Towards Equity in Women's Health: Bridging Promises, Action, and Progress.

Foreword Towards Equity in Women’s Health: Bridging Promises, Action, and Progress Heling Bao1;  Linhong Wang2,3,#   Women’s health equity refers to the equitable achievement of optimal health outcomes for all women, irrespective of  gender,  socioeconomic  status,  race,  geographic  location,  or  other  social  determinants  of  health.  This  concept emphasizes  dismantling  systemic  barriers  and  customizing  interventions  to  address  the  diverse  needs  of  women throughout  their  life  course  (1).  Bridging  women’s  health  disparities  yields  substantial  economic  and  societal benefits. The World Health Organization (WHO) estimates that eliminating gender health gaps could contribute 12 trillion US dollars (USD) to the global economy by 2040 (2). Globally, progress remains uneven. While high- income countries have made significant advances in reducing maternal mortality, profound disparities persist in low- resource  settings.  Moreover,  challenges  endure  even  in  developed  regions,  where  socioeconomically  disadvantaged populations  experience  disproportionately  higher  rates  of  preventable  diseases  such  as  cervical  cancer  (3).  Current impediments  include  fragmented  health  policies,  inadequate  funding  for  gender-specific  research,  and  cultural stigmas that restrict healthcare access. For instance, merely 5% of global health research addresses conditions specific to women (4), perpetuating critical gaps in evidence-based care. The World Economic Forum 2024 identifies nine key  health  conditions  that  collectively  account  for  one-third  of  the  women’s  health  gap:  breast  cancer,  cervical cancer,  menopause,  endometriosis,  premenstrual  syndrome,  postpartum  hemorrhage,  maternal  hypertensive disorders,  migraine,  and  ischemic  heart  disease  (5).  Addressing  these  disparities  necessitates  progressing  beyond universal commitments to implementing targeted interventions that address inequities in treatment approaches, care delivery systems, data collection, and funding allocation — a central theme in advancing women’s health equity. This special issue comprises five pivotal studies addressing the three leading contributors to the global women’s health gap: breast cancer, cervical cancer, and menopausal syndrome. Breast cancer remains the predominant cause of cancer-related mortality among women, while cervical cancer — though highly preventable — continues to claim numerous  lives  due  to  inequitable  access  to  vaccines  and  screening  services.  Menopause,  despite  being  a  natural physiological transition, receives inadequate attention in health systems worldwide, despite its profound impact on women’s physical and mental well-being (6). For cervical cancer elimination, Zhang et al. estimated cervical cancer screening rates based on national surveillance data, revealing persistent coverage disparities, particularly in rural and resource-limited settings (7), while Gao et al. assessed human papillomavirus (HPV) infection severity and cervical lesion prevalence utilizing screening data from 23 provincial-level administrative divisions (PLADs) (8). Together, these investigations provide actionable evidence to accelerate China’s cervical cancer elimination strategy. Bao et al. examined the relationship between socioeconomic status (SES) and breast cancer incidence through cohort analysis, underscoring  the  necessity  for  SES-stratified  prevention  approaches  (9).  Complementing  this  research,  Liu  et  al. analyzed  breast  nodule  detection  rates  using  healthcare  big  data  across  31  PLADs  in  China,  advocating  for  risk- tailored screening programs that prioritize high-burden regions (10). Finally, Yong et al. investigated the prevalence and  severity  of  menopausal  symptoms  in  women  aged  40–60,  challenging  the  long-standing  neglect  of  post- reproductive  health  in  policy  agendas  (11).  Collectively,  these  studies  illuminate  critical  pathways  to  close  the women’s  health  gap:  from  SES-informed  cancer  prevention  strategies  to  equitable  screening  expansion  and comprehensive  life-course  care.  By  translating  robust  evidence  into  targeted  interventions,  we  advance  toward bridging promises with measurable progress. China  has  made  significant  strides  in  narrowing  women’s  health  disparities  through  initiatives  including substantial  reductions  in  maternal  and  infant  mortality  rates,  implementation  of  nationwide  breast  and  cervical cancer  screening  programs,  and  the  recent  incorporation  of  adolescent  health  and  menopause  management  into national  women’s  health  guidelines.  