{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:08:46Z","timestamp":1783948126303,"version":"3.55.0"},"reference-count":79,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Autoimmune diseases are identified by the chronic inflammation and tissue damage resulting from unregulated immune responses throughout the body. Systemic lupus erythematosus, type 1 diabetes mellitus, and Hashimoto\u2019s thyroiditis are among the 80+ characterized conditions, 80% of which are diagnosed in women. The compounded effects of biological sex and hormones; social identities, such as age, race, and gender; and other determinants on health highlight a pressing need for an inclusive approach to address disparities for women living with autoimmune diseases. Such an approach must recognize and incorporate intersectional experiences of diverse populations of women into biomedical research, clinical practice, and policy solutions. Research must prioritize inclusive designs, data collection, and representation of women in clinical studies. Clinical care must focus on developing guidelines and promoting patient\u2013provider interactions that meet a range of demographic needs. Health care policies must support financial investments in research and equitable access to care. This review provides an overview of the impacts of autoimmune diseases on women\u2019s health through an intersectional lens, identifies persistent gaps in addressing the unique needs of women, and proposes recommendations for a comprehensive, equity-focused approach to mitigate disparities and better serve all women at risk for or living with autoimmune diseases.<\/jats:p>","DOI":"10.3390\/ijerph21101339","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T07:53:05Z","timestamp":1728546785000},"page":"1339","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Autoimmune Health Crisis: An Inclusive Approach to Addressing Disparities in Women in the United States"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8331-326X","authenticated-orcid":false,"given":"Syreen","family":"Goulmamine","sequence":"first","affiliation":[{"name":"Society for Women\u2019s Health Research, Washington, DC 20036, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9482-6959","authenticated-orcid":false,"given":"Sarah","family":"Chew","sequence":"additional","affiliation":[{"name":"Society for Women\u2019s Health Research, Washington, DC 20036, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1747-9148","authenticated-orcid":false,"given":"Irene O.","family":"Aninye","sequence":"additional","affiliation":[{"name":"Society for Women\u2019s Health Research, Washington, DC 20036, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"600","DOI":"10.2353\/ajpath.2008.071008","article-title":"Sex Differences in Autoimmune Disease from a Pathological Perspective","volume":"173","author":"Fairweather","year":"2008","journal-title":"Am. J. Pathol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"102266","DOI":"10.1016\/j.coi.2022.102266","article-title":"The Increasing Prevalence of Autoimmunity and Autoimmune Diseases: An Urgent Call to Action for Improved Understanding, Diagnosis, Treatment, and Prevention","volume":"80","author":"Miller","year":"2023","journal-title":"Curr. Opin. Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.nurpra.2022.01.019","article-title":"The Lived Experiences of Women Seeking a Diagnosis of Systemic Lupus Erythematosus","volume":"18","author":"Cesario","year":"2022","journal-title":"J. Nurse Pract."},{"key":"ref_4","first-page":"e8094","article-title":"The Prevalence of Autoimmune Disorders in Women: A Narrative Review","volume":"12","author":"Angum","year":"2020","journal-title":"Cureus"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1136\/ard.59.3.230","article-title":"Development of Additional Autoimmune Diseases in a Population of Patients with Systemic Lupus Erythematosus","volume":"59","author":"Mcdonagh","year":"2000","journal-title":"Ann. Rheum. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Desai, M.K., and Brinton, R.D. (2019). Autoimmune Disease in Women: Endocrine Transition and Risk Across the Lifespan. Front. Endocrinol., 10.","DOI":"10.3389\/fendo.2019.00265"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.autrev.2018.10.001","article-title":"The Association of Other Autoimmune Diseases in Patients with Graves\u2019 Disease (with or without Ophthalmopathy): Review of the Literature and Report of a Large Series","volume":"18","author":"Ferrari","year":"2019","journal-title":"Autoimmun. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Hu, X., Chen, Y., Shen, Y., Tian, R., Sheng, Y., and Que, H. (2022). Global Prevalence and Epidemiological Trends of Hashimoto\u2019s Thyroiditis in Adults: A Systematic Review and Meta-Analysis. