Congress is being urged to invest US$20bn over 10 years to close the women’s health gap.

The American College of Obstetricians and Gynecologists, the Society for Women’s Health Research and the Women First Research Coalition have unveiled the National Strategy to Close the Women’s Health Gap.

The framework calls for a coordinated national effort to improve women’s health research, care and outcomes.

It says women make up more than half of the US population, but their health needs across conditions and life stages have been understudied and underserved for decades.

Kathryn Schubert, president and chief executive of the Society for Women’s Health Research, said: “The women’s health gap has persisted for far too long.

“This strategy offers Congress a road map to improve health outcomes, drive innovation, and build a healthier future for women, families, and communities.”

The strategy notes that Congress required women to be included in National Institutes of Health-funded clinical research through the NIH Revitalization Act in 1993.

However, it says major gaps remain in women’s health research, clinical care and how evidence is put into practice.

The plan proposes US$7bn for research and innovation, including expanded federal investment in women’s health research across the NIH, VA, DoD and the Advanced Research Projects Agency for Health.

It would also establish a Women’s Health Research Interdisciplinary Fund at the NIH and create a national network of Women’s Health Centers of Excellence.

The centres would aim to accelerate the translation of research into clinical care and serve as training sites for researchers and clinicians.

A further US$1bn would be used for regulatory coordination and modernisation, including cross-agency collaboration and work to address sex differences in drug and treatment approvals.

Sex differences are biological differences between females and males that can affect disease risk, symptoms, treatment response and side-effects.

The funding would also support updated NIH tracking systems for women’s health research investment and publication standards on how sex as a biological variable is considered in research.

The strategy calls for US$4bn for data and evidence infrastructure, including a public-private partnership focused on women’s midlife health data.

It would also convene a public workshop to review existing women’s health research datasets and develop common data elements to fill gaps and make datasets more widely available.

Another US$7bn would go towards strengthening the clinical and research workforce.

This would include career pathways, loan repayment programmes, a women’s health clinical workforce loan repayment programme modelled on the National Health Service Corps and interdisciplinary training.

The workforce measures would include particular emphasis on rural and underserved areas.

The final US$1bn would support public awareness and education campaigns to improve health literacy, preventive care and participation in women’s health research.

Health literacy means a person’s ability to find, understand and use health information to make decisions about care.

The campaigns would use digital and traditional media developed in consultation with patient advocacy organisations and relevant medical societies.

Sandra E Brooks, chief executive of the American College of Obstetricians and Gynecologists, said: “Closing the women’s health gap requires not only funding research, but also investment in the people who conduct that research and those who translate research findings and discoveries into better patient care.

“Strengthening the women’s health research and clinical workforce is critical to accelerating the innovation needed to improve health outcomes for women.”

The strategy says women have higher annual out-of-pocket healthcare costs than men and live 25 per cent of their lives in poorer health.

Supporters say this strengthens the economic and public health case for long-term congressional investment.

The framework has been endorsed by organisations across women’s health, ageing, heart disease, autoimmune disease, cancer, reproductive medicine and neurological conditions, including the Women’s Alzheimer’s Movement at Cleveland Clinic, the National MS Society and UsAgainstAlzheimer’s.

Stardust shared sensitive period tracking data with third-party analytics firms, according to new privacy research from Mozilla.

The findings expose a privacy divide in femtech, where users often trust apps with highly sensitive reproductive health information.

The research was carried out by Mozilla’s Privacy Not Included team, which tested several period tracking apps.

It found that Stardust, a period tracker used by millions, shared users’ reproductive health data with analytics companies, a practice the research said contrasted with its privacy-first marketing.

Analytics companies collect and examine information about how people use digital products, often to help businesses understand user behaviour or improve marketing.

The findings raise questions about whether privacy promises made by health apps match what happens to users’ data.

According to research reported by TechCrunch, one other period tracking app tested by Mozilla received what researchers called a “squeaky clean” rating, suggesting similar services can operate without sharing sensitive health data in the same way.

Period tracking apps have come under greater scrutiny in the US since the 2022 overturning of Roe v Wade, which removed federal constitutional protection for abortion.

Some users and privacy advocates have warned that menstrual and reproductive health data could potentially be sought in legal cases.

The research also points to a broader regulatory problem for consumer health apps.

In the US, many health apps are not covered by HIPAA, the health privacy law that applies to medical providers and some healthcare organisations.

That means some consumer apps may be able to collect, share or monetise sensitive health data under rules that differ from traditional healthcare privacy protections.

The femtech market, estimated in the report at US$50bn, has grown quickly, but privacy regulation has not always kept pace with app development.

Stardust had not publicly responded to Mozilla’s findings at the time of the original report, and its privacy policy remained live on its website.

The issue is particularly sensitive for period tracking because the data can reveal patterns around fertility, pregnancy, contraception and reproductive health.

Mozilla’s wider Privacy Not Included initiative has examined consumer technology products for privacy and security concerns since launching in 2017, including connected devices, children’s toys and health apps.

