What Regina Benjamin Could Mean to Women's Health

Certainly, health reform will be her top priority, but what about gender and racial disparities?

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Earlier today, President Obama nominated Regina Benjamin to become surgeon general. He pointed out that Benjamin hails from the small Alabama fishing village of Bayou La Batre with a mixture of whites, blacks, and Asians, a "diverse but poor rural community."

Besides describing the down-and-out health clinic she runs—destroyed by two hurricanes and a recent fire—Benjamin recounted her family's sad medical history in a Rose Garden statement following the nomination announcement: a mother who died of smoking-related lung cancer; an older brother, her only sibling, dead from HIV; a father befallen by diabetes and high blood pressure. "My family isn't here today because of preventable diseases," she said.

Like Supreme Court nominee Sonia Sotomayor, who says her Latina heritage will factor into how she rules, Regina Benjamin may put a new imprint on the largely ceremonial position of surgeon general, one that recognizes her experience as an African-American woman. Certainly, she'll help Obama push for health reform, drawing on her practice in a community where some 40 percent of the residents lack health insurance. But I wonder if she'll also put a high priority on addressing the science of racial and gender disparities. Just last week, new research published in the Journal of the National Cancer Institute found that black breast cancer patients had worse survival rates than white patients, despite getting identical treatments and follow-up. Certainly, more attention could be paid to the biological differences among various ethnic groups. I say "ethnic" rather than "racial" because scientists are just beginning to understand how the country your ancestors hailed from—not just your race—may determine the types of diseases you're more likely to get, even certain subtypes of breast cancer.

I'm guessing that she'll address treatment disparities that still plague women and minorities, as well as poor folks, in disproportionate numbers. I recently reported on how women and minorities are less likely than white men to get the appropriate treatment for heart failure. Research disparities make a good target, too. Not enough women are included in clinical trials, and the same goes for African-Americans. Pregnant women are hardly studied at all: Little is known, for example, about how certain medications like antidepressants or antiseizure drugs affect a growing fetus or the pregnant woman herself. In fact, several medical ethicists last week called for the inclusion of pregnant women in the government's National Children's Study, saying that pregnant women are the least studied population in our society. Benjamin's views on this, of course, are still unknown. We'll just have to stay tuned to find out.