Uterine fibroids, benign growths that develop from the muscle tissue comprising the uterus, are the most common type of growth found in the pelvis. Also referred to as leiomyomas or myomas, uterine fibroids affect millions of women globally.
While uterine fibroids are quite common among women aged 30 to 40, there exist racial disparities in their prevalence and manifestation in the United States. Not only are Black women more likely to have uterine fibroids, but they also experience their occurrence at younger ages. Additionally, uterine fibroids tend to grow more quickly in Black women. This past June, Michigan Medicine received a $7.8 million grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (of the National Institutes of Health) to address inequities surrounding uterine fibroids. As we celebrate this historic feat, we must also underscore the significance of sustained effort as we work to fill funding gaps in women’s health research.
As we celebrate this historic feat, we must take note of what necessitates such a feat in the first place. The shortcomings of current medical research on maternal health disparities bar people from understanding the full scope of this issue across many spheres. Many studies on fibroids are about the genetic and biological basis of their development, which tend to leave researchers with very little information about Black women’s unique circumstances. Because race has no biological basis, studies that fixate on genetics and biology do not paint the full—or in some cases, any—picture. Excluded from many of these studies are the role of environmental factors, or structural racism, in shaping Black women’s health outcomes. In other words, researchers are looking for explanations in places that often obscure and/or disregard the social determinants of health.
It’s also important to note that the issue of uterine fibroids is one among many that go without adequate attention or efforts to heighten awareness. Polycystic ovary syndrome, or PCOS, impacts anywhere between 6% and 12% of birthing people of reproductive age worldwide, and remains ‘invisible’, despite its prevalence. Despite standing as the leading cause of infertility for birthing people of reproductive age, PCOS remains largely unheard of among many. What’s worse, physicians are not often trained to recognize and treat the condition, which means that the very nature of our training within the biomedical establishment makes the clinical space conducive to prolonged diagnosis and treatment.
These findings closely align with an observation stemming from the work of mathematician Arthur Mirin in 2021. His research demonstrated that the funding for various conditions that disproportionately impact women is incommensurate with the burden of disease. In other words, despite the prevalence of certain conditions among women in the United States, there exists a parity of funding that aligns with their overall impact.
As noted in the above article, Mirin is not the only one to make this observation. A smaller analysis of cancer funding found that cancerl cancers receive less support than do other cancers when accounting for lethality. One thing is quite evident: despite comprising a little over half of the United States population, women’s health needs go largely unaccounted for, and in many cases, unmet. In terms of reasoning, the article posits a number of historical conditions contributing to current realities. In addition to research studies themselves, women have been historically underrepresented in clinical trials.
The work of Michigan Medicine is revolutionary, and it should stand as the tip of the iceberg. As the National Institutes of Health continues to spearhead and support efforts to address the issues facing women, other institutional bodies must follow suit if we are to adequately address the issues facing birthing people in the United States.