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.1020709"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2392","DOI":"10.1001\/jama.2020.22196","article-title":"Autoimmune Thyroid Disease in Women","volume":"325","author":"Mammen","year":"2021","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/pedi.12112","article-title":"Puberty as an Accelerator for Diabetes Complications","volume":"15","author":"Cho","year":"2014","journal-title":"Pediatr. Diabetes"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Ciarambino, T., Crispino, P., Leto, G., Mastrolorenzo, E., Para, O., and Giordano, M. (2022). Influence of Gender in Diabetes Mellitus and Its Complication. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23168850"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"98","DOI":"10.34172\/hpp.2020.18","article-title":"Prevalence and Incidence of Type 1 Diabetes in the World: A Systematic Review and Meta-Analysis","volume":"10","author":"Mobasseri","year":"2020","journal-title":"Health Promot. Perspect."},{"key":"ref_13","first-page":"139","article-title":"Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics","volume":"1","author":"Crenshaw","year":"1989","journal-title":"Univ. Chic. Leg. Forum"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1186\/s12939-014-0119-x","article-title":"An Intersectionality-Based Policy Analysis Framework: Critical Reflections on a Methodology for Advancing Equity","volume":"13","author":"Hankivsky","year":"2014","journal-title":"Int. J. Equity Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1093\/heapol\/czw020","article-title":"10 Best Resources On\u2026 Intersectionality with an Emphasis on Low- and Middle-Income Countries","volume":"31","author":"Larson","year":"2016","journal-title":"Health Policy Plan"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e072243","DOI":"10.1136\/bmj-2022-072243","article-title":"Using an Intersectionality Approach to Transform Health Services for Overlooked Healthcare Users and Workers after Covid-19","volume":"381","author":"Mothupi","year":"2023","journal-title":"BMJ"},{"key":"ref_17","unstructured":"Mbah, O., Sevak, P., Amos, L., Bradley, K., and Mastri, A. (2022). Advancing Equity by Incorporating Intersectionality in Research and Analysis What Is Equity?."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1136\/annrheumdis-2022-222276","article-title":"Rising Incidence and Prevalence of Systemic Lupus Erythematosus: A Population-Based Study over Four Decades","volume":"81","author":"Hocaoglu","year":"2022","journal-title":"Ann. Rheum. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1002\/art.41632","article-title":"Prevalence of Systemic Lupus Erythematosus in the United States: Estimates from a Meta-Analysis of the Centers for Disease Control and Prevention National Lupus Registries","volume":"73","author":"Izmirly","year":"2021","journal-title":"Arthritis. Rheumatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/BF03401282","article-title":"Hashimoto\u2019s Thyroiditis: History and Future Outlook","volume":"12","author":"Hiromatsu","year":"2013","journal-title":"Hormones"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"bvac172","DOI":"10.1210\/jendso\/bvac172","article-title":"Hypothyroidism Prevalence in the United States: A Retrospective Study Combining National Health and Nutrition Examination Survey and Claims Data, 2009\u20132019","volume":"7","author":"Wyne","year":"2022","journal-title":"J. Endocr. Soc."},{"key":"ref_22","unstructured":"Mincer, D.L., and Jialal, I. (2024, September 29). Hashimoto Thyroiditis\u2014StatPearls-NCBI Bookshelf, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459262\/."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1001\/jama.2013.285606","article-title":"Variation in Rates of Autoimmune Thyroid Disease by Race\/Ethnicity in US Military Personnel","volume":"311","author":"McLeod","year":"2014","journal-title":"JAMA"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/S2213-8587(23)00025-6","article-title":"Trends in Incidence of Youth-Onset Type 1 and Type 2 Diabetes in the USA, 2002\u201318: Results from the Population-Based SEARCH for Diabetes in Youth Study","volume":"11","author":"Wagenknecht","year":"2023","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1001\/jama.2024.2103","article-title":"Prevalence of Type 1 Diabetes Among US Children and Adults by Age, Sex, Race, and Ethnicity","volume":"331","author":"Fang","year":"2024","journal-title":"JAMA"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"364","DOI":"10.3390\/diabetology3020027","article-title":"Gender Difference in Type 1 Diabetes: An Underevaluated Dimension of the Disease","volume":"3","author":"Tatti","year":"2022","journal-title":"Diabetology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1089\/jwh.2019.8247","article-title":"Sex as a Biological Variable: A 5-Year Progress Report and Call to Action","volume":"29","author":"Arnegard","year":"2020","journal-title":"J. Womens Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"102423","DOI":"10.1016\/j.autrev.2019.102423","article-title":"Comparative United States Autoimmune Disease Rates for 2010\u20132016 by Sex, Geographic Region, and Race","volume":"19","author":"Roberts","year":"2020","journal-title":"Autoimmun. