Wellness Brands Respond to Inequity in Women’s Health Research – WWD

When Devin McGhee Kirkland, cofounder of adaptogenic wellness brand Deon Libra, received the clinical testing results for the brand’s hero topical product Big Up Body Glaze, $63, she was surprised. The participants were all white men between the ages of 50 and 65. She immediately told the team, “Go back and do it again because that’s not my target market.” 

McGhee Kirkland founded her wellness brand after losing her father to a stress-induced heart attack and discovering that Black people are disproportionately affected by stress. That assessment is backed up by data. According to Mental Health America, Black adults “are more likely to have feelings of sadness, hopelessness, and worthlessness,” compared to their white counterparts. While McGhee Kirkland had to redo her clinical testing to reflect the brand’s audience, her experience is not uncommon. It is pervasive across brands’ clinical trials and within the traditional health care system. 

Women and minorities were not required in clinical research until 1993 when Congress passed the National Institutes of Health Revitalization Act. Prior to that, females were considered small versions of men for the sake of findings. While they are included now, most clinical research is still conducted on a relatively homogenous group. Typically the number of women included in clinical research is slim and the number of women of color is even smaller, resulting in products and drugs not analyzed fairly for all people. 

For example, a study from Cell Reports Medicine shows that between 2017 and 2020, 2 percent to 5 percent of participants in oncology trials were Black and 4 to 6 percent were Hispanic or Latinx; women in total accounted for less than half of all participants. Furthermore, according to research published in the Journal of the American Medical Association, between 2015 and 2019, Black women accounted for 6 percent of participants in cardiovascular studies. This is pervasive across categories, whether it be pharmaceutical drugs, skin and body care products, injectables and fillers or mental health. 

“It’s estimated that we’re still underrepresented in three out of every four clinical trials and then when you look at minority data, it’s even worse,” said Dr. Somi Javaid, board certified OB-GYN and founder of HerMD, a clinic focused on women’s health. “Some of it has to do with the fact that distrust of the medical system is more pervasive in minority groups. Historically, it’s because of the way they’ve been treated by the medical system.”

Digging deeper into the statistics reveals that the amount of research into women’s health specifically is even smaller. According to the National Institutes of Health, clinical research for conditions that predominantly affect women is widely underfunded, especially in comparison to those which only affect men. 

“The reason that women’s health care is where it’s at is because of lack of data, lack of funding, lack of female decision-makers, so even though we outnumber men in the health care workforce, we don’t outnumber them in decision-making groups,” said Javaid. 

McGhee Kirkland agreed. “The inequity in health with women and with Black people, people are talking about it,” she said. “The issue is nobody’s doing anything about it.”

Without taking action, this research gap can lead to delayed diagnoses and adverse results for women and women of color. “By not having the data you may miss a diagnosis now because you may not recognize it in that population because it may present differently,” Javaid said. 

As the health care system seems to slowly prioritize women in testing and research, wellness brands, like Deon Libra, Evvy, The Honey Pot and Mavida have taken matters into their own hands to effect change. 

“There’s this interesting phenomenon in women’s health specifically where start-ups are doing what you would assume the health care and medical and academic institutions would do for us,” said Evvy cofounder and chief executive officer Priyanka Jain.

For Evvy, a vaginal microbiome test and care company, it all goes back to the fact women weren’t included in research until 1993. 

“There’s just so much we don’t know about how health and disease manifests in uniquely female bodies,” Jain said.

This lack of understanding kick-started Evvy’s first product: a Vaginal Health Test, $129, to test the bacteria for common conditions and provide users with one-on-one telehealth care. The brand is offering women and people with vaginas specific treatments, while the traditional health care system may chock symptoms up to a common condition, like a urinary tract infection. Through this model, Evvy is compiling comprehensive data on the vaginal microbiome, as research on women’s health specifically has been slim; thus far, 97 percent of Evvy’s users have opted in to have their data collected. It is the world’s largest data set on the vaginal microbiome, according to the brand. 

This research is also reflective of the U.S. population, unlike most clinical trials. 

“Our patient population reflects the racial diversity of the United States already. What we’re seeing is that we are not only able to offer our services to a wider diversity of people, but that means that the data that we’re collecting on the back-end also reflects that diversity,” Jain said. “What we’re seeing is, unsurprisingly, health and disease look slightly different on different types of people.” 

