A powerful new report from the National Academies of Sciences, Engineering, and Medicine has shone a harsh spotlight on the declining state of women’s health in the United States, raising urgent questions about medical research funding and health inequities that hold major implications for women and girls globally, including in Thailand. Despite the nation’s wealth and medical advancements, American women are living shorter lives than their peers in other high-income countries, facing disproportionate disability in their later years, and enduring alarming rates of maternal deaths and violence—all while research on their health remains chronically underfunded (PRB.org).
For Thai readers, the findings offer a cautionary tale and a critical lens for self-reflection: If even the world’s richest nation struggles to ensure women’s health equity and research prioritization, what lessons and preemptive actions can Thailand take to avoid similar pitfalls?
The new report paints a sobering picture: U.S. women had a life expectancy of just 79.3 years in 2021—a staggering four years less than women in Costa Rica and eight years behind Japanese women. Of the 38 countries in the OECD, the U.S. placed a dismal 33rd. Researchers blame a complex mix of factors including higher rates of smoking, obesity, substance abuse, and suicide—all of which are closely linked to entrenched societal issues such as sexism and racism that drive health disparities.
“The gap in life expectancy between women in the United States and those in other high-income countries has increased,” notes researchers from Brown University, underscoring a disturbing pattern of stalled or reversed progress. America’s women not only live shorter lives, but are spending a growing share of their later years in poor health, contending with disabling chronic conditions at rates that outstrip their male peers.
“Women may be living longer but not healthier lives than men,” explains a University of Southern California gerontologist, whose review of four decades of data revealed that women gained more years of life, but more of those years came encumbered by disability (PRB.org).
Examining the reasons behind these grim statistics, the report highlights America’s persistently high maternal mortality rate, which is among the highest in the developed world and dramatically worse for non-Hispanic Black women, who are 3.5 times more likely to die during and soon after childbirth compared to their white counterparts. Researchers from the University of Colorado Boulder and the University of Maryland attribute these disparities to systemic racism in social, political, economic, and health care systems.
According to a recent CDC analysis, a stunning 84% of maternal deaths between 2017 and 2019 were determined to be preventable. This exposes major deficiencies both in health system responsiveness and in efforts to confront the underlying structural inequities that endanger women of color in particular—a dynamic echoed in many multicultural societies, Thailand included, where socio-economic and ethnic disparities can also affect women’s health outcomes.
The report also points to escalating dangers for young women. Rates of suicide and homicide among American women ages 25 to 34 have risen compared to previous generations, with American Indian, Alaska Native, and Black women facing especially steep increases. For example, the homicide rate for young Black women surged nearly 60% in the past two decades. These stark numbers reflect not just individual risk factors but broader societal issues, including increased vulnerability due to inadequate social support networks, exposure to violence, and reduced access to mental health services.
Adding further concern, new research reviewed by the University of Michigan links restrictive abortion laws to worse health outcomes, including increased risk of complications and severe financial hardship for women and families. The Supreme Court’s 2022 decision to overturn Roe v. Wade is projected to widen these risks and health disparities, putting more women at risk of unsafe reproductive care and economic instability.
“Girls, women, families, society, and the economy all pay a price for the gaps in knowledge about women’s health,” stress the report authors, emphasizing that closing these gaps “will require more than increased funding… it will require dedicated action, careful prioritization, and oversight to ensure objectives are achieved.”
One of the most damning revelations is the chronic underfunding of women’s health research by the National Institutes of Health (NIH). Despite the Office of Research on Women’s Health (ORWH) being established over three decades ago, less than 9% of NIH’s budget is devoted to this field, and that share has declined over the past decade. Most NIH centers do not prioritize women’s health in their strategic plans, and grant review panels often lack sufficient expertise in women’s health to make informed funding decisions. Panel experts argue that these institutional shortcomings both reflect and reinforce the medical system’s historic bias towards male bodies and experiences—a problem long noted in medical research literature (The Lancet).
Against this backdrop, the National Academies committee is urging major reforms, proposing that ORWH be elevated to a full Women’s Health Research Institute with a broader research mandate and greater oversight authority. The committee also calls for a new interdisciplinary research fund and the appointment of more grant reviewers with expertise in women’s health.
The implications for Thailand are profound. Although maternal mortality and life expectancy numbers differ, many of the same underlying challenges—such as gendered disparities in access to care, underrepresentation of women in clinical studies, and a medical system that frequently overlooks women’s specific health needs—are relevant here. Thailand’s own push to lower maternal mortality rates and improve health outcomes for women and girls, especially in ethnic minority and rural populations, demands close attention to these lessons (World Bank).
Historically, Thailand made dramatic progress in reducing maternal mortality, from over 400 deaths per 100,000 live births in the 1960s to under 50 today, thanks to nationwide initiatives in public health, family planning, and rural health services. But persistent gaps remain, especially in regard to ethnic minorities, adolescent women, and migrant workers, mirroring the layers of social inequity seen in the U.S. (UNFPA Thailand).
Thai policymakers, researchers, and advocates have a rare opportunity to apply this comparative lens, proactively addressing both research gaps and service inequities before they become deeply entrenched. Key areas for improvement include promoting gender-sensitive clinical research, ensuring that strategic health plans explicitly prioritize women’s health, and expanding interdisciplinary, cross-sectoral collaboration—including the perspectives of educators, sociologists, anthropologists, and women’s rights advocates, not just clinicians and medical scientists.
Moving forward, Thailand can consider several practical steps inspired by the U.S. findings:
- Increase research funding specifically tied to women’s health, with clear targets and transparent reporting;
- Ensure representation of women’s health experts in grant review and policymaking panels;
- Prioritize data collection and analysis that disaggregates health outcomes by sex, ethnicity, geography, and socio-economic status, enabling more nuanced intervention;
- Support interdisciplinary and community-based research that factors in mental health, reproductive rights, violence prevention, and socio-economic empowerment;
- Learn from cautionary tales of underfunding and policy missteps in other countries, such as the U.S., as a mechanism for safeguarding progress at home.
For Thai women, families, and policymakers, the American crisis is a reminder that economic advancement does not automatically deliver health equity. Sustained prioritization, investment, and vigilance are required to prevent similar reversals in women’s health gains. Reflecting on Buddhist teachings on compassion and the human body, Thai society can reaffirm its commitment to supporting women’s health across all walks of life—with practical action and policy innovation, not just good intentions.
Above all, the U.S. experience demonstrates that neglecting women’s health is not just a clinical or scientific issue, but one with reverberating impacts on families, communities, and economies. As Thai leaders and the public continue to build on past progress for maternal and women’s health, now is the vital time to ensure that those efforts are durable, inclusive, and future-proof.
For more information, readers can consult original research and policy summaries at PRB.org.