The findings come as US lawmakers continue to debate stronger federal privacy rules for sensitive health information collected by consumer apps.

The American Data Privacy and Protection Act, which has been stalled in Congress since 2023, includes provisions addressing sensitive health information collected by consumer apps.

Experts have also warned that anonymised health data can sometimes be re-identified when combined with other information, such as location data.

Re-identification means linking supposedly anonymous data back to a specific person.

A 2019 study found that menstrual cycle data combined with location information could identify individual users with high accuracy.

State-level privacy laws in places such as California, Virginia and Colorado have also given consumers new rights around personal data, although enforcement can vary.

Privacy advocates say the research underlines the need for clearer data practices, stronger safeguards and greater transparency in femtech.

For users, the findings are a reminder that health apps do not automatically protect health information in the same way as healthcare providers.

The report suggests period tracker companies that put privacy first may be better placed to build trust in a market where long-term use depends on confidence.

Mozilla’s investigation suggests privacy promises in femtech do not always match practice, and that period trackers can function without sharing sensitive user data in the same way.

Smoking and alcohol were linked to breast cancer and irregular heartbeat in women aged 55 and over, a global analysis suggests.

Breast cancer and atrial fibrillation or flutter represent a growing global health burden, but the reasons for similar rates in some regions are not well understood.

Atrial fibrillation, also known as AFib, is an irregular heartbeat.

Study co-author Dr Shu Wang, director of the Breast Disease Center at Peking University People’s Hospital, said: “Identifying shared risk factors is important for developing interventions that support optimal health, such as smoking cessation and alcohol restriction, which could potentially reduce the global incidence of breast cancer and atrial fibrillation/flutter substantially.”

Researchers examined rates of breast cancer and atrial fibrillation or flutter among women aged 55 and over in 204 countries and territories.

They assessed exposure to 58 shared and distinct health, behavioural and lifestyle risk factors, including smoking, alcohol use, body mass index and physical activity.

The analysis found that 80 of 202 countries and territories, around 39 per cent, had similar rates of both conditions.

Breast cancer was the dominant condition in 65 countries, while atrial fibrillation or flutter was dominant in 57.

After accounting for multiple variables, smoking and alcohol use were linked to higher rates of both breast cancer and atrial fibrillation or flutter.

A further analysis estimated that reducing alcohol intake and smoking could potentially cut breast cancer risk by around 15 per cent and atrial fibrillation or flutter risk by about 12 per cent worldwide.

Alcohol use was estimated to contribute to 9.27 per cent of breast cancer cases and 7.57 per cent of atrial fibrillation or flutter cases.

High-income and developed countries, including the US, Canada, Australia, New Zealand and much of Europe, had elevated rates of both conditions.

The findings were consistent with previous research linking Western diets and sedentary lifestyles to greater risks of cardiovascular and metabolic conditions and cancer.

Wang said: “One of the most surprising aspects of our findings was how common both breast cancer and atrial fibrillation/flutter diagnoses were among women ages 55 and older in high-income regions, which highlights the influence of lifestyle.

“This is the first study combining global data with machine learning to show the relationship between the conditions, their location across the world and the shared risk factors of these two conditions.”

The highest-risk areas were mostly in Western countries, where exposure to smoking and alcohol was greater than in Eastern regions.

Researchers said the pattern could reflect lifestyle, social and community differences. Western countries were also more likely to have higher body mass index, sedentary lifestyles and greater exposure to Western diets.

Study co-authors Dr Zeye Liu and Dr Yi Shi said: “Nowadays, more and more people are paying attention to the link between cancer and cardiovascular health.

“Breast cancer and atrial fibrillation/flutter rise together across many regions of the world and share the same modifiable risk factors.

“From a cardiovascular perspective, this means that reducing smoking and alcohol use could help lower the risk of both conditions at the same time.”

Dr Laxmi Mehta, chair of the American Heart Association’s Council on Clinical Cardiology, was not involved in the research.

She said: “Many of the same modifiable factors, including smoking, alcohol use, poor diet, physical inactivity and obesity, contribute to both breast cancer and cardiovascular disease including atrial fibrillation/flutter, as confirmed by this study’s findings.

“This overlap underscores the importance of integrated lifestyle strategies to reduce risk of cardiovascular disease and cancer. The American Heart Association’s Life’s Essential 8 highlights key behaviours and health factors essential for prevention and reducing risk.”

The researchers created global risk maps that could help healthcare professionals and policymakers develop prevention strategies tailored to different regions.

They plan to add long-term research and genetic, metabolic and socioeconomic data to future analyses.

The study used information from the Global Burden of Disease 2021 database.

Machine learning was used to examine global patterns, links between the two conditions and risk factors specific to different regions. Machine learning uses computer systems to identify patterns in large amounts of data.

The research was based on national-level information and did not include data about individual patients, meaning it cannot prove cause and effect.

Differences in screening, healthcare resources, data collection and definitions between countries may also have affected the results.