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What’s in a Presidential Memorandum? Explaining the One Establishing the White House Initiative on Women’s Health Research

February 20, 2024
by Kayla Yup

Last November, President Joe Biden made women’s health a federal priority.

In the Oval Office, Biden signed a presidential memorandum launching the first-ever White House Initiative on Women’s Health Research. Women’s Health Research at Yale’s very own Dr. Carolyn M. Mazure was tapped to chair the endeavor, alongside leadership from First Lady Dr. Jill Biden and the White House's Gender Policy Council.

“Women make up more than half the population. But for too long, they've been underrepresented when it comes to health research and the money spent on that research,” President Biden said at the signing. “That’s going to change today.”

At only three months old, the Initiative is still early into its journey to tackling disparities in women’s health research. Luckily, they have Dr. Mazure at the helm, and decades of foundational work by centers such as WHRY to guide them. First Lady Dr. Biden has since embarked on a tour of the nation’s top research facilities, from Cedars-Sinai in California to a recent stop at Morehouse School of Medicine in Atlanta.

She’s calling on universities, investors, startups, doctors, government, and advocates, to join her in the Initiative’s efforts.

“Together, we will build a future where women — all women — aren’t just an after-thought, but a first thought, where health care meets the needs of everyone,” First Lady Dr. Biden said in Atlanta.

Now, if you’re like me, you may have a million questions about what the memorandum entails, and what the Initiative will accomplish. So, I decided to break down what the document actually means, and most importantly, why it matters.

Here’s a WHRY Fellow’s guide to understanding the Memorandum on the White House Initiative on Women’s Health Research.

What is a Presidential Memorandum?

A presidential memorandum is a directive issued by the president to manage the executive branch. This particular memorandum creates the White House Initiative on Women’s Health Research and directs agencies to carry out specific actions.

Taking it Section by Section

Section 1

The memorandum starts off with a primer on disparities in women’s health research.

Here are some key takeaways:

Despite women comprising half of the United States population, a “lack of timely research and data on women’s health has left health care providers without important tools to diagnose and treat millions of women with debilitating conditions.”

What are some of these conditions?

Here’s the spread they provided: cardiovascular disease (note: more than 60 million women in the United States live with a form of heart disease), Alzheimer’s disease (note: two thirds of those with AD are women), autoimmune disorders (note: 80 percent of those with these disorders are women), mental health conditions (note: women are more likely to have depression and anxiety), and conditions unique to women, such as endometriosis and fibroids.

Beyond the direct health consequences, underinvesting in women’s health research can lead to decreased well-being and quality of life for women, cause women to be held back in the workplace, and negatively impact families’ economic security. Meanwhile increasing investments can “yield broad societal gains,” such as lower health care costs and a more productive and inclusive workforce.

The memorandum also called for the acceleration of research on women’s health needs across the lifespan, with an emphasis on conditions more prevalent among women and conditions linked to midlife and later.

Check out this paragraph: “We all have a part to play in galvanizing women’s health research, developing innovative and cutting-edge interventions that promote women’s health, and ensuring that women across the United States have access to high-quality health care.”

Section 2

Section 2 simply states that the White House Initiative on Women’s Health Research will be housed within the Office of the First Lady — meaning that First Lady Dr. Biden is heading the effort.

Section 3

This section says that President Biden will designate a Chair — our very own Dr. Mazure — to lead the Initiative and hold a position in the Office of the First Lady and collaborate with the White House Gender Policy Council. It also fills the rest of the Initiative’s membership with heads from 20 different offices, agencies, and departments.

Another key point is that the Department of Health and Human Services will provide the funding and administrative support needed for the Initiative to function (although each agency/office in the Initiative will pay their own expense for participating).

Section 4

Here, the Initiative’s mission is clearly defined: “to advance women’s health research in the United States.”

And how will the Initiative fulfill this mission?

The Initiative will look for areas of additional investment in women’s health research and set priorities to guide federal research investments. In other words, it will figure out important gaps in our knowledge of women’s health — and identify the research needed to fill those gaps. It will also develop policy recommendations that fulfill three purposes: ensuring women’s health needs are reported for federal research and data collection efforts, addressing health disparities and inequities impacting women, and supporting the translation of research from the bench to the bedside.

Some of the Initiative’s other functions are meant to engage the greater community. For example, the Initiative will identify opportunities for public-private partnerships in hopes of driving innovation. It will also work with the scientific community to help promote the publication of “actionable research and data on women’s health,” with plans to make Federal datasets available to support this research. Another function is to evaluate opportunities to “recruit, train and support” women pursuing careers in health and biomedical research.

The last function involves the public. President Biden tasked the Initiative with finding ways to increase awareness of the need for greater investment in women’s health research, and inform the public about disparities in women’s health research and outcomes.

Section 5

This section sets a deadline for the first part of the directive. Within 45 days of this memorandum, enacted on Nov. 13, 2023, the Initiative has to provide recommendations to the President on “concrete actions that agencies and offices can take to advance women’s health research.”

The heads of agencies and offices in the Initiative must also provide information to the Chair (Dr. Mazure) and inform the President (through the Chair) about their progress at least twice a year.

Section 6

This memorandum can only be implemented within the bounds of applicable law and available appropriations.

The Takeaway

The Initiative has a lot to accomplish within its advisory role — from finding gaps in our knowledge of women’s health and guiding investments in those areas, to hopefully driving innovation through public-private partnerships. I’ll look forward to the progress updates.

To close, I’ll leave you with a statement First Lady Dr. Biden released when the Initiative was first launched: “Every woman I know has a story about leaving her doctor’s office with more questions than answers. Not because our doctors are withholding information, but because there’s just not enough research yet on how to best manage and treat even common women’s health conditions. In 2023, that is unacceptable.”

In 2024, and every year from now, it will continue to be unacceptable. Let’s hope to see change.

Submitted by Sara Luciano on February 20, 2024