The dominance of men in politics has also been a significant factor in shaping policies on women's health. As demonstrated by Our Bodies in Ourselves (OBOS) and the Boston Women's Health Book Collective, a seminal book that introduced key ideas, women are often the catalysts for social change. Women are often well-informed health care consumers and are overrepresented in the health care workforce and among health care consumers. However, they are underrepresented in policymaking positions.
Following the many political successes noted above, from the legalization of contraception and abortion to the increased representation of women in academic medicine, women found themselves in an increasingly strong position to participate in policy debates and bring about significant changes in the health care system. In the 1990s, in an effort to address longstanding inequities in women's participation in medical research, and the significant lack of clinically relevant biomedical and health services research for women, the National Institutes of Health (NIH) Revitalization Act of 1993 established the Office of Women's Health at the NIH. This type of act requires that women and minorities be adequately represented in all government-supported research projects. As part of this act, the NIH sponsored the Women's Health Initiative, a 15-year, $625 million, multisite project that included prevention studies to investigate heart disease, osteoporosis, and breast and colon cancer. These studies are primarily aimed at ensuring that the 30-year gain in longevity during the 20th century is translated into a true improvement in quality of life. In the year of 1996, Women on Women's Health established the Centers of Excellence in Women's Health, with the goal of integrating women's health research, medical training, public health education, community outreach, and clinical services. These centers strive to recruit, retain, and promote women in academic medicine.
As the U.S. As outlined in the Department of Health and Human Services Office of Women's Health's (2002) A Century of Women's Health: 1900-2000, women have accomplished other important political accomplishments, including the passage of:
● Title IX of the Education Amendments (1976) prohibiting sex discrimination in all educational programs receiving federal funding
● The Pregnancy Discrimination Act (1978), prohibiting sex discrimination in employment based on pregnancy, childbirth, or related medical conditions
● The Breast and Cervical Cancer Mortality Prevention Act (1990), requiring the provision of mammograms and Pap smears
● The Mammography Quality Standards Act (1992), establishing national standards and a uniform system of quality control of mammography clinics nationwide
● The Infertility Prevention Act (1992), providing screening, treatment, counseling, and follow-up treatment to women diagnosed with STDs
● The Family and Medical Leave Act (1993), providing women and men with Enables women to take up to three months of leave in a 12-month period to care for family, without losing their job
● The Violence Against Women Act (1994), defining new federal crimes of violence against women and establishing enhanced penalties to fight against sexual assault and domestic violence Other accomplishments include:
● Appointment of Patricia Harris, an African American, as the first female Secretary of Health, Education, and Welfare (1979)
● Consolidation of maternal, infant, child, and adolescent health at the state level through the Maternal and Child Health Services Block Grant (1981)
● Establishment of The Women's Race for the Cure (1983) to raise funds for breast cancer research, education, screening, and treatment programs
● Appointment of Margaret Mary Heckler as the first Secretary of the Department of Health and Human Services (1983), known for the initiation of fixed rates for Medicare payments to hospitals.
With each president and administration, the political environment presented by the ideology of elected officials is likely to facilitate or hinder efforts to gain ground on health and social justice issues. Reproductive health issues are highly affected by such changes, although public health conditions dictate a public policy agenda that may seem contradictory with a contemporary political view. For example, despite a conservative government during the Reagan and senior Bush administrations, the high prevalence of HIV/AIDS prompted then-U.S. Surgeon General Dr. C. Everett Koop to discuss public messages on condom use as a way to curb HIV/AIDS transmission.
