A multifaceted approach to global health.

World Health Day underscores the scientific community's commitment to achieving health equity for all. It is paramount to eliminate bias in research that has traditionally focused on men, neglecting the specific needs of diverse populations. Innovative clinical trial designs are being developed with more inclusive enrollment. Ensuring equitable access to essential antibiotics, coupled with robust infection prevention and control measures, is vital to safeguarding public health. The pursuit of health equity extends beyond the realm of medicine. Investments in local food production and robust social safety nets are critical for mitigating the effects of climate change on access to healthy diets. Additionally, in times of polycrisis, prioritizing the unique needs of children and empowering community-led healthcare initiatives in conflict zones are essential steps. By taking these actions, we can move closer to realizing everyone's fundamental right to health.

Londa Schiebinger.

Dr. Londa Schiebinger is an international leader on the intersection of sex, gender, and science. In this interview with Cell, she discusses the Gendered Innovations project, the persistent STEM gender gap, the importance of considering sex- and gender-related variables and intersectionality in research, and the future of sex and gender research.

Reflecting on Progress in and Establishing Benchmarks for Sex and Gender Health Education.

ABSTRACT: Sex and gender influence every aspect of human health; thus, sex- and gender-related topics should be incorporated in all aspects of health education curricula. Sex and gender health education (SGHE) is the rigorous, intersectional, data-driven integration of sex and gender into all elements of health education. A multisectoral group of thought leaders has collaborated to advance SGHE since 2012. This cross-sector collaboration to advance SGHE has been successful on several fronts, primarily developing robust interprofessional SGHE programs, hosting a series of international SGHE summits, developing sex- and gender-specific resources, and broadening the collaboration beyond medical education. However, other deeply entrenched challenges have proven more difficult to address, including accurate and consistent sex and gender reporting in research publications, broadening institutional support for SGHE, and the development and implementation of evaluation plans for assessing learner outcomes and the downstream effects of SGHE on patient care. This commentary reflects on progress made in SGHE over the first decade of the current collaboration (2012-2022), articulates a vision for next steps to advance SGHE, and proposes 4 benchmarks to guide the next decade of SGHE: (1) integrate sex, gender, and intersectionality across health curricula; (2) develop sex- and gender-specific resources for health professionals; (3) improve sex and gender reporting in research publications; and (4) develop evaluation plans to assess learner and patient outcomes.

A framework for sex, gender, and diversity analysis in research.

Funding agencies have ample room to improve their policies.

Sex, gender, and intersectional puzzles in health and biomedicine research.

Excellent research integrates sex, gender, and/or intersectional analysis-from the very beginning and throughout the research process. This article highlights techniques for analyzing sex, how sex and sex interact, how sex and gender interact, and the need for intersectional analysis. Designing sex, gender, and intersectional analysis into research is one crucial component contributing to world-class health and biomedicine.

Diversifying history: A large-scale analysis of changes in researcher demographics and scholarly agendas.

BACKGROUND: In recent years, interest has grown in whether and to what extent demographic diversity sparks discovery and innovation in research. At the same time, topic modeling has been employed to discover differences in what women and men write about. This study engages these two strands of scholarship to explore associations between changing researcher demographics and research questions asked in the discipline of history. Specifically, we analyze developments in history as women entered the field. METHODS: We focus on author gender in diachronic analysis of history dissertations from 1980 (when online data is first available) to 2015 and a select set of general history journals from 1950 to 2015. We use correlated topic modeling and network visualizations to map developments in research agendas over time and to examine how women and men have contributed to these developments. RESULTS: Our summary snapshot of aggregate interests of women and men for the period 1950 to 2015 identifies new topics associated with women authors: gender and women's history, body history, family and households, consumption and consumerism, and sexuality. Diachronic analysis demonstrates that while women pioneered topics such as gender and women's history or the history of sexuality, these topics broaden over time to become methodological frameworks that historians widely embraced and that changed in interesting ways as men engaged with them. Our analysis of history dissertations surface correlations between advisor/advisee gender pairings and choice of dissertation topic. CONCLUSIONS: Overall, this quantitative longitudinal study suggests that the growth in women historians has coincided with the broadening of research agendas and an increased sensitivity to new topics and methodologies in the field.

The Integration of Sex and Gender Considerations Into Biomedical Research: Lessons From International Funding Agencies.

