1
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Pape M, Miyagi M, Ritz SA, Boulicault M, Richardson SS, Maney DL. Sex contextualism in laboratory research: Enhancing rigor and precision in the study of sex-related variables. Cell 2024; 187:1316-1326. [PMID: 38490173 DOI: 10.1016/j.cell.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/21/2023] [Accepted: 02/08/2024] [Indexed: 03/17/2024]
Abstract
Understanding sex-related variation in health and illness requires rigorous and precise approaches to revealing underlying mechanisms. A first step is to recognize that sex is not in and of itself a causal mechanism; rather, it is a classification system comprising a set of categories, usually assigned according to a range of varying traits. Moving beyond sex as a system of classification to working with concrete and measurable sex-related variables is necessary for precision. Whether and how these sex-related variables matter-and what patterns of difference they contribute to-will vary in context-specific ways. Second, when researchers incorporate these sex-related variables into research designs, rigorous analytical methods are needed to allow strongly supported conclusions. Third, the interpretation and reporting of sex-related variation require care to ensure that basic and preclinical research advance health equity for all.
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Affiliation(s)
- Madeleine Pape
- Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland.
| | - Miriam Miyagi
- Center for Computational Molecular Biology, Brown University, Providence, RI, USA
| | - Stacey A Ritz
- Department of Pathology & Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Marion Boulicault
- Department of Philosophy, University of Edinburgh, Edinburgh, Scotland
| | - Sarah S Richardson
- Department of the History of Science, Harvard University, Cambridge, MA, USA; Committee on Degrees in Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA, USA
| | - Donna L Maney
- Department of Psychology, Emory University, Atlanta, GA, USA; Harvard-Radcliffe Institute, Harvard University, Cambridge, MA, USA
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2
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Lee KMN, Rushovich T, Gompers A, Boulicault M, Worthington S, Lockhart JW, Richardson SS. A Gender Hypothesis of sex disparities in adverse drug events. Soc Sci Med 2023; 339:116385. [PMID: 37952268 DOI: 10.1016/j.socscimed.2023.116385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/06/2023] [Accepted: 10/28/2023] [Indexed: 11/14/2023]
Abstract
Pharmacovigilance databases contain larger numbers of adverse drug events (ADEs) that occurred in women compared to men. The cause of this disparity is frequently attributed to sex-linked biological factors. We offer an alternative Gender Hypothesis, positing that gendered social factors are central to the production of aggregate sex disparities in ADE reports. We describe four pathways through which gender may influence observed sex disparities in pharmacovigilance databases: healthcare utilization; bias and discrimination in the clinic; experience of a drug event as adverse; and pre-existing social and structural determinants of health. We then use data from the U.S. FDA Adverse Event Reporting System (FAERS) to explore how the Gender Hypothesis might generate novel predictions and explanations of sex disparities in ADEs in existing widely referenced datasets. Analyzing more than 3 million records of ADEs between 2014 and 2022, we find that patient-reported ADEs show a larger female skew than healthcare provider-reported ADEs and that the sex disparity is markedly smaller for outcomes involving death or hospitalization. We also find that the sex disparity varies greatly across types of ADEs, for example, cosmetically salient ADEs are skewed heavily female and sexual dysfunction ADEs are skewed male. Together, we interpret these findings as providing evidence of the promise of the Gender Hypothesis for identifying intervenable mechanisms and pathways contributing to sex disparities in ADEs. Rigorous application of the Gender Hypothesis to additional datasets and in future research studies could yield new insights into the causes of sex disparities in ADEs.
