Background and History
Longstanding
inequities in women’s health in the education of health professionals were
first addressed in a substantive manner by a 1993 congressional directive,
which provided a basis for major changes in national policy. By 1994, NIH
policy recommended the inclusion of women and minorities as subjects in
clinical research, and the NIH Office of Research on Women's Health (ORWH) went
on to fund two surveys. Women’s Health in
the Medical School Curriculum (1996) and Women’s Health in the Dental School Curriculum (1997) became
seminal reports related to women’s health in both medical and dental education.
And, in 2001, the IOM published Exploring
the Biologic Contributions to Human Health: Does Sex Matter?, which
“established the credibility of biologic differences affecting the health and
health outcomes of both men and women.”[1]
With
an understanding of the inextricable link between oral and systemic health, and
with support from the ORWH and the Health Resources and Services
Administration, ADEA sponsored two pioneering reports: Women’s Health in the Dental School Curriculum: Report of a Survey and
Recommendations (1999) and Women’s
Health in the Dental School Curriculum: Survey Report and Recommendations
(2012). The ADEA Women’s Health Information Network Focus Group, convened in
2003, identified 23 disease areas of importance, with the intention of their
inclusion in a digital network for dental health practitioners to improve their
understanding of diseases and disorders affecting women’s health.
In
the 1999 Women’s Health in the Dental
School Curriculum report, the focus was primarily on female reproductive
biology; a “lifespan” approach to women’s health was not considered in 1997. A
new paradigm for women’s health that included interprofessional education
(IPE), team-based care and a science base that benefits the health of both
genders emerged from the 2012 study. Due to the connection between oral and
overall health in the rest of the body, fibromyalgia, chronic fatigue, pelvic
inflammatory disease, cervical dysplasia/cancer, obesity, lipoprotein disorders
and lung cancer were required to be included in dental school courses more in
2012 than in 1999.
The
2012 report contains many positive findings—foremost was that women’s health
was being integrated in multiple disciplines across multiple subject areas.
Women’s health instruction was being blended into curricula and covered as part
of lectures or seminars but not necessarily as stand-alone topics. More than
half of the respondents in 2012 reported that instruction on the impact of
gender on oral health and health issues across life stages was required. All
respondents in 2012 reported required coursework on osteoporosis and alveolar
bone loss in postmenopausal women. Although improvements were seen in the 2012
report, both reports identified the need for continued change regarding women’s
health content in the curriculum of U.S. dental schools.
Anticipating
and complementing the release of the 2013 Health Resources and Services
Administration (HRSA) Women’s Health
Curricula: Final Report on Expert Panel Recommendations for Interprofessional
Collaboration across the Health Professions, ADEA sponsored symposia on
gender-based research in dental and interprofessional education in 2012, 2013
and 2015.
[1] Women’s Health in the Dental School
Curriculum 2012: Survey Report and Recommendations, pg. 2