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APPENDIX A

WOMEN’S HEALTH EVENTS OF THE 20^th CENTURY

1906- The Food and Drug Administration Established: This agency is established by the Pure Food and Drug Act to regulate the safety of foods and medicines, giving women new support in protecting themselves and their families.

1908- Protecting Working Women and Children: The Supreme Court upholds the right of states to ensure the safety of working women and children who had not been included in labor union protection in Muller vs. Oregon.

1912- The Federal Children’s Bureau Established: One of its first tasks is to write and distribute two public health pamphlets directed at women consumers: Prenatal Care and Infant Care. By century’s end, women were able to access health information through thousands of self-help books, Internet web sites, and government publications.

1913- The First Public Discussion of the Word Cancer: A Ladies Home Journal magazine article entitled “What Can We Do About Cancer?” was published. The American Society for the Control of Cancer is formed that same year.

1915- Radical Mastectomy Proven Effective for Breast Cancer: This disfiguring surgery, developed by Dr. William Halstead, becomes the standard of care for women with breast cancer.

1916- First Birth Control Clinic Opens: Margaret Sanger and her sister Ethyl Byrne opened a birth control clinic in Brooklyn, New York. The authorities shut it down ten days later under the Comstock Law. In those ten days, nearly 500 women came in for help and advice on contraception. The Comstock Law, passed in 1873, defined information on birth control and contraception as obscene and outlawed its distribution.

1921- The Sheppard-Towner Act: This law provides federal funding (with matching state funds) to reduce maternal and infant mortality. It was fiercely opposed by the American Medical Association (AMA), and some members of Congress as too socialistic. Some of the influential pediatricians in the AMA who were in favor of the bill broke off from the organization and created the American Academy of Pediatrics. The law is allowed to lapse in 1929.

1929- Selling Mrs. Consumer Published: This popular book was written by a female home economics and marketing expert, and highlighted women’s roles as the primary household consumers.

1933- Sodium Pentathol Introduced as Anesthesia for Childbirth: This drug replaces opiates and other sedatives that had a longer lasting effect on mother and baby, and meant that more women could have pain relief during labor and delivery.

1935- Title V of the Social Security Act: This maternal and child health legislation authorized grants-in-aid to states to fund maternal, infant, and child health programs, including services for crippled children.

1935- Cure Found for “Childbed” Fever: Sulfanomides were introduced as a cure for puerperal fever, contracted from unsterile conditions during childbirth and a leading cause of maternal death.

1936- U.S. vs. One Package: Margaret Sanger and the National Committee for Federal Legislation on Birth Control win a judicial decision (U.S. vs. One Package) that exempts doctors from the Comstock Law restrictions on dissemination of contraceptive information.

1938- The Food and Drug Administration’s Authority Broadened: The agency is given authority to regulate cosmetics and medical devices.

1942- Planned Parenthood Named: The American Birth Control League changes its name to Planned Parenthood, over the objections of its founder, Margaret Sanger. Planned Parenthood was believed to be a more acceptable name to mainstream America.

1943- Emergency Maternity and Infant Care Program: This program provides free and complete maternity care to the wives and infants of men serving in the four lowest grades of the military during World War II. The program ended in 1949.

1950- The American Cancer Society Begins Promotion of Breast Self-exam: There is still no scientific proof by century’s end, that it actually improves breast cancer survival rate.

1953- The Kinsey Report Published: Sexual Behavior in the Human Female was published by researcher Michael Kinsey, as a companion to the 1948 Report, Sexual Behavior in the Human Male. More than 5,500 interviews with women showed that many enjoyed having a sexual life. This provoked widespread controversy, and altered the perception of women’s sexuality. Later analyses have questioned much of Kinsey’s methodology.

1956- La Leche League Formed: This group is started by seven mothers to promote breastfeeding after it falls out of fashion in the 1920s. It is not until the year 2001 that the U.S. Department of Health and Human Services releases its first policy promoting breastfeeding, calling it the best source of infant nutrition.