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1111\/j.1475-6773.2010.01143.x","article-title":"Data and Measurement Issues in the Analysis of Health Disparities","volume":"45","author":"Bilheimer","year":"2010","journal-title":"Health Serv. Res."},{"key":"ref_30","first-page":"100252","article-title":"Race\/Ethnicity Reporting and Representation in US Clinical Trials: A Cohort Study","volume":"11","author":"Turner","year":"2022","journal-title":"Lancet Reg. Health-Am."},{"key":"ref_31","first-page":"2297","article-title":"Plasma Hormone Levels in Different Ethnic Populations of Women","volume":"36","author":"Hill","year":"1976","journal-title":"Cancer Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"455","DOI":"10.5606\/ArchRheumatol.2018.6832","article-title":"Clinical and Serologic Characteristics of Systemic Lupus Erythematosus in the Arab World: A Pooled Analysis of 3,273 Patients","volume":"33","author":"Adwan","year":"2018","journal-title":"Arch. Rheumatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"209","DOI":"10.2105\/AJPH.2021.306590","article-title":"Lack of Arab or Middle Eastern and North African Health Data Undermines Assessment of Health Disparities","volume":"112","author":"Awad","year":"2022","journal-title":"Am. J. Public Health"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Bates, N., Chin, M., and Becker, T. (2022). Measuring Sex, Gender Identity, and Sexual Orientation, National Academies Press.","DOI":"10.17226\/26424"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Lleo, A. (2017). Geoepidemiology and the Impact of Sex on Autoimmune Diseases. Principles of Gender-Specific Medicine: Gender in the Genomic Era, Academic Press. [3rd ed.].","DOI":"10.1016\/B978-0-12-803506-1.00022-X"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1093\/ije\/dyg156","article-title":"Genders, Sexes, and Health: What Are the Connections\u2014and Why Does It Matter?","volume":"32","author":"Krieger","year":"2003","journal-title":"Int. J. Epidemiol."},{"key":"ref_37","first-page":"301","article-title":"Consequences of Undertreatment of Hypothyroidism","volume":"84","author":"Effraimidis","year":"2024","journal-title":"Endocrine"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"rkaa006","DOI":"10.1093\/rap\/rkaa006","article-title":"Medically Explained Symptoms: A Mixed Methods Study of Diagnostic, Symptom and Support Experiences of Patients with Lupus and Related Systemic Autoimmune Diseases","volume":"4","author":"Sloan","year":"2020","journal-title":"Rheumatol. Adv. Pract."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/S1049-3867(01)00080-9","article-title":"Caregiving: Challenges and Implications for Women\u2019s Health","volume":"11","author":"Donelan","year":"2001","journal-title":"Women\u2019s Health Issues"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"A479","DOI":"10.1016\/j.autrev.2011.11.022","article-title":"The Influence of Sex and Gender on the Immune Response","volume":"11","year":"2012","journal-title":"Autoimmun. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.autrev.2011.10.022","article-title":"Genes, Epigenetic Regulation and Environmental Factors: Which Is the Most Relevant in Developing Autoimmune Diseases?","volume":"11","author":"Costenbader","year":"2012","journal-title":"Autoimmun. Rev."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Greer, J.M., and Mccombe, P.A. (2012). The Role of Epigenetic Mechanisms and Processes in Autoimmune Disorders. Biologics, 6.","DOI":"10.2147\/BTT.S24067"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1080\/08820130802205886","article-title":"Autoimmune Disease during Pregnancy and the Microchimerism Legacy of Pregnancy","volume":"37","author":"Nelson","year":"2008","journal-title":"Immunol. Investig."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"102864","DOI":"10.1016\/j.jaut.2022.102864","article-title":"Pregnancy-Related Complications in Systemic Lupus Erythematosus","volume":"132","author":"Tan","year":"2022","journal-title":"J. Autoimmun."