In health, like everything else, men and women really are different

Introduction

Health studies still do not adequately root out differences between men and women, according to a new report from the National Academy of Sciences.

In the past, researchers concerned with how a study might damage a fetus or how the flux of hormones in women’s bodies might impact the data meant they recruited fewer women. The gap in accurate health data for women started getting attention in 1985, and touched off a shift toward more accurate research and regulation.

Clinical trials about diseases, devices and drugs don’t regularly analyze outcomes by sex or gender “and it is unclear whether adequate numbers of women are being enrolled in clinical trials to allow adequate analysis,” the report says.

One factor keeping women out of trials can be that diseases present themselves differently. So a cardiovascular-disease trial with inclusion criteria looking for early onset and chest pain will draw more men because women get heart disease at an older age on average and are less likely than men to report chest pain during a heart attack.

The independent science panel’s report recommends that medical journal editors require studies to present separate data results for men and women, and that the Food and Drug Administration ensure that a drug or device has been assessed for different impacts on men and women before going on the market. The study also encouraged researches to take quality of life concerns, which women often rank as more important to their own assessment of their overall health, into their work.

FAST FACT: Women generally report worse health than men even though men have shorter life expectancy and an earlier average onset of many diseases.

Other new watchdog reports released by the Government Accountability Office (GAO), various federal Offices of Inspector General (OIG), and other government entities:

FINANCE

• U.S. global dominance slipped since 2005 with telltale signs such as China surpassing America as top high-tech exporter and foreign companies obtaining 51 percent of U.S. patents (National Academy of Sciences)
• The number of subprime mortgages originated in 2000-07 that were seriously delinquent rose to 1.4 million at the end of 2009, up 300,000 from the end of 2008 (GAO)

HEALTH CARE

• Medicare paid nearly $566,000 for questionable bills submitted by doctors caring for hospice patients in 2009, and six of the 10 physicians with the highest questionable payments were in Florida (OIG).

ENVIRONMENT

• Analysis needed of the trade-offs to meet Florida Everglades targets for both water quantity and water flow (National Research Council).
• NOAA is at a “critical juncture” and must try to restore the reputation and fairness of its enforcement actions with fishermen in the Northeast U.S. (OIG).
• EPA’s Enforcement, Compliance and History Online (ECHO) database for air, water, and hazardous waste programs has a 91.5 percent data accuracy rate, short of the agency’s required 95 percent accuracy rate (OIG).

MISC.

• ACORN Housing Corp. of Chicago, now operating as Affordable Housing Centers of America, should be placed on HUD’s “inactive” status until it documents how it used 80 percent of $3.3 million in HUD counseling grants in 2008-09 on salaries (OIG).