With this business model, the brand, which recently raised $14 million in a series A round, is also launching sexually transmitted infection testing and care, and plans to launch additional offerings in the future to continue to close the research gap. 

The research gap isn’t unique to traditional health care. It also affects the beauty category, most notably fillers and injectables. According to dermal filler Restylane Refyne’s package insert, only 9 percent of participants were Black and 15 percent were Hispanic in the product’s testing. California-based aesthetic nurse practitioner Ginille Brown recognized this inequity and started her own practice, Ginille Beauty Aesthetics.

“There are people who look like me that want to get these treatments and are getting the treatments, and they want to learn more about it… The products that we get launched in the United States that are FDA-approved, I was just finding they weren’t serving my patients of color,” she said, noting she uses most products off-label to better address the concerns of her patients. 

To educate on how she is using the products, Brown has taken to social media, where she’s received an outpouring of support. 

“[Patients say,] ‘I found you on social media. I saw Black and brown girls on your page. I’ve never seen that before. I’ve never seen another Indian woman do treatments. I’ve never seen a Black girl who gets lip fillers,’” she said. “I try to show real patients in my social.” 

While many of the clinical trials predominantly include white women, the industry is slowly responding, according to Brown. For example, she is on the Allergan Aesthetics Equity, Equality, Diversity and Inclusion board aiming to improve research and marketing. 

This research gap has also led to an education gap. With anti-sex-education initiatives coming into play and expected to continue increasing this year, according to the Sexuality Information and Education Council of the United States (SIECUS), females are increasingly misinformed about their bodies and sexual health. This is perpetuated by doctor’s visits becoming shorter and shorter, leaving limited time for questions. According to the National Black Women’s Reproductive Justice Agenda, “youth of color have a disproportionate risk of negative sexual health outcomes.”

Brands like The Honey Pot are leading with accessible and equitable sexual wellness education, while also conducting 130 of its own clinical trials with more than 3,400 diverse participants. The brand has recently doubled down on its back-to-school initiative, with 2,277 Walmart end caps, emphasizing the campaign across social media and email and hosting a tour of historically Black colleges and universities (HBCUs). 

Through this tour, the brand popped up at five schools with a decked-out dorm room, where students could learn about sexual health, stock up on products and ask questions. 

“You’re conditioning them to make sure that they’re taking care of their body and that’s why back-to-school is so important,” said Bea Dixon, The Honey Pot’s founder and CEO, noting the brand employs skits, comedy and diverse imagery across its educational materials to speak to a wide range of consumers.

Mission-driven initiatives like Black Girls Guide to Surviving Menopause have also popped up to provide women’s health education and how it impacts women of color differently. Specifically, research from Study of Women’s Health Across the Nation shows Black women are likely to start menopause earlier and experience more severe symptoms than their white counterparts. 

“We’re providing a political framing around the menopause experience and how it can be exacerbated or stereotyped because of systemic oppression like racism and patriarchy and homophobia,” said Black Girls Guide to Surviving Menopause founder Omisade Burney-Scott. 

Through this project, the brand holds global community events, hosts a podcast and releases digital zines. 

While menopausal education is lacking, especially for women of color, there is also a major gap when it comes to maternal mental health care, which led Dr. Sarah Oreck to start Mavida Health. According to the Maternal Mental Health Leadership Alliance, 50 percent of cases of postpartum depression among women of color go undiagnosed. 

“Black and brown women are disproportionately impacted by maternal morbidity and mortality. Mental health issues are the number-one complication of childbirth, but we don’t know what therapy modalities work for one or what works for the other or what types of treatments are better,” said Oreck. 

Through Mavida Health, which provides mental health clinical care for recent mothers, Oreck is aiming to address this lacking amount of research through its own findings and by partnering with academic institutions in the future. 

With building the platform, making sure providers reflected a diverse group of women was essential. 

“We need the people who are actually doing the work to also reflect that diversity, and then to recruit patients that have that diversity, so we can help those populations in a more nuanced way,” Oreck said. 

While wellness brands are responding to these growing inequities, further support is needed. “If the responsibility is going to be put on the shoulders of small brands, how does the medical world support us, the small brands doing the research, or how do investors and people get behind that part of the business,” said McGhee Kirkland. “Part of the wellness industry should be also on the medical industry. It shouldn’t just be on brands to conduct the research.”