This academic term marked the start of my second year as a WHRY Undergraduate Fellow. On September 12 at WHRY’s 25th anniversary celebration, I had the pleasure of catching up on the decades of scientific discovery generated by this extraordinary center. As a student majoring in Biology and the History of Science, I was thrilled to hear about WHRY’s work changing science and improving lives. The aspiring science journalist in me wanted to document everything.
First to the stage was Yale School of Medicine (YSM) Dean Nancy Brown, MD, who kicked off the evening’s presentations with a look back to 1998 – the year of WHRY’s inception. At the time, the idea of dedicating a research center to study the health of women was groundbreaking. Yale’s was one of the first. Dean Brown credited the vision for this interdisciplinary research center to its founding director – Carolyn Mazure, PhD, the Norma Weinberg Spungen and Joan Lebson Bildner Professor in Women’s Health Research and Professor of Psychiatry and Psychology.
Thanks to this vision, coupled with support from then YSM Dean David Kessler and Associate Dean for Administration Ruth Katz (who was in the audience) and a forward-looking inaugural grant from The Patrick and Catherine Weldon Donaghue Medical Research Foundation, WHRY has played a major role in developing women’s health as a nationally and internationally recognized field of scientific study.
To provide a snapshot of the research generated through WHRY, Dean Brown turned the stage over to three outstanding researchers who, among hundreds of faculty members who have received WHRY support, presented their ground-breaking research that contributed to advancing women’s health.
The first WHRY investigator to speak was Yale University President and Chris Argyris Professor of Psychology Peter Salovey, PhD. In 1999, well before he moved to Woodbridge Hall, Salovey received one of the original WHRY grants in which he sought to apply social psychology principles to health messaging — with a special focus on women.
With the help of WHRY’s funding, Dr. Salovey designed new public health messages that informed women from low-income groups who were at risk for breast cancer about the value of their having mammograms. His strategy, when tested in New Haven, increased the rate of mammography among this population of women, and this success rippled through Connecticut as the state adopted Dr. Salovey’s messaging strategy.
Dr. Salovey’s study demonstrated the value of reaching out and building a relationship with the community. And, as he reported in a 2001 Yale News article, "Our team was welcomed into the common rooms of housing developments, where you find people living in the most challenging circumstances in the city.” In designing these messages with input from women in the community, Dr. Salovey showed that principles derived through psychological research can guide “a community-level intervention that actually changes peoples' health behavior.”
Next to speak about her relationship with WHRY was Akiko Iwasaki, PhD, Sterling Professor of Immunobiology, who reminded the audience that giving voice to women’s health means extending research beyond studying only reproductive biology. Dr. Iwasaki received funding from WHRY for research on sex differences in the immune response to invading pathogens, such as bacteria and viruses, including the coronavirus.
In her comments about WHRY, Dr. Iwasaki recalled receiving an email from Dr. Mazure at the start of the COVID-19 pandemic about the emerging data showing men were almost twice as likely to have a severe form of the disease and die than women. Agreeing that this sex difference in outcome provided an opportunity to uncover aspects of the mechanism used by the virus to infect and become deadly, Drs. Mazure and Iwasaki decided that an investigation of sex differences in the immune response to COVID-19 was warranted.
In her subsequent WHRY-funded study, Dr. Iwasaki found that men had a higher innate immune response (the body's first line of defense responding to all pathogens in the same way) to the virus while, in contrast, women had more of an adaptive immune response (that first identifies the invader, and then targets it specifically). This insight into the action of the virus spurred possible intervention strategies and gained widespread attention, in both the mainstream news media and among researchers and health care providers. Dr. Iwasaki has continued to build on her early experience with this disease to pioneer studies on Long COVID.
Mark Saltzman, PhD, the Goizueta Foundation Professor of Biomedical and Chemical Engineering, was the next speaker. Holding up a vial of liquid containing microscopic nanoparticles as he spoke, Dr. Saltzman explained that these non-toxic and biodegradable particles, invisible to the naked eye, were manufactured in his lab. Their job is to carry drug molecules to locations where they are needed.
Dr. Saltzman’s latest target is the culprit behind as many as half of premature deliveries: intra-amniotic infections. An ongoing WHRY study by Yale pediatric surgeon Dr. David Stitelman and Dr. Saltzman is evaluating the feasibility of nanoparticles carrying antibiotics to the fetal space during pregnancy to treat intra-amniotic infections – thus reducing premature delivery and its accompanying short and long-term health challenges.
“The type of funding WHRY provides is critical for the innovation-based work I do,” Dr. Saltzman previously told Yale News. “Early funding, particularly for collaborative projects with unproven technologies, is critical.”
Everyone also had the opportunity to hear from WHRY’s Advisory Council Chair, Susanna Krentz. “I am so very proud to be affiliated with WHRY. As a Yale College graduate, I was taught that we had a responsibility to lead, discover, and share what we know with the world. This is exactly what WHRY does,” she said. Council member Wendy Naratil and Tom Naratil spoke as key supporters of WHRY, emphasizing what the research and educational efforts of the center meant to them: “Truly helping others have better, healthier lives.”
Closing the evening were comments by Dr. Mazure, who spoke of the “sea change” in research in the late 1990s precipitated by new requirements from the National Institutes of Health. These stated that clinical trials funded by the NIH – the largest single funder of biomedical research in the country – must include women as subjects to provide long overdue data on the health of women. At the same time, the Institute of Medicine issued a formal response in 2001 to an ongoing debate about the value of investigating the biology of women beyond reproductive health, indicating that there was “sufficient knowledge to validate the scientific study of sex differences.”
Thus, by the start of the 21st century, said Dr. Mazure, “landmark research policy and scientific guidance clearly stated that study participants should include women, and that the influence of biological sex and social experience of gender on health should be studied. Today, women’s health is recognized as a field of scientific study that, importantly, includes yet extends beyond reproductive health. It is marked by an exponential growth in useful and clinically meaningful data, innovations in care, and new careers, and participation comes from many disciplines.”
As a consequence, there has been a growth of clinically relevant data on sex and gender effects that inform care on a whole variety of disorders, from heart disease to cancers to brain-based disorders, to name just a few. Examples of important contributions in basic science have included a better understanding of how sex chromosomes influence the function of cells through protein expression, receptors, signaling, and cellular pathways, which are often regulated differently in females and males.
Nonetheless, she pointed out there is so much more to do. As a 2022 Commonwealth Fund report tells us, compared to other developed economies – women of reproductive age in the U.S. have the highest rates of death from avoidable causes. Women, overall, also are at higher risk for various disorders, co-occurring disorders, psychosocial stressors, and living in poverty.
Ever with a view to the future, Dr. Mazure said these data are “our next call to action, and what is exciting about the future is – we can change this. We have already shown that it can alter the landscape of research, advance science, and improve outcomes. There is no reason to think that we cannot or will not continue to advance health for everyone by studying the influence of biological sex and social experience of gender in determining health outcomes.
“When inclusion is a fundamental part of our design and method of study, it brings scientific impact and practical benefit to everyone,” Mazure said. “And in so doing, public health thrives.”
