2007 marked UCSF's tenth year as a nationally-designated Center of Excellence in Women's Health (CoE). The last decade has seen major advances in women's health, and the UCSF CoE has played a key role in this process leading innovations in clinical practice, development of new knowledge, and in professional and community education. We were one of the original six institutions given the 'Center of Excellence' honor by the US Department of Health and Human Services Office on Women's Health, and there are now 23 Centers across the country.

Advancing Women's Health Care

• Imagine a future in which every doctor who cares for you understands your unique female biology and values your preferences.
• Imagine a future in which health care providers work in teams and share information with each other -- and you -- via the internet.
• Imagine a brand new state of the art hospital in San Francisco devoted entirely to providing women a lifetime of reproductive health, where a woman can have a baby in a birthing center, receive the latest in breast cancer care, uterine fibroid treatment or incontinence all in a woman-centered environment.

That future is closer than you think thanks to the vision of lifelong women's healthcare advocate and expert Dr. Nancy Milliken. Dr. Milliken, who for decades has pioneered efforts to change the medical system from within, helped create the UCSF National Center for Excellence in Women's Health in 1996. Now a decade later she is a force behind the planned new UCSF Women's Specialty Hospital at Mission Bay. The Women's Hospital is part of a new $1.5 billion UCSF medical complex scheduled to break ground in 2011.

“Women are the major health care decision makers in this country. They make 70 to 90 percent of the decisions for their health, their parents' health, their in-laws' health and their children's health. By truly respecting women and giving them information they need to make those decisions, we can have a major positive impact on communities.”

-Dr. Nancy Milliken

• What is one of the biggest changes you have seen in women’s healthcare?

• What about the current concern about cosmetics?

excerpted from the Bay Area Women's Journal (BAWJ)

BAWJ:  What is one of the biggest changes you have seen in women’s healthcare?

Dr. Milliken: The biggest change is the recognition that by excluding women from clinical research trials we might be providing ineffective or unsafe care to women.

Women were excluded as subjects because we are more difficult and thus more costly to study, due for example, to daily hormone fluctuations. Historically, the solution was to study only men and then assume the findings applied to women. That reasoning was scientifically flawed. We need to study women to know what works in women.

This began to change in the 1990s; Congresswomen in office at that time really helped bring about change. Another driving force was Bernadine Healy, the first female head of NIH. Studies are no longer funded unless women are represented in numbers large enough to be valid.

Another major change in women’s lives is that we are living longer. Just think, at the beginning of the 20th century the average lifespan for women was 48 years, by the end it was 85. This means women are living a full third of their lives past menopause and we have known very little about health in those added years.

Knowing how women are different from men is essential to understanding prevention strategies, screening and diagnostic testing as well as medical and surgical treatments. This is essential if those added years are going to be long and healthful.

Once we have the new knowledge we must put it into action.  There are two great routes to accomplish this. One is to make sure that the curricula in our health professional schools are up to date so we train our doctors, nurses and pharmacists to be able to take care of the unique needs of both women and men.

Secondly we need to put this new info into the hands of women. This is a most effective strategy because women are extraordinarily thoughtful and savvy consumers of health care.

BAWJ:  What about the current concern about cosmetics?

Dr. Milliken: We are starting a new research and policy program on women’s reproductive health and the environment. There are a number of potential toxins in the environment that we will be looking at and we don’t know what the results are going to be.

It is possible that some cosmetics may be found to be harmful to reproductive health – they have not yet been rigorously tested. The European Union has already restricted over 1,000 chemicals found in personal care products. It is something for women to pay attention to and to go with the safest alternatives.

Read the full article of Dr. Milliken and the Center of Excellence as featured in the Bay Area Women's Journal.

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