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Affiliation(s)
- Katharine M N Lee
- Tulane University, Department of Anthropology, 101 Dinwiddie Hall, 6823 St. Charles Ave., New Orleans, LA, 70118, USA.
| | - Tamara Rushovich
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Annika Gompers
- Emory University Rollins School of Public Health, Department of Epidemiology, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
| | - Marion Boulicault
- Massachusetts Institute of Technology, Department of Linguistics and Philosophy, 77 Massachusetts Ave, Cambridge, MA, 02139, USA; University of Edinburgh, School of Philosophy, Psychology and Language Sciences, 40 George Square, Edinburgh, EH8 9JX, UK.
| | - Steven Worthington
- Institute for Quantitative Social Science, Harvard University, 1737 Cambridge Street, Cambridge, MA, 02138, USA
| | - Jeffrey W Lockhart
- University of Chicago, Social Sciences Division, 1155 E. 60th St., Chicago, IL, 60637, USA.
| | - Sarah S Richardson
- Department of the History of Science, Harvard University, 1 Oxford Street, Cambridge, MA, 02138, USA; Committee on Degrees in Studies of Women, Gender, and Sexuality, Boylston Hall, Harvard University, Cambridge, MA, 02138, USA.
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3
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Zhao H, DiMarco M, Ichikawa K, Boulicault M, Perret M, Jillson K, Fair A, DeJesus K, Richardson SS. Making a 'sex-difference fact': Ambien dosing at the interface of policy, regulation, women's health, and biology. Soc Stud Sci 2023; 53:475-494. [PMID: 37148216 DOI: 10.1177/03063127231168371] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The U.S. Food and Drug Administration's (FDA) 2013 decision to lower recommended Ambien dosing for women has been widely cited as a hallmark example of the importance of sex differences in biomedicine. Using regulatory documents, scientific publications, and media coverage, this article analyzes the making of this highly influential and mobile 'sex-difference fact'. As we show, the FDA's decision was a contingent outcome of the drug approval process. Attending to how a contested sex-difference fact came to anchor elite women's health advocacy, this article excavates the role of regulatory processes, advocacy groups, and the media in producing perceptions of scientific agreement while foreclosing ongoing debate, ultimately enabling the stabilization of a binary, biological sex-difference fact and the distancing of this fact from its conditions of construction.
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4
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Rushovich T, Gompers A, Lockhart JW, Omidiran I, Worthington S, Richardson SS, Lee KMN. Adverse Drug Events by Sex After Adjusting for Baseline Rates of Drug Use. JAMA Netw Open 2023; 6:e2329074. [PMID: 37603336 PMCID: PMC10442708 DOI: 10.1001/jamanetworkopen.2023.29074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/07/2023] [Indexed: 08/22/2023] Open
Abstract
This cross-sectional study examines adverse drug events reported by sex in the US Food and Drug Administration (FDA) database after adjusting for drug use by males and females.
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Affiliation(s)
- Tamara Rushovich
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Annika Gompers
- Emory University Rollins School of Public Health, Atlanta, Georgia
| | | | | | - Steven Worthington
- Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts
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5
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Affiliation(s)
- Joseph Dov Bruch
- Department of Public Health Sciences, The University of Chicago, Chicago, IL 60637, USA.
| | - Sarah S Richardson
- Department of the History of Science and Committee on Degrees in Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA, USA
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6
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Richardson SS. Equality as a work in progress The Patriarchs Angela Saini Beacon Press, 2023. 256 pp. Science 2023; 379:763. [PMID: 36821667 DOI: 10.1126/science.adg2268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
History shows that neither patriarchy nor parity is inevitable.
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Affiliation(s)
- Sarah S Richardson
- The reviewer is at the Department of the History of Science, Harvard University, Cambridge, MA 02138, USA
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7
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Danielsen AC, Boulicault M, Gompers A, Rushovich T, Lee KMN, Richardson SS. How Cumulative Statistics Can Mislead: The Temporal Dynamism of Sex Disparities in COVID-19 Mortality in New York State. Int J Environ Res Public Health 2022; 19:14066. [PMID: 36360943 PMCID: PMC9658081 DOI: 10.3390/ijerph192114066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/14/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
Overall, men have died from COVID-19 at slightly higher rates than women. But cumulative estimates of mortality by sex may be misleading. We analyze New York State COVID-19 mortality by sex between March 2020 and August 2021, demonstrating that 72.7% of the total difference in the number of COVID-19 deaths between women and men was accrued in the first seven weeks of the pandemic. Thus, while the initial surge in COVID-19 mortality was characterized by stark sex disparities, this article shows that disparities were greatly attenuated in subsequent phases of the pandemic. Investigating changes over time could help illuminate how contextual factors contributed to the development of apparent sex disparities in COVID-19 outcomes.
