When you think “health,” what comes to mind? Perhaps visions of your annual check-up, attention to diet and exercise, or the medications that help you manage your physical or mental health? How about access to and quality of education, financial stability, neighborhood safety, and health care?
The latter are what we call social determinants of health, the non-medical – both positive and negative – factors that play a significant role in the quality of our well-being, especially when evaluating the risk for certain diseases and conditions.
This is why it is important to recognize that a “one-size-fits-all” approach to risk factors for illness does not work. Just this April, the American Heart Association released a scientific statement that non-biological factors affect each woman’s risk for heart disease and contended that research protocols can overlook the social differences among women of varied backgrounds. This includes social determinants that are risk factors, and those that have a constructive impact on health and well-being, such as a support system, community engagement, and access to quality health information.
Women’s Health Research at Yale, however, considers these factors. For twenty-five years, we have emphasized the importance of studying representative populations, ensuring inclusion of different populations of women, considering the influence of gender, and acknowledging the intersection of biological and social variables.
Dr. Soohyun Nam’s WHRY-funded study, supported by the Rice Family Foundation, focused on the treatment of insomnia as experienced by Black women because of the disproportionately high rate of insomnia in this population. Her investigation of mindfulness therapy for insomnia included attention to the social experience that could contribute to the underlying stress found in sleep disturbance. Dr. Nam demonstrated that the therapy reduced episodes of insomnia and related anxiety, while also reducing blood pressure, which is important because high blood pressure can contribute to conditions such as heart disease. Moreover, the therapy is low-cost and easy-to-access making it ideal to implement in the community or virtually, factors which help women who may not have the means – transportation, childcare, or time off work – to get to a clinical setting for regular treatment.
Similarly, Dr. Clare Flannery’s study on the relationship between atypical endometrial hyperplasia (AEH) and obesity points to ways many different communities can consider how the social determinants of health affect cancer risk. These include family eating patterns, community food environments, and food costs. Dr. Flannery’s research into how obesity related insulin levels affect AEH and how we can mitigate its development into endometrial cancer will go a long way toward improving the health of women negotiating these social factors. And, with your support, Women’s Health Research at Yale will continue to identify and fund research projects that improve the health of women and families in all communities.