Eye on the Future of Women's Health Research

Madison, Wisconsin — In 1968, Gloria Sarto, MD '56, PhD, one of the first female obstetrics-gynecology residents at University of Wisconsin-Madison, lost her medical privileges when she allowed a friend of a patient whose husband was out of town to be present in the delivery room. Then she was ridiculed and chastised for introducing the Lamaze birthing method to her pregnant patients. Many people also questioned her when she was the first Wisconsin obstetrician to perform amniocentesis to predict fetal genetic abnormalities. But, as is widely known, some 40 years later all these are common practices nationwide.

Strong women leaders such as Sarto, professor of obstetrics and gynecology at the UW School of Medicine and Public Health (SMPH), deserve credit for paving the way for the most radical changes in women's health in the last half century, says Molly Carnes, MD, MS, who directs the UW Center for Women's Health Research (CWHR) with Sarto as co-director. A geriatrician focused on older women's health issues, Carnes, an SMPH professor of medicine, has been a trailblazer as well.

Since her first days in academic medicine, Carnes was troubled by the lack of women faculty. Even today the problem is alarming: Though 50 percent of medical students are women, less than 10 percent of tenured medical school faculty members are women. Carnes is delighted, however, that four of the SMPH's 26 departments now are chaired by women.

Ten years ago, Carnes asked Sarto to join her in establishing the CWHR to foster the careers of women in academic medicine, particularly at UW-Madison, and to support women's health research. With an annual budget of more than $3 million, the center operates seven federally funded graduate, postdoctoral and research career development programs, including the first Health Disparities Research Scholars Program in the country.

On February 12, 2009, the CWHR celebrated its 10th anniversary at the Health Sciences Learning Center. Robert Golden, MD, dean of the school, greeted the approximately 100 people in attendance and praised the center for its work.

"The UW Center for Women's Health Research represents the best traditions of academics in general and the best tradition of this place in particular," he said. "They...are using evidence to advance important causes that will ultimately elevate the health and well-being of all."

Carolyn Clancy, MD, director of the Agency for Health Care Research and Quality in the U.S. Department of Health and Human Services, presented the keynote address, titled "Towards Gender Equality and Health: From Evidence to Action."

Sarto gave a nod to the past with her talk, "20th Century Milestones in Women's Health," while current scholars and alumni shared their work in a poster session, setting the stage for the future.

Three former CWHR Scholars also were showcased at the event. Each gave a testimonial about the significant role the center and its founders have played in their career development.

Though counseling psychologist Angela Byars-Winston, PhD, first joined the UW-Madison School of Education faculty in 1997, it was several years later that she met Carnes - and discovered their shared interest in research addressing recruitment and retention of women and students of color in science, medicine and engineering careers.

Their meeting led to a collaboration on a grant, with Byars-Winston ultimately being hired as a CWHR associate scientist in 2007.

Byars-Winston credits the center with helping her to put theory into practice.

"We've been able to move the research from identifying the various factors that prevent retention to creating programs and research-based interventions," she says.

The research has led to the development of the Sloan Engineering Mentoring Program, which enhances academic success by providing first-year undergraduate students opportunities that increase access to and inclusion in academic and professional resources.

Byars-Winston emphasizes that the goal must be to foster a culture that values diversity, not just to improve diversity through numbers.

Cynthia Carlsson, MD, MS, first met Carnes in 1995, when she interviewed for her internal medicine residency at UW Hospital and Clinics following a fellowship in geriatrics.

"I was at this critical point in time where I wanted to continue clinical science training, but I didn't really have a support mechanism to move me towards that," Carlsson says.

Carnes guided her to apply for a fellowship in older women's health, which gave her the protected time she needed to launch her academic career studying interventions to prevent Alzheimer's disease, which is more common in women than men.

Following support on CWHR training programs, Carlsson became a tenure-track faculty member in the Department of Medicine. She is also medical director of the Memory Assessment Clinic at the William S. Middleton Memorial Veterans Hospital.

Earlise Ward, PhD, talks about finding herself at the proverbial "fork in the road" in 2002, after finishing her postdoctorate training in counseling psychology. Should she continue her work as a staff psychologist for a local mental health agency or pursue a career in research?

She chose to become a CWHR Scholar and continued her research to understand African Americans' low use of mental health services and learned more about their beliefs and traditional methods of coping.

Two years ago, she put her research into practice with a pilot study, "The Oh Happy Day Depression Intervention," a cognitive behavioral group approach to treating depression in older African American women offered at a local church and community center.

Ward says that the center's philosophy of collaboration and interdisciplinary teamwork has greatly influenced her career development and how she manages projects. In 2007 she became the first non-nurse assistant professor on tenure track in the UW nursing school.

Collectively, the three researchers are working to change the face of women's health with the ultimate goal of creating a healthcare system that can meet the unique needs of a diverse population. And, in the end, each hopes to follow in the footsteps of Carnes and Sarto and leave legacies of their own.