To improve the outcomes of research and medicine, government-based international research funding agencies have implemented various types of policies and mechanisms with respect to sex as a biological variable and gender as a sociocultural factor. After the 1990s, the US National Institutes of Health (NIH), the Canadian Institutes of Health Research (CIHR), and the European Commission (EC) began requesting that applicants address sex and gender considerations in grant proposals, and offering resources to help the scientific community integrate sex and gender into biomedical research. Although it is too early to analyze data on the success of all of the policies and mechanisms implemented, here we review the use both of carrots (incentives) and sticks (requirements) developed to motivate researchers and the entire scientific research enterprise to consider sex and gender influences on health and in science. The NIH focused on sex as a biological variable (SABV) aligned with an initiative to enhance reproducibility through rigor and transparency; CIHR instituted a sex- and gender-based analysis (SGBA) policy; and the EC required the integration of the "gender dimension," which incorporates sex, gender, and intersectional analysis into research and innovation. Other global efforts are briefly summarized. Although we are still learning what works, we share lessons learned to improve the integration of sex and gender considerations into research. In conjunction with refining and expanding the policies of funding agencies and mechanisms, private funders/philanthropic groups, editors of peer-reviewed journals, academic institutions, professional organizations, ethics boards, health care systems, and industry also need to make concerted efforts to integrate sex and gender into research, and we all must bridge across silos to promote systemwide solutions throughout the biomedical enterprise. For example, policies that encourage researchers to disaggregate data by sex and gender, the development of tools to better measure gender effects, or policies similar to SABV and/or SGBA adopted by private funders would accelerate progress. Uptake, accountability for, and a critical appraisal of sex and gender throughout the biomedical enterprise will be crucial to achieving the goal of relevant, reproducible, replicable, and responsible science that will lead to better evidence-based, personalized care for all, but especially for women.

Ensuring that biomedical AI benefits diverse populations.

Artificial Intelligence (AI) can potentially impact many aspects of human health, from basic research discovery to individual health assessment. It is critical that these advances in technology broadly benefit diverse populations from around the world. This can be challenging because AI algorithms are often developed on non-representative samples and evaluated based on narrow metrics. Here we outline key challenges to biomedical AI in outcome design, data collection and technology evaluation, and use examples from precision health to illustrate how bias and health disparity may arise in each stage. We then suggest both short term approaches-more diverse data collection and AI monitoring-and longer term structural changes in funding, publications, and education to address these challenges.

Gender-related variables for health research.

BACKGROUND: In this paper, we argue for Gender as a Sociocultural Variable (GASV) as a complement to Sex as a Biological Variable (SABV). Sex (biology) and gender (sociocultural behaviors and attitudes) interact to influence health and disease processes across the lifespan-which is currently playing out in the COVID-19 pandemic. This study develops a gender assessment tool-the Stanford Gender-Related Variables for Health Research-for use in clinical and population research, including large-scale health surveys involving diverse Western populations. While analyzing sex as a biological variable is widely mandated, gender as a sociocultural variable is not, largely because the field lacks quantitative tools for analyzing the influence of gender on health outcomes. METHODS: We conducted a comprehensive review of English-language measures of gender from 1975 to 2015 to identify variables across three domains: gender norms, gender-related traits, and gender relations. This yielded 11 variables tested with 44 items in three US cross-sectional survey populations: two internet-based (N = 2051; N = 2135) and a patient-research registry (N = 489), conducted between May 2017 and January 2018. RESULTS: Exploratory and confirmatory factor analyses reduced 11 constructs to 7 gender-related variables: caregiver strain, work strain, independence, risk-taking, emotional intelligence, social support, and discrimination. Regression analyses, adjusted for age, ethnicity, income, education, sex assigned at birth, and self-reported gender identity, identified associations between these gender-related variables and self-rated general health, physical and mental health, and health-risk behaviors. CONCLUSION: Our new instrument represents an important step toward developing more comprehensive and precise survey-based measures of gender in relation to health. Our questionnaire is designed to shed light on how specific gender-related behaviors and attitudes contribute to health and disease processes, irrespective of-or in addition to-biological sex and self-reported gender identity. Use of these gender-related variables in experimental studies, such as clinical trials, may also help us understand if gender factors play an important role as treatment-effect modifiers and would thus need to be further considered in treatment decision-making.

Sex and gender analysis improves science and engineering.