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Le Donne, M., Mento, C., Settineri, S., Antonelli, A., and Benvenga, S. (2017). Postpartum Mood Disorders and Thyroid Autoimmunity. Front. Endocrinol., 8.","DOI":"10.3389\/fendo.2017.00091"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/S2213-8587(14)70248-7","article-title":"Risk of All-Cause Mortality and Vascular Events in Women versus Men with Type 1 Diabetes: A Systematic Review and Meta-Analysis","volume":"3","author":"Huxley","year":"2015","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1097\/GME.0000000000000125","article-title":"High Prevalence of Increased Interleukin-17A Serum Levels in Postmenopausal Estrogen Deficiency","volume":"21","author":"Bohaty","year":"2014","journal-title":"Menopause"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3299","DOI":"10.1007\/s10067-022-06268-y","article-title":"Health Disparities in Systemic Lupus Erythematosus\u2014A Narrative Review","volume":"41","author":"Hasan","year":"2022","journal-title":"Clin. Rheumatol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1089\/jwh.2024.0489","article-title":"Diversity of Authorship in Clinical Practice Guidelines\u2014Not There Yet","volume":"33","author":"Tong","year":"2024","journal-title":"J. Womens Health"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e000793","DOI":"10.1136\/rmdopen-2018-000793","article-title":"Systemic Lupus Erythematosus: State of the Art on Clinical Practice Guidelines","volume":"4","author":"Tamirou","year":"2019","journal-title":"RMD Open"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Graham, R., Mancher, M., Wolman, D.M., Greenfield, S., and Steinberg, E. (2011). Clinical Practice Guidelines We Can Trust, National Academies Press.","DOI":"10.17226\/13058"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1016\/S0140-6736(18)32268-2","article-title":"Differences in Clinical Practice Guideline Authorship by Gender","volume":"392","author":"Merman","year":"2018","journal-title":"Lancet"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/S0140-6736(21)02759-8","article-title":"Racialised People in Clinical Guideline Panels","volume":"399","author":"Persaud","year":"2022","journal-title":"Lancet"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1038\/s41584-020-00517-7","article-title":"The Road to Equity for Women in Academic Rheumatology","volume":"16","author":"Mahmood","year":"2020","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1002\/acr.23518","article-title":"2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015\u20132030","volume":"70","author":"Battafarano","year":"2018","journal-title":"Arthritis. Care Res."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Fitzgerald, C., and Hurst, S. (2017). Implicit Bias in Healthcare Professionals: A Systematic Review. BMC Med. Ethics, 18.","DOI":"10.1186\/s12910-017-0179-8"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1016\/j.jacc.2020.12.031","article-title":"Does Patient-Physician Gender Concordance Influence Patient Perceptions or Outcomes?","volume":"77","author":"Lau","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.3899\/jrheum.200682","article-title":"Racial Differences in Patient-Provider Communication, Patient Self-Efficacy, and Their Associations With Systemic Lupus Erythematosus\u2013Related Damage: A Cross-Sectional Survey","volume":"48","author":"Sun","year":"2021","journal-title":"J. Rheumatol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/j.semarthrit.2018.05.012","article-title":"Physician-Patient Interactions in African American Patients with Systemic Lupus Erythematosus: Demographic Characteristics and Relationship with Disease Activity and Depression","volume":"48","author":"Drenkard","year":"2019","journal-title":"Semin. Arthritis. Rheum."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1038\/s41584-021-00668-1","article-title":"Global Epidemiology of Systemic Lupus Erythematosus","volume":"17","author":"Barber","year":"2021","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"rkaa078","DOI":"10.1093\/rap\/rkaa078","article-title":"Exploring Intentional Medication Non-Adherence in Patients with Systemic Lupus Erythematosus: The Role of Physician\u2013Patient Interactions","volume":"5","author":"Leung","year":"2021","journal-title":"Rheumatol. Adv. Pract."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1007\/s11606-011-1748-z","article-title":"Addressing Racial Healthcare Disparities: How Can We Shift the Focus from Patients to Providers?","volume":"26","author":"Burgess","year":"2011","journal-title":"J. Gen. Intern. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"E1579","DOI":"10.1210\/jc.2012-2043","article-title":"Health Disparities in Endocrine Disorders: Biological, Clinical, and Nonclinical Factors\u2014An Endocrine Society Scientific Statement","volume":"97","author":"Golden","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_64","unstructured":"National Academies of Sciences, Engineering, and Medicine (2024). Advancing Research on Chronic Conditions in Women, National Academies Press."