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Affiliation(s)
| | - Marion Boulicault
- College of Computing, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Linguistics and Philosophy, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Annika Gompers
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Tamara Rushovich
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | | | - Sarah S. Richardson
- Department of the History of Science, Harvard University, Cambridge, MA 02138, USA
- Committee on Degrees in Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA 02138, USA
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8
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Penkler M, Jacob CM, Müller R, Kenney M, Norris SA, da Costa CP, Richardson SS, Roseboom TJ, Hanson M. Developmental Origins of Health and Disease, resilience and social justice in the COVID era. J Dev Orig Health Dis 2022; 13:413-416. [PMID: 34709151 DOI: 10.1017/s204017442100060x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The COVID-19 pandemic has shone a spotlight on how health outcomes are unequally distributed among different population groups, with disadvantaged communities and individuals being disproportionality affected in terms of infection, morbidity and mortality, as well as vaccine access. Recently, there has been considerable debate about how social disadvantage and inequality intersect with developmental processes to result in a heightened susceptibility to environmental stressors, economic shocks and large-scale health emergencies. We argue that DOHaD Society members can make important contributions to addressing issues of inequality and improving community resilience in response to COVID-19. In order to do so, it is beneficial to engage with and adopt a social justice framework. We detail how DOHaD can align its research and policy recommendations with a social justice perspective to ensure that we contribute to improving the health of present and future generations in an equitable and socially just way.
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Affiliation(s)
- Michael Penkler
- Munich Center for Technology in Society, Technical University of Munich, Munich, Germany
| | - Chandni M Jacob
- Institute of Developmental Sciences and NIHR Southampton Biomedical Research Centre, Southampton University Hospital and University of Southampton, Southampton, UK
| | - Ruth Müller
- Munich Center for Technology in Society, Technical University of Munich, Munich, Germany
- School of Life Sciences and School of Management, Technical University of Munich, Munich, Germany
| | - Martha Kenney
- Department of Women and Gender Studies, San Francisco State University, San Francisco, California, USA
| | - Shane A Norris
- Institute of Developmental Sciences and NIHR Southampton Biomedical Research Centre, Southampton University Hospital and University of Southampton, Southampton, UK
- South African Medical Research Council (SAMRC)/Wits Developmental Pathways for Health Research Unit (DPHRU), Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Clarissa P da Costa
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany
- Centre for Global Health, Technical University of Munich, Munich, Germany
| | - Sarah S Richardson
- Department of the History of Science and Studies of Women, Gender and Sexuality, Harvard University, Cambridge, Massachusetts, USA
| | - Tessa J Roseboom
- Department of Obstetrics and Gynaecology, Department of Epidemiology and Data Science, Amsterdam Reproduction and Development, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Mark Hanson
- Institute of Developmental Sciences and NIHR Southampton Biomedical Research Centre, Southampton University Hospital and University of Southampton, Southampton, UK
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9
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Sudai M, Borsa A, Ichikawa K, Shattuck-Heidorn H, Zhao H, Richardson SS. Law, policy, biology, and sex: Critical issues for researchers. Science 2022; 376:802-804. [PMID: 35587987 PMCID: PMC10001427 DOI: 10.1126/science.abo1102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Researchers should be aware of how sex-difference science is (mis)applied in legal and policy contexts.
