step of the research process that will apply to relevant research funded through the CDMRP beginning on October 1, 2024;
Standardizing CDMRP and Military Health System Research funding opportunity announcements to encourage applicants to consider research on health areas and conditions that affect women; and
Committing DoD’s Small Business Innovation Research (SBIR) program and the Small Business Technology Transfer (STTR) program to increase its investments in supporting innovators and early-stage small businesses engaged in research and development on women’s health.
These new announcements build on recent work that DoD has already done to advance women’s health research -including the establishment of a joint collaborative to improve women’s health research with the Department of Veterans Affairs (VA), DoD’s new Military Women’s Health Research Program, and the appointment of Dr Lynette Hamlin as the first-ever dedicated Director of the Military Women’s Health Research Program at the Uniformed Services University of Health Sciences – as well as DoD’s prior investments in women’s health research.
Investing in women’s health research and evidence-based care is critical to meeting the health care needs of the women served by DoD. The DoD provides medical care to more than 230,000 active-duty service women, nearly 2 million women military retirees, and to the family members of the active force and of retirees. Compared to men, this population experiences more than twice the rate of conditions in hematological, genitourinary, endocrine, nutrition, and immunity-related disorder categories.
Additionally, women’s rates for illness and injury-specific diagnoses, such as those associated with the musculoskeletal system and connective tissue, are more than 1.5 times those of male rates. DoD’s systematic surveillance and research of health conditions among Service women at a population level will bolster treatment options, improve patient care, and support breakthrough technologies and resources for women inside and outside of the military health system. Information on specific DoD policy efforts can be found below.
Congressionally directed medical research programs
CDMRP funds a wide variety of specialized health research areas that affect women, such as Alzheimer’s disease, multiple sclerosis, lupus, orthopedic and musculoskeletal injuries, and various cancers. In Fiscal Year (FY) 2022 and FY 2023, CDMRP funded 751 grants, produced 625 studies, and supported 706 researchers. For FY 2024, depending on the applications received, DoD anticipates investing more CDMRP funding for women’s health research than in previous years. These funds will be used to support research on topics such as rheumatoid arthritis, chronic fatigue, eating disorders, and gynecological cancers.
In addition to this new commitment, DoD adopted a new policy that will require researchers interested in CDMRP funding to consider sex as a biological variable in study design and analysis. Intentional consideration of biological variables, like sex, in medical research improves our understanding of health and disease in men and women. Under the new policy, CDMRP-funded research must consider the known and potential sex differences in disease prevalence, presentation, and outcomes. Peer and programmatic panels will review applications for how sex as a biological variable is incorporated into the proposed research and data analysis plans.
This new policy aligns with a similar policy adopted by the National Institutes of Health and will take effect on October 1, 2024. The new policy will apply to applications submitted for FY 2025 CDMRP funding opportunities, contingent on FY 2025 funding for CDMRP-managed programs. White House and DoD officials highlighted this change at DoD’s 2024 Military Health System Research Symposium, the Department’s premier scientific meeting.
Accounting for women’s health across DoD’s research programs and processes
DoD has taken action to ensure that women’s health is considered throughout the research application process. For instance, the CDMRP, the Uniformed Services University of Health Sciences (USUHS), and the Military Health System Research Program have all included standardized language in their FY 2024 funding opportunity announcements to encourage research on women’s health, including consideration of sex as a biological variable and its relationship to socioeconomic factors in affecting health outcomes. Additionally, for these programs, DoD has implemented policies to ensure that reviewers consider women’s health when evaluating research proposals, where appropriate.
Uniformed Services University of Health Sciences
The USUHS established the Military Women’s Health Research Program (MWHRP) in 2023, under the leadership of Dr Lynette Hamlin, the program’s inaugural Director. The MWHRP funds $1.67 million in research grants annually, sponsors publications and webinars to share important research findings, and encourages women to participate in the SBIR program and the STTR program. Over the last five years, USUHS has sponsored 76 grants, and produced 32 presentations and 152 publications specific to women’s health research.
USUHS also established the Military Women’s Health Research Consortium to develop and guide best practices for the clinical care of women in the Military Health System. Recent research focus areas include studying interventions for physical and emotional pain due to uterine fibroids, evaluating treatment options for women with low back pain, and studying the effects of prenatal mental health support.
Defense Health Program Small Business Innovation Research and Small Business Technology Transfer Programs
The Defense Health Agency (DHA) SBIR and STTR programs are statutorily required programs established to increase the participation of small businesses in federal research and development. These programs enable DHA to spark the development of future technologies to improve warfighter health and survival. DHA SBIR and STTR revised the DoD Broad Agency Announcement (BAA), the funding mechanism utilized for these programs, to encourage participation in innovation and entrepreneurship by women. Additionally, to enhance investments in applied research and practice focused on women’s health, SBIR and STTR have requested women’s health research topics from stakeholders as part of the FY 2025 BAA development process.
DoD/VA Women’s Health Research Collaborative
To further our collaboration and partnership with the VA, the joint DoD/VA health executive committee established a Women’s Health Research Collaborative in 2024, which will explore opportunities to promote joint efforts to advance women’s health research and improve evidence-based care for the women they serve: Service members, veterans, and their spouses, surviving spouses, dependents, and family caregivers. Additionally, the Collaborative will increase coordination with the goal of improving care and care delivery across the lifespan of women Service members, veterans, and other beneficiaries. The Collaborative will also advance research on key women’s health issues and develop a roadmap to close pressing research gaps, including those specifically affecting Service women and women veterans.
Moreover, the department ensures our providers are trained in gender-specific care. Through the DoD/VA Women’s Health Working Group, two mini-residencies are held annually to build provider proficiency. The DoD/VA Women’s Musculoskeletal Mini-Residency and DoD/VA Women’s Mental Health Mini-Residency offer health care providers, from both departments, opportunities to learn about the latest research while strengthening skills and knowledge in how to assess, diagnose, and treat women Service members, veterans, and other beneficiaries.
The DoD/VA also developed a Women’s Midlife Health Concerns Working Group to develop a needs assessment tool that will be deployed to women Service members, veterans, and other beneficiaries to gather their input on their midlife health concerns, including menopause and cardiovascular health. This group will make recommendations and develop tools to build provider proficiency in appropriately assessing and treating midlife health concerns.
Additional DoD actions to support the health needs of women Service members, retirees, and their eligible family members include the establishment of the Women’s Midlife Telehealth Clinic – the first US-based study examining birth outcomes between births attended by Certified Nurse Midwives and physicians focused on births within the MHS – and the provision of world-class cancer care and translational research at the Murtha Cancer Center at Walter Reed Gynecological Cancer Center of Excellence.
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