Examining structured representation and designated fiscal support for women's health in the U.S. Department of Health and Human Resources.

The United States Department of Health and Human Services (DHHS) is committed to monitoring, protecting, and improving the health of the nation. We examine the structure established within DHHS to address the health of women; review initiatives generated by women's health offices, advisors, and coordinators within DHHS agencies; and contrast the budgets provided to women's health offices with those of the parent DHHS agencies. Data were obtained from DHHS and other public government documents, DHHS websites, contact with agency personnel, and literature review. Significant clinical, research, and educational efforts important to the health of women have resulted from representation for women's health within the DHHS. Yet, structured representation and designated fiscal support necessary to maintain and expand these efforts are variable and not guaranteed across agencies. Only one Office of Women's Health and one Senior Advisor position are supported by statute, one director's position for an Office of Women's Health has been downgraded in government rank, and two other women's health positions had their reporting structure changed, making them less centrally located in their respective agencies. During the last 4 years of unprecedented growth within DHHS, only one Office of Women's Health received consistent increases in budgeted dollars. There is a clear need to support and stabilize representation for women's health within DHHS in order to maintain current productive efforts, coordinate existing and developing initiatives, and integrate new topics of importance to women's health into each agency. This can be accomplished by establishing structured offices by statute and ensuring future funding commensurate with the mission of each office.