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Affiliation(s)
- Maayan Sudai
- Faculty of Law, Faculty of Humanities, Women and Gender Studies Program, University of Haifa, Haifa, Israel
| | - Alexander Borsa
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
| | | | | | - Helen Zhao
- Department of Philosophy, Columbia University, New York, NY, USA
| | - Sarah S Richardson
- Studies of Women, Gender and Sexuality, Harvard University, Cambridge, MA, USA. Department of the History of Science, Harvard University, Cambridge, MA, USA
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10
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Abstract
Policies that require male-female sex comparisons in all areas of biomedical research conflict with the goal of improving health outcomes through context-sensitive individualization of medical care. Sex, like race, requires a rigorous, contextual approach in precision medicine. A "sex contextualist" approach to gender-inclusive medicine better aligns with this aim.
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Affiliation(s)
- Marina DiMarco
- Department of History & Philosophy of Science, University of Pittsburgh, 1101 Cathedral of Learning, 4200 Fifth Avenue, Pittsburgh, PA 15260, USA.
| | - Helen Zhao
- Department of Philosophy, Columbia University, 708 Philosophy Hall, MC: 4971, 1150 Amsterdam Avenue, New York, NY 10027, USA
| | - Marion Boulicault
- Department of Linguistics and Philosophy, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Sarah S. Richardson
- Department of History of Science, Harvard University, 1 Oxford Street, Cambridge, MA 02138, USA,Committee on Degrees in Studies of Women, Gender, and Sexuality, Harvard University Boylston Hall, Cambridge, MA 02138, USA
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11
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Danielsen AC, Lee KM, Boulicault M, Rushovich T, Gompers A, Tarrant A, Reiches M, Shattuck-Heidorn H, Miratrix LW, Richardson SS. Sex disparities in COVID-19 outcomes in the United States: Quantifying and contextualizing variation. Soc Sci Med 2022; 294:114716. [PMID: 35042136 PMCID: PMC8743486 DOI: 10.1016/j.socscimed.2022.114716] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 01/01/2022] [Accepted: 01/08/2022] [Indexed: 12/26/2022]
Abstract
This paper presents the first longitudinal study of sex disparities in COVID-19 cases and mortalities across U.S. states, derived from the unique 13-month dataset of the U.S. Gender/Sex COVID-19 Data Tracker. To analyze sex disparities, weekly case and mortality rates by sex and mortality rate ratios were computed for each U.S. state, and a multilevel crossed-effects conditional logistic binomial regression model was fitted to estimate the variation of the sex disparity in mortality over time and across states. Results demonstrate considerable variation in the sex disparity in COVID-19 cases and mortalities over time and between states. These data suggest that the sex disparity, when present, is modest, and likely varies in relation to context-sensitive variables, which may include health behaviors, preexisting health status, occupation, race/ethnicity, and other markers of social experience.
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Affiliation(s)
| | - Katharine Mn Lee
- Division of Public Health Sciences, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave, Campus Box 8100, St. Louis, MO, 63110, USA
| | - Marion Boulicault
- Department of Linguistics and Philosophy, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, 02139, USA; Department of Philosophy, University of Adelaide, 259 North Terrace, Adelaide, SA, 5000, Australia
| | - Tamara Rushovich
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Annika Gompers
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Amelia Tarrant
- Department of Human Evolutionary Biology, Harvard University, 11 Divinity Avenue, Cambridge, MA, 02138, USA
| | - Meredith Reiches
- Department of Anthropology, University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA, 02125, USA
| | - Heather Shattuck-Heidorn
- Women and Gender Studies, University of Southern Maine, 94 Bedford Street, Portland, ME, 04102, USA
| | - Luke W Miratrix
- Harvard Graduate School of Education, 13 Appian Way, Cambridge, MA, 02138, USA
| | - Sarah S Richardson
- Department of the History of Science, Harvard University, 1 Oxford St, Cambridge, MA, 02138, USA; Committee on Degrees in Studies of Women, Gender, and Sexuality, Harvard University, Boylston Hall, Cambridge, MA, 02138, USA
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12
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Richardson SS. Engaging with the science of fetal origins. Nature 2022; 601:26. [PMID: 34983986 DOI: 10.1038/d41586-021-03839-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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13
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Gompers A, Bruch JD, Richardson SS. Are COVID-19 Case Fatality Rates a Reliable Measure of Sex Disparities? Womens Health Issues 2021; 32:87-89. [PMID: 34930640 PMCID: PMC8616740 DOI: 10.1016/j.whi.2021.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Annika Gompers
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | - Joseph D Bruch
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Sarah S Richardson
- Committee on Degrees in Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, Massachusetts; Department of the History of Science, Harvard University, Cambridge, Massachusetts
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14
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Shattuck-Heidorn H, Danielsen AC, Gompers A, Bruch JD, Zhao H, Boulicault M, Marsella J, Richardson SS. A finding of sex similarities rather than differences in COVID-19 outcomes. Nature 2021; 597:E7-E9. [PMID: 34552251 DOI: 10.1038/s41586-021-03644-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 05/11/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Heather Shattuck-Heidorn
- Women and Gender Studies Program, University of Southern Maine, Portland, ME, USA. .,Studies of Women, Gender and Sexuality, Harvard University, Cambridge, MA, USA.