1956- Dependents Medical Care Act: This program provided Government-sponsored health insurance (CHAMPUS) for the dependents of members of the Armed Forces.

1959- The Barbie Doll Created: This was the first popular doll to be shaped like a woman, with an impossible-to-attain figure. Little girls everywhere loved the doll, but critics claimed it encouraged girls to adopt unhealthy habits to stay unreasonably thin, and set an unrealistic standard of beauty for decades to come.

1960- The FDA Approves the Birth Control Pill: The Pill gives women unprecedented sexual and reproductive freedom. The controversy over its approval eventually leads to the first packaged insert that explains the risks and benefits of a medication. By the year 2000, it is still the most popular form of birth control.

1961- Worldwide Alert on Thalidomide: The efforts of a woman scientist, Frances Kelsey, M.D., Ph.D., led the FDA not to approve thalidomide for use in the U.S., saving countless numbers of babies from the severe deformities seen among babies in Europe. Worldwide alarm led to legislation in the United States in 1962 that gave the FDA new authority to require that drugs must be shown to be effective prior to approval, and also required manufacturers to report unexpected harm (adverse events).

1965- Birth Control Made Legal for Married Couples: In Griswold vs. Connecticut, the Supreme Court overturns one of the last state laws to prohibit the use of contraceptives by married couples.

1965- Medicaid and Medicare: Medicare is created as a national program to provide federal coverage for health services to individuals aged 65 and over, a population that is disproportionately female. Medicaid was passed as part of President Lyndon Johnson’s War on Poverty and provides medical assistance to poor families with dependent children, low-income elderly, the blind, and people with disabilities. It was designed to be administered by each of the 50 states.

1965- Family Planning Funds: As part of the War on Poverty, the Office of Economic Opportunity makes available federal funding for family planning for low-income women.

1970- Our Bodies, Ourselves Published: This breakthrough book was produced by the Boston’s Women’s Health Book Collective. It is written by women (not medically trained) to teach other women about their bodies, and encourages them to be critical health care consumers.

1970- Medical Schools Sued for Gender Discrimination: In 1965, only 7 percent of medical students in the U.S. were women. The Women’s Equity Action League sued most medical school in the nation to correct this inequity. By the late 1990’s nearly half of medical students are women. Still, by the end of the century, only eight U.S. medical schools are headed by women deans.

1970- Title X Family Planning Funding: This law establishes a federally-funded program nation-wide to provide family planning services to low-income women

1971- The National Cancer Act Passed: This law, signed by President Richard M. Nixon, greatly expanded funding for cancer research.

1972- Title IX Revolutionizes Athletics for Women: Title IX of the Education Amendments of 1972 prohibits sex discrimination in all educational programs receiving federal funding.

1973- Roe vs. Wade: While a woman’s right to abortion is not explicitly found in the Constitution, and while the practice of abortion is opposed by many Americans, the U.S. Supreme Court held in this landmark case that limiting a woman’s right to terminate her pregnancy violates the Due Process clause of the 14th Amendment.

1974- The Food and Drug Administration Outlaws the Dalkon Shield: This brand of intrauterine device is ruled to be unsafe due to increased complications with pregnancies and a higher risk of pelvic inflammatory disease.

1976- Hyde Amendment: This amendment banned the use of Medicaid funds for abortion services, unless a woman’s life is in danger. The law was broadened in 1994 to allow Medicaid coverage for abortion in cases of rape or incest.

1978- Pregnancy Discrimination Act: This law prohibited sex discrimination in employment on the basis of pregnancy, childbirth, or related medical conditions.

1979- Patricia Harris, an African American, is appointed as the first female Secretary of Health, Education, and Welfare. Later that year, Congress established a separate Department of Education and Harris’ department became the Department of Health and Human Services. Harris had been a professor at Howard University Law School and a businesswoman before her appointment.

