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As a physician at Duke, I often saw how women, especially those juggling chronic illness, caregiving, and limited healthcare access, faced delays in getting the right care. What stood out wasnt just the complexity of their conditions, but how predictable the barriers were. Women face unique challenges in getting timely access to the care they need. Many care options are simply inconvenient and often do not meet patients where they are. For example, forcing a busy working mom to take the day off work, driving 30 minutes for a routine screening can be a challenge if having to juggle a 9-5 and childcare too. Many women are caregivers for aging parents or children, compounding the challenge of taking care of oneself. To make health more equitable, women require convenient options to engage in their health and readily participate in research. Recently, a landmark 40-year study of beta-blockers, one of the most common medications prescribed, demonstrated that adverse effects on women, when taken after specific types of heart attacks. This flew in the face of what I was taught in medical school, though at that time there werent enough studies with women participants and the information just wasnt available. For years, women have been prescribed these medications, based on study designs that didnt adequately represent them. Its not just that women are underdiagnosed or left out of research; its that we’remissing a massive opportunity to advance health by elevating options for women. Women are the most frequent healthcare decision makers, but also the longest consumers of healthcare (i.e. women live longer than men!) in the economy. While women account for 80% of healthcare decisions, they also make up 65% of the healthcare workforce. They experience more chronic disease, and spend more out-of-pocket, not including maternity costs. They use more prescriptions, attend more appointments, and shape family health behavior. If youre building a product, launching a trial, or setting a research agenda, the reality is simple: Youre already in the business of womenshealth, whether you know it or not. WOMENS HEALTH IS MORE THAN BIKINI MEDICINE For too long, womens health has been conventionally categorized by the body parts covered by a bikinireproductive care, breast cancer screenings, and obstetrics related topics. This is instead of what it truly involves: the whole body. Several studies show women are consistently and disproportionately affected by stroke, cardiovascular disease, neurocognitive disorders such as dementia, and more. Women are the cornerstone of the entire healthcare market,whichcan boost the global economy $1 trillion annually by 2040. Bikini medicine has left care gaps in everything from heart disease to chronic pain. On the biopharma side, just 4% of R&D spending targets medical research specific to women. And yet in 2024, female-focused startups received only 8.5% of digital health funding, down from nearly 15% in 2020. This isnt about a lack of innovation. Its about a lack of prioritization. WHEN WOMEN ARE LEFT OUT, EVERYONE PAYS There are real costs when women are left out of the data: Clinical risk: Women are twice as likely to experience side effects and we arent sure why. Potentially, its because trials skew male. Economic drag: Women spend 25% more of their lives in poor health compared to men. That results in billions in lost productivity and missed potential. Reputational fallout: In a consumer-driven world, building products that dont work well for half the population is a fast way to lose trustand market share. Getting women into research is not a nice-to-have. Its critical for safety, quality, and return on investment, and to develop therapies that work well for over half of the people they are prescribed to. CLOSING THE GAP COULD UNLOCK $1 TRILLION A YEAR McKinsey estimates that improving outcomes for women could add $1 trillion to the global economy annually, by 2040. Thats not wishful thinking. Its rooted in simple interventionsbetter diagnosis, smarter data, faster access to care. Consider this: Half of all women in the U.S. Half of all women in the U.S. each year skip or delay care, often due to costs, scheduling issues, or a lack of trust in the system. Couple this with clinical research historically, and there is less substantial womens data available to train AI models powering the future of care, even though women take more medications and manage more chronic conditions. This is where the opportunity lies. Build for the real world, and you build a better business. DESIGNING FOR WOMEN DOESNT MEAN EXCLUDING OTHERS Theres a common fear that focusing on women somehow limits your market. But the opposite is true. Solutions that meet womens needslike care navigation, chronic disease support, and flexible benefitssolve for a broader population, too. What makes womens health complex is also what makes it valuable. If your product or trial can work for women across life stages, it can be used to inspire solutions for anyone. WHAT SHOULD HAPPEN NEXT If we want to change the trajectory of womens health, we need to: Make convenient options for women to improve access to resources and research participation. Fund more companies prioritizing women in their design and leadership. Follow the January 2025 FDA guidance for trials and datasets to reflect real-world populations, like menopausal status and menstrual cycles. Expand benefits that meet womens needs beyond reproductive care. Build tools that understand female physiology and behavioral patterns. This isnt just a moral imperative. Its a competitive one. LETS SHIFT THE CONVERSATION Equity in healthcare is an imperative focus of health innovation and personal to many of us, but theres a business case thats been hiding in plain sight. Women are the health economys chief consumers, workers, and unpaid labor force. Failing to invest in women is failing to invest in the market. Joy Bhosai, MD MPH is founder and CEO of Pluto Health. Jessica Federer, MPH is the managing director of the Womens Health Fund, and an investor in Pluto Health
