Women in the United States constitute a very diverse group of individuals. Their emancipation, achievements in higher education, and representation at the highest levels of business, government, and public policy will enable women to capitalize on the successes accomplished over the past century and to shape the health care system to adequately meet the needs of the contemporary female health care consumer. At one end of the spectrum, we see women who seek a balance between family responsibilities and achievement in professional life, and between beauty and health; women who are highly educated, with a level of sophistication that demands information and knowledge about health conditions and diseases; a collaborative dynamic of decision making between health care provider and patient; a better integration of women's physical and mental health into general medical practice; a holistic approach to treatment; recognition of spirituality as a new and integral dimension of health; a network of support for women across the entire health spectrum; and a health care system that can accommodate diversity in ethnicity, creed, origin, languages, and sexual orientation in the female population. At the other end of the spectrum, the female population includes younger women with unwanted pregnancies; those who never seek prenatal care; those who are struggling to provide for their families; those who transition from welfare to work and face multiple barriers to adequate childcare; those who did not have the knowledge and/or means to seek preventive/routine health and cancer screening services because they were uninsured or underinsured, and presented with metastatic cancer upon diagnosis; those whose STDs went undiagnosed and/or untreated and resulted in secondary infertility; those who are sexually assaulted and abused; and those who are victims of domestic violence. The challenges are many and varied, and there are many areas that require immediate attention. Meeting these challenges will require a fundamental transformation in the way health care is financed and delivered, and the extent to which academic medicine and the allied health professions are able to integrate these changes into their curricula and produce a cadre of health professionals who are adequately trained to serve this population. Women must continue to build on and expand the successes made over the past century and create the social, political, and health care environments for future generations.