| | - Ann Caroline Danielsen
- Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Annika Gompers
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Joseph Dov Bruch
- Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Helen Zhao
- Department of Philosophy, Columbia University, New York, NY, USA
| | - Marion Boulicault
- Department of Linguistics and Philosophy, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Jamie Marsella
- Department of the History of Science, Cambridge, MA, USA
| | - Sarah S Richardson
- Studies of Women, Gender and Sexuality, Harvard University, Cambridge, MA, USA.,Department of the History of Science, Cambridge, MA, USA
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15
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Rushovich T, Boulicault M, Chen JT, Danielsen AC, Tarrant A, Richardson SS, Shattuck-Heidorn H. Sex Disparities in COVID-19 Mortality Vary Across US Racial Groups. J Gen Intern Med 2021; 36:1696-1701. [PMID: 33818679 PMCID: PMC8020825 DOI: 10.1007/s11606-021-06699-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/04/2021] [Indexed: 10/28/2022]
Abstract
BACKGROUND Inequities in COVID-19 outcomes in the USA have been clearly documented for sex and race: men are dying at higher rates than women, and Black individuals are dying at higher rates than white individuals. Unexplored, however, is how sex and race interact in COVID-19 outcomes. OBJECTIVE Use available data to characterize COVID-19 mortality rates within and between race and sex strata in two US states, with the aim of understanding how apparent sex disparities in COVID-19 deaths vary across race. DESIGN AND PARTICIPANTS This observational study uses COVID-19 mortality data through September 21, 2020, from Georgia (GA) and Michigan (MI). MAIN MEASURES We calculate age-specific rates for each sex-race-age stratum, and age-standardized rates for each race-sex stratum. We investigate the sex disparity within race groups and the race disparity within sex groups using age-standardized rate ratios, and rate differences. KEY RESULTS Within race groups, men have a higher COVID-19 mortality rate than women. Black men have the highest rate of all race-sex groups (in MI: 254.6, deaths per 100,000, 95% CI: 241.1-268.2, in GA:128.5, 95% CI: 121.0-135.9). In MI, the COVID-19 mortality rate for Black women (147.1, 95% CI: 138.7-155.4) is higher than the rate for white men (39.1, 95% CI: 37.3-40.9), white women (29.7, 95% CI: 28.3-31.0), and Asian/Pacific Islander men and women. COVID-19 mortality rates in GA followed the same pattern. In MI, the male:female mortality rate ratio among Black individuals is 1.7 (1.5-2.0) while the rate ratio among White individuals is only 1.3 (1.2-1.5). CONCLUSION While overall, men have higher COVID-19 mortality rates than women, our findings show that this sex disparity does not hold across racial groups. This demonstrates the limitations of unidimensional reporting and analyses and highlights the ways that race and gender intersect to shape COVID-19 outcomes.
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Affiliation(s)
- Tamara Rushovich
- Population Health Sciences Department, Harvard Graduate School of Arts and Sciences, Cambridge, MA, USA.
