The good news: Over the last two decades, medical breakthroughs and more inclusive research have significantly improved the lives of women with cardiovascular disease, depression and osteoporosis, according to a new report by the Institute of Medicine.

The bad news: Prevention efforts, including for substance abuse, are failing many women, especially ethnic minorities.

“Prevention efforts overall have not been as effective as we’ve hoped,” says psychologist Hortensia Amaro, PhD, an associate dean and distinguished professor in the Bouvé College of Health Sciences and director of the Institute on Urban Health Research at Northeastern University and a member of the committee that released the report. “There is still a pressing need to develop efficacious HIV/AIDS and substance abuse prevention interventions for African-American and Latina women and take them to scale nationally.”

In many cases, scientists have developed and tested interventions that reduce risk for HIV/AIDS and/or substance use, but these interventions have not been implemented on a large scale, says Amaro. In other cases, such as in HIV/AIDS and substance abuse prevention, there is a dearth of evidence-based programs that are tailored for specific populations, such as Latina girls and women.

And in some instances, interventions are not sufficiently incorporating the gendered nature of risk, such as in substance abuse prevention. For example, research has suggested that some girls and young women are introduced to use of substances by boyfriends, and substance abuse prevention efforts have largely ignored this source of risk for young women, says Amaro. In addition, prevention and treatment studies often lack appropriate gender-specific analysis that would help evaluate whether approaches work as well with women as with men, she says.

The report also identified another bright spot: Women with HIV/AIDS are receiving better treatment now than in previous years. This has led to lower levels of mortality, for both women and men. However, prevention efforts, specifically for African-Americans and Latinas, are not stemming the spread of the virus. Among American women living with HIV/AIDS, 64 percent are black and 15 percent are Latina.

“It’s great to see progress in many treatments for women,” says Amaro. “But we still need more research that includes sufficient samples of diverse populations who have different risk profiles, resources and needs. And we need the public health system to better integrate evidence-based approaches on a large scale so it can have a meaningful impact on women’s well being.”

—J. Clark

Read the IOM report, “Women’s Health Research: Progress, Pitfalls and Promise.”