What Gets Funded Shapes What We Know: 15 Years of Canadian Womens Health Research

ImportanceFunding of womens health research has been low, with a narrow focus on what is considered womens health. Understanding which lifespan stages and areas of womens health are funded is essential to determine the breadth of womens health research and identify where gaps in research are concentrated. ObjectiveTo examine which lifespan stages and areas of womens health were more likely to be funded in open Canadian grant competitions. Evidence ReviewPublicly available funded Canadian Institutes of Health Research (CIHR) Project Grant abstracts from 2009 and 2023 were coded for mention of a hormonal transition period (puberty, menstrual cycle, pregnancy/postpartum, perimenopause/menopause), exogenous hormone use (hormonal contraception, fertility treatments, menopause hormone therapy), and/or a female-specific health condition. Abstracts were also coded for Indigenous health and Two Spirit, Lesbian, Gay, Bisexual, Trans, Transgender or Trans Identified, Queer, Intersex, Asexual, Plus (S2/LGBTQIA+) populations. Remaining grant abstracts were grouped by common theme.Abstracts were analyzed for changes in research representation and funding over time and whether funding was lower than expected based on population prevalence or proportion of the lifespan spent in that stage. FindingsNearly 50% of female-specific research focused on cancers (breast, gynecologic) or pregnancy and did not significantly increase in funding or representation over time. Of the funded grant abstracts that focused on pregnancy, ~22% examined outcomes pertaining only to the fetus/offspring, not the birthing parent. Over 15 years, 2.37% of all CIHR abstracts over 15 years were devoted to pregnancy, whereas only 0.24% was devoted to other hormonal life stages (menstrual cycles, menopause). For all hormonal transition stages except pregnancy, the proportion of grants and funding devoted to that stage was lower than expected based on the proportion of the lifespan spent in that stage. Conclusions and RelevanceThese findings reflect the narrow breadth of womens health, which largely focused on cancers (breast, gynecologic) or pregnancy, rather than being distributed across key life course stages that shape womens health. To advance science for all, the heterogeneity and complexity in womens health across the lifespan must be embraced and barriers for womens health research must be removed. Key PointsO_ST_ABSQuestionC_ST_ABSWhich areas and life stages of womens health are most likely to be funded in Canadian open grant competitions, and where are funding gaps concentrated? FindingsNearly half of female-specific grants focused on cancer or pregnancy, with little change over time. Pregnancy dominated hormonal-stage research, often excluding maternal outcomes, while menstrual and menopausal stages were rarely funded. For most life stages, funding was lower than expected based on lifespan representation. MeaningWomens health research funding remains narrowly focused. Broader, life-course-inclusive investment is needed to address critical gaps and advance equitable health science.