However,  substantial  challenges  persist:  pronounced  gender  and  urban-rural disparities  in  vulnerability  and  healthcare  access  remain  evident,  while  systemic  barriers  —  including  fragmented health  financing  mechanisms  and  insufficient  prioritization  of  women’s  health  issues  —  continue  to  undermine China CDC Weekly Copyright © 2025 by Chinese Center for Disease Control and Prevention CCDC Weekly / Vol. 7 / No. 10 319 equity goals. Additionally, women’s health equity represents not merely a healthcare concern but also an economic and  workforce  imperative.  To  accelerate  progress,  six  strategic  priorities  warrant  immediate  attention.  First, enhancing  comprehensive  data  collection  systems  to  capture  the  nuanced  needs  of  diverse  female  populations  is essential. Second, expanding support for basic science and clinical research focused on women-specific conditions is critical to address persistent gaps in evidence-based care. Third, developing sex-based healthcare delivery systems will ensure  more  tailored  and  effective  services  across  the  lifespan.  Fourth,  implementing  accessible  solutions  can effectively bridge geographic and socioeconomic barriers to care. Fifth, directing substantial resources into women’s health fields will create sustainable infrastructure to support these comprehensive efforts. Finally, ensuring workplace accommodations for pregnant, postpartum, and menopausal women is vital to promote long-term well-being and productivity. By prioritizing these strategic actions, China can establish global leadership in addressing the women’s health gap.  doi: 10.46234/ccdcw2025.051  # Corresponding author: Linhong Wang, [email protected].   1 Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; 2 National Center for Chronic  and  Non-communicable  Disease  Control  and  Prevention,  Chinese  Center  for  Disease  Control  and  Prevention,  Beijing,  China;  3  Chinese Association of Women and Child Health Studies, Beijing, China. Copyright © 2025 by Chinese Center for Disease Control and Prevention. All content is distributed under a Creative Commons Attribution Non Commercial License 4.0 (CC BY-NC). Submitted: February 17, 2025 Accepted: February 26, 2025 Issued: March 07, 2025 REFERENCES   World Health Organization. Health equity. 2025. https://www.who.int/health-topics/health-equity#tab=tab_1. [2025-2-15].1.  McKinsey Global Institute. COVID-19 and gender equality: countering the regressive effects. 2020. https://www.mckinsey.com/featured-insights/future- of-work/covid-19-and-gender-equality-countering-the-regressive-effects. [2025-2-15]. 2.  Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B, et al. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline  analysis  of  the  WHO  global  cervical  cancer  elimination  initiative.  Lancet  Glob  Health  2023;11(2):e197  −  206.  https://doi.org/10.1016/S2214- 109X(22)00501-0. 3.  Funding research on women’s health. Nat Rev Bioeng 2024;2(10):797-8. http://dx.doi.org/10.1038/s44222-024-00253-7.4.  World Economic Forum. Blueprint to close the women’s health gap: how to improve lives and economies for all. 2025. https://reports.weforum.org/docs/ WEF_Blueprint_to_Close_the_Women%E2%80%99s_Health_Gap_2025.pdf. [2024-2-15]. 5.  El  Khoudary  SR,  Greendale  G,  Crawford  SL,  Avis  NE,  Brooks  MM,  Thurston  RC,  et  al.  The  menopause  transition  and  women’s  health  at  midlife:  a progress  report  from  the  Study  of  Women’s  Health  Across  the  Nation  (SWAN).  Menopause  2019;26(10):1213  −  27.  https://doi.org/10.1097/GME. 0000000000001424. 6.  Zhang M, Wang LM, Zhang X, Li C, Zhao ZP, Yu MT, et al. Cervical cancer screening rates among Chinese women — China, 2023–2024. China CDC Wkly 2025;7(10):321-6. https://doi.org/10.46234/ccdcw2025.052. 7.  Gao D, Zhao GL, Wang XY, Juan J, Shi YP, Xu TY, et al. Association between high-risk human papillomavirus infection and cervical cytology in health check-up women — 23 PLADs, China, 2023. China CDC Wkly 2025;7(10):327-33. https://doi.org/10.46234/ccdcw2025.053. 8.  Bao HL, Fang LW, Cong S, Guo XL, Fu ZT, Liu XL, et al. Female breast cancer incidence and association with individual-level socioeconomic status in a population-based cohort, China, 2018–2024. China CDC Wkly 2025;7(10):341-6. https://doi.org/10.46234/ccdcw2025.055. 9.  Liu, XX, Xing YX, Zu YN, Bao HL, Ding X, Chen YC, et al. Detection and BI-RADS classification of female breast nodules, China, 2021. China CDC Wkly 2025;7(10):347-52. https://doi.org/10.46234/ccdcw2025.056. 10.  Yong ZH; Yang YH; Yang YL; Yang L; Zhao YX; Luo XM, et al. Prevalence and severity of menopausal symptoms in women of different ages — China, 2023–2024. China CDC Wkly 2025;7(10):334-40. https://doi.org/10.46234/ccdcw2025.054. 11.   Linhong Wang Professor  and  Chief  Expert  of  the  National  Center  for  Chronic  and  Noncommunicable Disease Control and Prevention, China CDC, Beijing, China Chinese Association of Women and Child Health Studies, Beijing, China China CDC Weekly 320 CCDC Weekly / Vol. 7 / No. 10 Chinese Center for Disease Control and Prevention