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E-Commerce
Leading the Exceptional Women Alliance gives me a front-row seat to how accomplished women lift each other through mentorship and growth. Joanna Dodd Massey is a corporate board director and Fortune 500 executive with expertise in risk, governance, and crisis leadership. She has a PhD in psychology and advises boards and executives navigating high-stakes challenges and organizational change. Q: Why do family conversations turn so tense during the holidays? Massey: Alcohol and forced family fun play a role, but underneath it all is our biology. Human beings are one of those species that cant survive alonewere hardwired for connection because our survival depends on belonging to a tribe. When someone attacks our beliefs, the automatic part of our brain reacts as if were in danger. It doesnt know the difference between a tiger in the wild and a relative on a rant. That reactionwhat we call the fight, flight, or freeze responseshuts down the rational part of the brain that handles logic and self-control. Its why calm people suddenly get intensely defensiveor disappear into the kitchen. Q: The minute someone mentions politics at dinner, most of us reach for the wine or change the subject. Is there a better way? Massey: YesI teach an easy three-step process: (1) honor yourself, (2) honor your neighbor, (3) share your story. Our country was founded on the idea that all people are created equal and endowed with unalienable rights, including freedom of thought and expression. When you stand in that liberty, you dont need others to agree with you. If someone mocks or shames you, thats just their opinion. These three steps are an easy way to remember that disagreement doesnt exile you from humanity. In fact, having disagreements amicably shows that Americans can respect differences and still break bread togetherjust like we did at the first Thanksgiving. Q: Tell us about those three steps. How do they work? Massey: Step 1: Honor yourself is about keeping yourself grounded and your rational brain in the drivers seat. First, notice whats happening in your body before you open your mouth. If your heart rate spikes, your jaw tightens, or your shoulders creep toward your ears, thats your survival system signaling that its about to take controland once it does, theres nothing you can do to stop it. When you notice those signs, take some deep breaths or use a breathing technique, like 4-square breathing. It distracts your mind and floods your cells with oxygen. With your rational brain still online, remind yourself theres nothing to winyou arent changing them, just like they arent changing you. Step 2: Honor your neighbor is about helping the other person stay in their right mind. When we feel attacked, defenses go up. The moment you shift the conversation from condemning to curiosity, everything changes. We all have a story that has shaped us, so say to the other person: Thats an interesting point that I hadn’t thought of. Can you tell me more about how you came to that understanding? When people feel heard, their survival system doesnt worry about being kicked out of the tribe. Step 3: Share your story is exactly what it saysyoure sharing your story, not your opinion. The automatic brain doesnt care about facts, data, or statistics, so using them wont change anyones mind. What can people here? Vulnerability. When you talk about your own experience, an argument turns into connection. Simply put, the answer to our differences is to humanize them, not politicize them. Q: So, we should just nod and agree with everyone? Massey: Not at all. These steps arent about agreeingthe goal is to have a conversation, not a confrontation. Think of it as dinner-table diplomacy. Q: That sounds nice in theory, but does it really work in practice? Massey: Yesand theres a great example from the pandemic. Former New Jersey governor Chris Christie, a respected conservative, joined a podcast where infectious disease experts debated anti-vaxxers, but no one was convinced. Then Christie told a personal story. He said he got vaccinated because his aunt and uncle died of COVID, and hed had a severe case himself. He said he got the vaccine because he didnt want to diebut also told them they didnt have to, because this is America and thats their right. What happened? He was calm and confident in his position (Step 1). He listened and respected their opinion (Step 2). He didnt try to convince them; he shared a very personal story (Step 3). Q: Whats the biggest takeaway for people heading into holiday dinners this year? Massey: Remember that everyone at the table has an internal Book of Life According to Mea lifetime of experiences that shaped their beliefs. You dont have to agree, but you can honor the humanity behind those differences. Larraine Segil is founder, chair and CEO of The Exceptional Women Alliance.