1980- Surgeon General’s Report on Women and Smoking: This report documented the growing number of women smokers and warned that if the trend was not reversed, smoking related diseases in women will reach epidemic proportions. By century’s end, the prophecy was realized. A new Surgeon General’s Report on Women and Smoking, written in 2000, revealed that since the release of the 1980 report, three million women had died prematurely from smoking related illnesses.

1981- National Black Women’s Health Project: This organization was established by Byllye Avery to improve the health of Black women by providing wellness education and services, health information, and advocacy.

1981- Maternal and Child Health Services Block Grants: This law consolidated programs for maternal, infant, child, and adolescent health at the State level, and transferred funding directly to the states in a block-grant format.

1983- The Public Health Service’s Task Force on Women’s Health Established: This task force signifies a new level of federal commitment to women’s health issues.

1983- The Komen Race for the Cure is Established: The Race for the Cure was established by Susan Goodman Komen to raise money for breast cancer research, education, screening and treatment programs. The five-kilometer race began as a single event in Dallas, Texas, and by century’s end became a series of more than a hundred races in the U.S. and around the world, with 69,000 runners and walkers, raising three million dollars annually.

1983- Margaret Mary Heckler is named Secretary of the Department of Health and Human Services: She served 16 years in the United States House of Representatives as a Republican from Massachusetts. As Secretary, Heckler introduced a system of set rates for Medicare payments to hospitals. She also helped to win Congressional approval of a law that helped ensure payment of court-ordered child support.

1985- Lumpectomy Declared As Effective Breast Cancer Treatment: Studies are released that show lump removal combined with radiation therapy is as effective a treatment as mastectomy for many breast cancers.⁷⁹

1986- New Policy on Women’s Health Research: The National Institutes of Health established a policy to increase participation in women’s health research, but in 1990, an Institute of Medicine Report said NIH was not moving quickly enough to implement this policy.

1987- Lung Cancer surpasses breast cancer as the leading cause of cancer death in women.

1989- Women’s Health Equity Act: This law, introduced by the Congressional Caucus for Women’s Issues, calls for an increased focus on women’s health through research, services, and prevention activities.

1990- Dr. Antonia Novello is Confirmed as the First Woman Surgeon General of the United States: She is also the first minority to be appointed to this position.

1990- Office of Research on Women’s Health is Established: This office was established at the National Institutes of Health to stimulate and serve as a focal point for women’s health research. Public hearings and a scientific workshop held at Hunt Valley, Maryland, produced the report “The National Institutes of Health: Opportunities for Research on Women’s Health,” which served as a blueprint for research at the NIH.

1990- Society for the Advancement of Women’s Health Research Founded: This organization’s mission was to improve the health of women through research.

1990- Breast and Cervical Cancer Mortality Prevention Act: This Congressional act provided mammograms and pap smears to underserved women (including low-income women, older women, and minority women).

1991- Office on Women’s Health Established: The Office on Women’s Health was established at the U.S. Department of Health and Human Services during the presidency of George H.W. Bush, to better coordinate women’s health activities, programs, and research throughout the U.S. Public Health Service.

1992- Mammography Quality Standards Act: This law was designed to set national standards and a uniform system of quality control for mammography clinics across the country.

1992- Infertility Prevention Act: This Act provided additional funds to establish screening, treatment, counseling, and follow-up services for sexually transmitted diseases that could lead to infertility in women if left undiagnosed and/or untreated.

1993- NIH Revitalization Act: This law requires the inclusion of women and members of racial and ethnic minority groups in all federally-funded population-based studies.

1993- Family and Medical Leave Act: This law provides employees with the right to take up to 12 weeks of unpaid leave during a 12-month period for family or medical reasons without the threat of having to leave their job permanently.