The goal of sex and gender analysis is to promote rigorous, reproducible and responsible science. Incorporating sex and gender analysis into experimental design has enabled advancements across many disciplines, such as improved treatment of heart disease and insights into the societal impact of algorithmic bias. Here we discuss the potential for sex and gender analysis to foster scientific discovery, improve experimental efficiency and enable social equality. We provide a roadmap for sex and gender analysis across scientific disciplines and call on researchers, funding agencies, peer-reviewed journals and universities to coordinate efforts to implement robust methods of sex and gender analysis.

Gendered Innovation in Health and Medicine.

Excellence in research requires careful attention to sex and gender analysis. The Gendered Innovations project, initiated in 2009, develops state-of-the-art methods of sex and gender analysis for basic and applied research. This chapter reviews recent developments in cardiovascular disease for (1) analyzing sex, (2) analyzing gender, and (3) policy initiatives.

Word embeddings quantify 100 years of gender and ethnic stereotypes.

Word embeddings are a powerful machine-learning framework that represents each English word by a vector. The geometric relationship between these vectors captures meaningful semantic relationships between the corresponding words. In this paper, we develop a framework to demonstrate how the temporal dynamics of the embedding helps to quantify changes in stereotypes and attitudes toward women and ethnic minorities in the 20th and 21st centuries in the United States. We integrate word embeddings trained on 100 y of text data with the US Census to show that changes in the embedding track closely with demographic and occupation shifts over time. The embedding captures societal shifts-e.g., the women's movement in the 1960s and Asian immigration into the United States-and also illuminates how specific adjectives and occupations became more closely associated with certain populations over time. Our framework for temporal analysis of word embedding opens up a fruitful intersection between machine learning and quantitative social science.

Making gender diversity work for scientific discovery and innovation.

Gender diversity has the potential to drive scientific discovery and innovation. Here, we distinguish three approaches to gender diversity: diversity in research teams, diversity in research methods and diversity in research questions. While gender diversity is commonly understood to refer only to the gender composition of research teams, fully realizing the potential of diversity for science and innovation also requires attention to the methods employed and questions raised in scientific knowledge-making. We provide a framework for understanding the best ways to support the three approaches to gender diversity across four interdependent domains - from research teams to the broader disciplines in which they are embedded to research organizations and ultimately to the different societies that shape them through specific gender norms and policies. Our analysis demonstrates that realizing the benefits of diversity for science requires careful management of these four interdependent domains.

One and a half million medical papers reveal a link between author gender and attention to gender and sex analysis.

Gender and sex analysis is increasingly recognized as a key factor in creating better medical research and health care 1-7 . Using a sample of more than 1.5 million medical research papers, our study examined the potential link between women's participation in medical science and attention to gender-related and sex-related factors in disease-specific research. Adjusting for variations across countries, disease topics and medical research areas, we compared the participation of women authors in studies that do and do not involve gender and sex analysis. Overall, our results show a robust positive correlation between women's authorship and the likelihood of a study including gender and sex analysis. These findings corroborate discussions of how women's participation in medical science links to research outcomes, and show the mutual benefits of promoting both the scientific advancement of women and the integration of gender and sex analysis into medical research.

Considering sex as a biological variable in preclinical research.

In June 2015, the National Institutes of Health (NIH) released a Guide notice (NOT-OD-15-102) that highlighted the expectation of the NIH that the possible role of sex as a biologic variable be factored into research design, analyses, and reporting of vertebrate animal and human studies. Anticipating these guidelines, the NIH Office of Research on Women's Health, in October 2014, convened key stakeholders to discuss methods and techniques for integrating sex as a biologic variable in preclinical research. The workshop focused on practical methods, experimental design, and approaches to statistical analyses in the use of both male and female animals, cells, and tissues in preclinical research. Workshop participants also considered gender as a modifier of biology. This article builds on the workshop and is meant as a guide to preclinical investigators as they consider methods and techniques for inclusion of both sexes in preclinical research and is not intended to prescribe exhaustive/specific approaches for compliance with the new NIH policy.-Miller, L. R., Marks, C., Becker, J. B., Hurn, P. D., Chen, W.-J., Woodruff, T., McCarthy, M. M., Sohrabji, F., Schiebinger, L., Wetherington, C. L., Makris, S., Arnold, A. P., Einstein, G., Miller, V. M., Sandberg, K., Maier, S., Cornelison, T. L., Clayton, J. A. Considering sex as a biological variable in preclinical research.