What Gets Funded Shapes What We Know: 15 Years of Canadian Women’s Health Research

Abstract Importance Funding of women’s health research has been low, with a narrow focus on what is considered women’s health. Understanding which lifespan stages and areas of women’s health are funded is essential to determine the breadth of women’s health research and identify where gaps in research are concentrated. Objective To examine which lifespan stages and areas of women’s health were more likely to be funded in open Canadian grant competitions. Evidence Review Publicly available funded Canadian Institutes of Health Research (CIHR) Project Grant abstracts from 2009 and 2023 were coded for mention of a hormonal transition period (puberty, menstrual cycle, pregnancy/postpartum, perimenopause/menopause), exogenous hormone use (hormonal contraception, fertility treatments, menopause hormone therapy), and/or a female-specific health condition. Abstracts were also coded for Indigenous health and Two Spirit, Lesbian, Gay, Bisexual, Trans, Transgender or Trans Identified, Queer, Intersex, Asexual, Plus (S2/LGBTQIA+) populations. Remaining grant abstracts were grouped by common theme. Abstracts were analyzed for changes in research representation and funding over time and whether funding was lower than expected based on population prevalence or proportion of the lifespan spent in that stage. Findings Nearly 50% of female-specific research focused on cancers (breast, gynecologic) or pregnancy and did not significantly increase in funding or representation over time. Of the funded grant abstracts that focused on pregnancy, ∼22% examined outcomes pertaining only to the fetus/offspring, not the birthing parent. Over 15 years, 2.37% of all CIHR abstracts over 15 years were devoted to pregnancy, whereas only 0.24% was devoted to other hormonal life stages (menstrual cycles, menopause). For all hormonal transition stages except pregnancy, the proportion of grants and funding devoted to that stage was lower than expected based on the proportion of the lifespan spent in that stage. Conclusions and Relevance These findings reflect the narrow breadth of women’s health, which largely focused on cancers (breast, gynecologic) or pregnancy, rather than being distributed across key life course stages that shape women’s health. To advance science for all, the heterogeneity and complexity in women’s health across the lifespan must be embraced and barriers for women’s health research must be removed. Key Points Question Which areas and life stages of women’s health are most likely to be funded in Canadian open grant competitions, and where are funding gaps concentrated? Findings Nearly half of female-specific grants focused on cancer or pregnancy, with little change over time. Pregnancy dominated hormonal-stage research, often excluding maternal outcomes, while menstrual and menopausal stages were rarely funded. For most life stages, funding was lower than expected based on lifespan representation. Meaning Women’s health research funding remains narrowly focused. Broader, life-course–inclusive investment is needed to address critical gaps and advance equitable health science.