1993- National Action Plan on Breast Cancer (NAPBC) Established: This public-private partnership was established by President William J. Clinton in response to a national petition drive (2.6 million signatures) coordinated by the National Breast Cancer Coalition. Its goal was to establish a comprehensive national plan to address the breast cancer epidemic. After providing leadership and sparking interest on issues from genetic testing to public education and clinical trials, the work of the NAPBC was handed over to private groups and the National Cancer Institute in 2000.

1994- Violence Against Women Act: This Act defined new federal crimes of violence against women and enhanced penalties to combat sexual assault and domestic violence.

1994- Offices of Women’s Health established at the Food and Drug Administration and the Centers for Disease Control and Prevention.

1994- BRCA1 and BRCA2 Identified: The DNA sequences of two genetic mutations linked to breast cancer are discovered, leading to the possibility of genetic testing for high risk women.

1994- Women of Childbearing Years Can Participate in Clinical Trials: The FDA issues guidance lifting the ban on inclusion of women with childbearing potential from early clinical studies (Phase 1 and early Phase 2). This ban (which had been in place since 1977) had been a significant barrier to women’s participation in clinical trials.

1996- The Personal Responsibility and Work Opportunity Reconciliation Act of 1996: A provision of this bill, Support for Families Transitioning into Job, was designed to help more mothers move into jobs. The law also guaranteed that women on welfare would continue to receive health coverage for their families, including at least one year of transitional Medicaid when they leave welfare for work.

1996- National Centers of Excellence in Women’s Health Designated: The DHHS Office on Women’s Health designated the first six National Centers of Excellence (CoEs) at academic medical centers around the country. These were model “one-stop-shopping” health programs designed to integrate women’s health research, clinical services and public education. By century’s end, there were fifteen CoEs, and three National Community Centers of Excellence in Women’s Health, with more planned for the future.

1996- Women’s Health in the Medical School Curriculum Published: This first guideline for including women’s health issues in medical school curriculum was published by the Office of Research on Women’s Health, the Health Resources and Services Administration, and the DHHS Office on Women’s Health.

1997- An Agenda for Research on Women’s Health in the 21st Century: This document expanded the Hunt Valley vision for women’s health research in the broader context of cultural and ethnic origins, geographic location, and socioeconomic strata.

1997- FDA Office of Women’s Health Launches “Take Time to Care Campaign”: This three year effort reached over 26 million Americans with the message “Use Medicines Wisely.” Done in partnership with the National Association of Chain Drug Stores and more than 80 other participating organizations, this campaign targeted the issue of preventing adverse drug reactions and medication errors.

1998- Gender Differences on Susceptibility to Environmental Factors Published: This Institute of Medicine Report encouraged more research into how certain factors, such as genetics and hormones, affect susceptibility to environmental influences in health status.

1998- The National Women’s Health Information Center (NWHIC) Launched: The DHHS Office on Women’s Health launched the first commercial-free combined Web site and toll-free phone number for women’s health information. By century’s end, NWHIC was receiving more than four million “hits” and several hundred thousand “user sessions” a month.

1999- Contraceptive Coverage in the Federal Employees Health Benefits Program: This law was attached to the 1999 Treasury, Postal Service, and General Government Appropriations Bill to offer contraceptive coverage to women insured through the Federal Employees Health Benefits Program.

1999- Women’s Health in the Dental School Curriculum Published: The first women’s health curriculum recommendations for dental schools were released by the NIH Office of Research on Women’s Health and the Health Resources and Services Administration.

1999- Lesbian Health: Current Assessment and Directions for the Future: This Institute of Medicine report recommended more research into health issues that might be unique to lesbian women.

2000- The Breast and Cervical Cancer Prevention and Treatment Act: This Congressional Act is designed to enable states to provide treatment services to eligible women through the Medicaid program.

2000- Exploring the Biological Contributions to Human Health: Does Sex Matter?: This Institute of Medicine report was initiated in 2000. It concluded that “every cell has a sex” and that medical research should focus more on sex differences and determinants on the biological level.

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Last Updated: June 2002