},{"key":"ref_65","unstructured":"National Academies of Sciences, Engineering, and Medicine (2024, August 01). Unequal Treatment Revisited: The Current State of Racial and Ethnic Disparities in Health Care: Proceedings of a Workshop. Unequal Treatment Revisited. Available online: https:\/\/nap.nationalacademies.org\/catalog\/27448\/unequal-treatment-revisited-the-current-state-of-racial-and-ethnic?utm_source=HMD+Email+List&utm_campaign=34b0bc43d5-EMAIL_CAMPAIGN_2023_08_10_07_41_COPY_01&utm_medium=email&utm_term=0_-3599385651-%5BLIST_EMAIL_ID%5D&mc_cid=34b0bc43d5&mc_eid=923a68a8c5."},{"key":"ref_66","first-page":"222","article-title":"Mary Saxon Developing Workforce Diversity in the Health Professions: A Social Justice Perspective","volume":"6","author":"Wilbur","year":"2020","journal-title":"Health Prof. Educ."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.2105\/AJPH.2018.304883","article-title":"The National Institute on Minority Health and Health Disparities Research Framework","volume":"109","author":"Alvidrez","year":"2019","journal-title":"Am. J. Public Health"},{"key":"ref_68","unstructured":"Ranji, U., Diep, K., Gomez, I., Sobel, L., and Salganicoff, A. (2024, August 01). Health Policy Issues in Women\u2019s Health. Available online: https:\/\/www.kff.org\/health-policy-101-health-policy-issues-in-womens-health\/?entry=table-of-contents-introduction."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"56","DOI":"10.2337\/dc22-1055","article-title":"Racial Disparities in Access and Use of Diabetes Technology Among Adult Patients With Type 1 Diabetes in a U.S. Academic Medical Center","volume":"46","author":"Kanbour","year":"2023","journal-title":"Diabetes Care"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s10900-022-01147-8","article-title":"An Intersectional Approach to Understanding Barriers to Healthcare for Women","volume":"48","author":"Petruzzi","year":"2023","journal-title":"J. Community Health"},{"key":"ref_71","unstructured":"(2024, August 12). Deloitte Hiding in Plain Sight: The Health Care Gender Toll. Available online: https:\/\/www2.deloitte.com\/content\/dam\/Deloitte\/us\/Documents\/life-sciences-health-care\/us-lshc-health-gender-gap.pdf."},{"key":"ref_72","first-page":"1399","article-title":"Healthcare Resource Utilization and Cost among Patients with Type 1 Diabetes in the United States","volume":"26","author":"Simeone","year":"2020","journal-title":"J. Manag. Care Spec. Pharm."},{"key":"ref_73","unstructured":"Carter, E.L. (2024, August 09). H.R.830\u2014HELP Copays Act: 118th Congress (2023\u20132024), Available online: https:\/\/www.congress.gov\/bill\/118th-congress\/house-bill\/830."},{"key":"ref_74","unstructured":"Wenstrup, B.R. (2024, August 09). H.R.2630\u2014Safe Step Act: 118th Congress (2023\u20132024), Available online: https:\/\/www.congress.gov\/bill\/118th-congress\/house-bill\/2630."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1002\/art.42837","article-title":"Introducing the Office of Autoimmune Disease Research","volume":"76","author":"Shanmugam","year":"2024","journal-title":"Arthritis Rheumatol."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Mastroianni, A.C., Faden, R., and Federman, D. (1994). Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies, National Academy Press.","DOI":"10.1136\/bmj.309.6961.1095"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1097\/ACM.0000000000002027","article-title":"The More Things Change, the More They Stay the Same: A Study to Evaluate Compliance With Inclusion and Assessment of Women and Minorities in Randomized Controlled Trials HHS Public Access","volume":"93","author":"Geller","year":"2018","journal-title":"Acad. Med."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"100553","DOI":"10.1016\/j.xcrm.2022.100553","article-title":"Advancing the Inclusion of Underrepresented Women in Clinical Research","volume":"3","author":"Bierer","year":"2022","journal-title":"Cell. Rep. Med."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1136\/bmj.p1035","article-title":"Is a Lack of Diversity among Clinical Practice Guideline Authors Contributing to Health Inequalities for Patients?","volume":"381","author":"Silver","year":"2023","journal-title":"BMJ"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/10\/1339\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:10:23Z","timestamp":1760112623000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/10\/1339"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,10]]},"references-count":79,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["ijerph21101339"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21101339","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,10]]}}}