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Marion Boulicault
- Department of Linguistics and Philosophy, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Department of Philosophy, University of Adelaide, Adelaide, Australia
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ann Caroline Danielsen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Amelia Tarrant
- Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA, USA
| | - Sarah S Richardson
- Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA, USA
- Department of the History of Science, Harvard University, Cambridge, MA, USA
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16
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Abstract
This cross-sectional study examines the clinical and societal implications of the exansion of private equity in women’s health care.
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Affiliation(s)
- Joseph D Bruch
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
| | - Alexander Borsa
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, New York, New York
| | - Zirui Song
- Harvard Medical School, Department of Health Care Policy, Boston, Massachusetts.,Department of Medicine, Massachusetts General Hospital, Boston
| | - Sarah S Richardson
- Department of the History of Science, Harvard University, Cambridge, Massachusetts.,Committee on Degrees in Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, Massachusetts
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17
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Richardson SS, Reiches MW, Bruch J, Boulicault M, Noll NE, Shattuck-Heidorn H. Is There a Gender-Equality Paradox in Science, Technology, Engineering, and Math (STEM)? Commentary on the Study by Stoet and Geary (2018). Psychol Sci 2020; 31:338-341. [PMID: 32043923 DOI: 10.1177/0956797619872762] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sarah S Richardson
- Department of the History of Science, Harvard University.,Committee on Degrees in Studies of Women, Gender, and Sexuality, Harvard University
| | | | - Joe Bruch
- Department of Population Health Sciences, Harvard University
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18
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Richardson SS, Borsa A, Boulicault M, Galka J, Ghosh N, Gompers A, Noll NE, Perret M, Reiches MW, Sandoval JCB, Shattuck-Heidorn H, Vitti J, Weir B, Zhao H. Genome studies must account for history. Science 2019; 366:1461. [PMID: 31857476 DOI: 10.1126/science.aaz6594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Sarah S Richardson
- Department of the History of Science, Harvard University, Cambridge, MA 02138, USA. .,Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA 02138, USA
| | - Alexander Borsa
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Marion Boulicault
- Department of Philosophy, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Jonathan Galka
- Department of the History of Science, Harvard University, Cambridge, MA 02138, USA
| | - Nayanika Ghosh
- Department of the History of Science, Harvard University, Cambridge, MA 02138, USA
| | - Annika Gompers
- Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA 02138, USA
| | - Nicole E Noll
- Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA 02138, USA.,Department of Psychology, Harvard University, Cambridge, MA 02138, USA
| | - Meg Perret
- Department of the History of Science, Harvard University, Cambridge, MA 02138, USA
| | - Meredith W Reiches
- Department of Anthropology, University of Massachusetts Boston, Boston, MA 02125, USA
| | | | | | - Joseph Vitti
- Seven Bridges Genomics, Charlestown, MA 02129, USA
| | - Brianna Weir
- Department of Evolutionary and Organismic Biology, Harvard University, Cambridge, MA 02138, USA
| | - Helen Zhao
- Department of Philosophy, Columbia University, New York, NY 10027, USA
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Sharp GC, Lawlor DA, Richardson SS. It's the mother!: How assumptions about the causal primacy of maternal effects influence research on the developmental origins of health and disease. Soc Sci Med 2018; 213:20-27. [PMID: 30055422 PMCID: PMC6137073 DOI: 10.1016/j.socscimed.2018.07.035] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 07/17/2018] [Accepted: 07/20/2018] [Indexed: 12/22/2022]
Abstract
Research on the developmental origins of health and disease (DOHaD) has traditionally focused on how maternal exposures around the time of pregnancy might influence offspring health and risk of disease. We acknowledge that for some exposures this is likely to be correct, but argue that the focus on maternal pregnancy effects also reflects implicit and deeply-held assumptions that 1) causal early life exposures are primarily transmitted via maternal traits or exposures, 2) maternal exposures around the time of pregnancy and early infancy are particularly important, and 3) other factors, such as paternal factors and postnatal exposures in later life, have relatively little impact in comparison. These implicit assumptions about the "causal primacy" of maternal pregnancy effects set the agenda for DOHaD research and, through a looping effect, are reinforced rather than tested. We propose practical strategies to redress this imbalance through maintaining a critical perspective about these assumptions.