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E-Commerce
Changing an organisms genome is a profound act, and the tools you use to make the changes don’t alleviate the need for responsible regulation. Since bursting onto the scene in 2012, CRISPR technology has been used to modify dozens of species from bacteria to livestock to plants, and even human embryos. Many countries have put ethical guardrails in place to prohibit creating designer babies. However, in agriculture, gene-edited crops are largely exempt from regulatory oversight, creating a “Wild West” where anything goes and edited crops are free to enter the food supply. Unlike traditional genetically modified organisms (GMO)used since the 1990s to create Roundup Ready seeds and many other widely used productsediting doesnt involve inserting transgenic DNA from other organisms. Instead, it tweaks the genes that already exist. As such, proponents claim its a safer approach: no Frankenfoods, just selective breeding on steroids. Following a massive industry lobbying campaign, such arguments have gained traction around the world. In Europe, regulators are forging ahead with a two-tier regulatory system for modified crops. While traditional GMOs remain heavily regulated, gene-edited crops are being given a free pass, with no oversight or labeling required. (Some heavily edited crops will still undergo a degree of scrutiny, though far less than GMO crops.) GENE EDITING NEEDS OVERSIGHT In the U.S., the USDAs SECURE Rule had, since 2020, similarly exempted most edited crops from regulatory oversightuntil it was ruled arbitrary and capricious and struck down last December by a California judge. For now, the USDA has reverted to its pre-2020 rulebookfull of red tape, but at least even-handed in the burdens imposed on agtech innovators. The issue here isnt that theres anything wrong with gene editing. One of us (Randall) spent several years leading gene editing research at numerous companies, including Inari, Arcadia, and Monsanto (now Bayer), and we can tell you that CRISPR is an incredible tool. Its already being used to create amazing new productsfrom bananas that wont go brown to rice thats resistant to destructive viruses. Researchers are also developing vitamin-packed tomatoes, carbon-sequestering strains of rice, and high-yield wheat. They should be applauded: Well need all these innovations, and more, to grow healthy, tasty, and affordable food for billions of people in a warming world. But while there isnt anything uniquely dangerous about gene editing, there isnt anything uniquely safe about it either. With both gene editing and transgenic methods, youre rewriting the genomeand what matters is the impact of the new genetic content, not where the underlying DNA letters came from. Whatever methods are used, genetic engineering can deliver enormous benefits, but brings real risksand requires proper oversight to ensure safety and maintain public confidence. THE GMO BACKLASH However, the current bifurcated approach that gives gene editing a pass creates a significant risk that regulators are sowing the seeds of a future backlash against genetic engineering. Paradoxically, GMO crops have one important benefit over gene-edited crops: Precisely because they contain transgenic genetic information, they can be easily detected using simple lab testing. Gene-edited crops, on the other hand, are typically indistinguishable from conventional crops, so if an edited crop were found to have harmful traits, it would be extremely difficultand unimaginably expensiveto verifiably remove it from the global food chain. The approach also distorts the marketplace by creating incentives for gene editing at the expense of future innovations using proven GMO technologies that farmers and consumers already rely on. Unfortunately, by downplaying the need for meaningful oversight of edited crops, we risk playing into the hands of the least scrupulous market participants. In China, gene editing techniques have already been misused to unlawfully edit the genomes of unborn babies, and Chinese firms are racing to create gene-edited medical treatments in ways that have raised eyebrows among Western regulators. Now, China is actively promoting gene editing for crops and livestock, too, in a bid to end its reliance on U.S. soybeans and other farm exports. Want to place a bet that no corners will be cut along the way? Were no Luddites, with Randall spending his career using genetic techniques to improve crops. Genetic engineering, encompassing both transgenic methods and gene editing, is the defining technological breakthrough of our time (sorry, ChatGPT). But its also among the most misunderstood, and certainly the most maligned, of modern technologies. Crop innovators, burned once by the demonization of GMOs, are understandably eager to avoid tarring gene editing methods with the same brush. A BACKDOOR APPROACH But in the rush to wave through gene editing technologies, were falling into the same trap. The industrys arrogant dismissal of safety concerns turned an entire generation against GMOs. Now, instead of being forthright with consumers about the power and potential of gene editing, the industry is trying to sneak it in by the back door as simply an extension of selective breeding methods used since the dawn of agriculture. The reality is more nuanced. Theres no need to panic about gene editing methods. But theres also no scientific basis for casting GMO crops as bad and edited crops as good. Both gene editing and genetic modification are incredibly powerful toolsand the novel plant traits they enable should be welcomed. But they should also be regulated, carefully and effectivelyand regulated as products, based on their own unique attributes, regardless of the processes used to create them. Its time to move away from process-oriented regulations and focus instead on creating a level playing field for both transgenic and gene-edited crops. We need an honest conversation and clear-eyed regulations of both technologies to protect the safety of the food chainand ensure that vital new agtech breakthroughs continue to develop in safe, transparent, and sustainable ways. Shely Aronov is CEO and cofounder of Innerplant. Randell Schultz, PhD, is vice president of research and development at Innerplant.
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E-Commerce
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