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Affiliation(s)
- Gemma C Sharp
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol Dental School, University of Bristol, United Kingdom.
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Population Health Science, Bristol Medical School, University of Bristol, United Kingdom
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Abstract
In the past, work on racial and ethnic variation in brain and behavior was marginalized within genetics. Against the backdrop of genetics' eugenic legacy, wide consensus held such research to be both ethically problematic and methodologically controversial. But today it is finding new opportunistic venues in a global, transdisciplinary, data-rich postgenomic research environment in which such a consensus is increasingly strained. The postgenomic sciences display worrisome deficits in their ability to govern and negotiate standards for making postgenomic claims in the transdisciplinary space between human population variation research, studies of intelligence, neuroscience, and evolutionary biology. Today some researchers are pursuing the genomics of intelligence on a newly grand scale. They are sequencing large numbers of whole genomes of people considered highly intelligent (by varying empirical and social measures) in the hope of finding gene variants predictive of intelligence. Troubling and at times outlandish futurist claims accompany this research. Scientists involved in this research have openly discussed the possibility of marketing prenatal tests for intelligence, of genetic engineering or selective embryo implantation to increase the likelihood of a high-IQ child, and of genotyping children to guide their education. In this permissive and contested environment, what would trustworthy research on the genomics of high intelligence look like?
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Affiliation(s)
| | | | | | | | | | | | - Janet Rich-Edwards
- Connors Center for Women's Health and Gender Biology at Harvard Medical School in Boston, Massachusetts, USA
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Richardson SS. Brain Storm: The Flaws in the Science of Sex Differences. By Rebecca M. Jordan-Young. Cambridge, MA: Harvard University Press, 2010. The Mirage of a Space between Nature and Nurture. By Evelyn Fox Keller. Durham, NC: Duke University Press, 2010. Signs: Journal of Women in Culture and Society 2012. [DOI: 10.1086/662695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kooker BM, Richardson SS. Information revolution in nursing and health care: educating for tomorrow's challenge. Semin Nurse Manag 1994; 2:79-84. [PMID: 7922661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Current emphasis on the national electronic highway and a national health database for comparative health care reporting demonstrates society's increasing reliance on information technology. The efficient electronic processing and managing of data, information, and knowledge are critical for survival in tomorrow's health care organization. To take a leadership role in this information revolution, informatics nurse specialists must possess competencies that incorporate information science, computer science, and nursing science for successful information system development. In selecting an appropriate informatics educational program or to hire an individual capable of meeting this challenge, nurse administrators must look for the following technical knowledge and skill set: information management principles, system development life cycle, programming languages, file design and access, hardware and network architecture, project management skills, and leadership abilities.
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Abstract
Expectancy effects on self-reported anxiety and self-generated cognitive strategies were evaluated in a dental analogue by means of a film response questionnaire and an interview. Seventy-two female college subjects, half high and half low in self-reported dental fear were assigned to three levels of expectancy set (positive, fearful and neutral) induced by means of a slide presentation and verbal set. Although expectancy effects on post-film anxiety were not significant, differences due to dental fear level were found. Interview protocols were rated for general cognitive response style (coping, catastrophizing or no strategy), arousal and absorption. Discriminant function analysis between response styles indicated that arousal level provided a strong contribution to the discriminant functions differentiating between the general response styles, separating non-strategy users from catastrophizers. Specific ratings of reported absorption were related to whether or not cognitive coping strategies were used. Expectancy set was related to the direction of these cognitions. The findings validate the use of dental analogue studies for investigating dental fear.
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Richardson SS. Does nursing education have a place in tertiary education? Aust Nurses J 1972; 1:16-8. [PMID: 4482170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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