Improving Medical Practices for Women
Dr. Vanessa Dalton and the Program on Women’s Healthcare Effectiveness Research
—By Veronica Sorter
On Tuesday, November 8th, 2022, the people of Michigan had the opportunity to add the “Reproductive Freedom for All” proposal to the State Constitution. The proposal passed and Michigan’s historical “Prop 3” became law. Although this grants many freedoms, a major area that still needs improvement is the research done on these medical practices for women.
One doctor who is researching these practices in medicine is OB/GYN Dr. Vanessa Dalton.
Her education
Early on in her education, Dr. Dalton had no plans of becoming a doctor. It was not until her senior year of college that it was even a thought. She explains that she planned on majoring in African studies, but realized that she was not that strong of a writer in humanities. Math and science were just naturally easier for her, so she switched to a major in chemistry and kept African American studies as her minor. For Dr. Dalton, it wasn’t clear to her how she could combine her passion for social issues and injustice with chemistry. So, to ensure she was still able to practice her passion for social injustices in a science-based field, she chose medicine, ultimately leading her to research underrepresented people. She went to medical school at the University of North Carolina and then completed her residency here at the University of Michigan.
Dr. Dalton’s program
Dr. Dalton is the founding director of the Program on Women’s Healthcare Effectiveness Research, or PoWHER (pronounced like power) for short, made up of staff from the Department of Obstetrics and Gynecology at Michigan Medicine. PoWHER conducts research, using different techniques, in hopes of improving the healthcare field for women: specifically, quality, access, and affordability. It also provides research opportunities to the University of Michigan’s Fellowship in Family Planning, as well as working with the Institute on Women and Gender, the Institute for Social Research, and the Institute for Healthcare Policy and Innovation.
Dr. Dalton describes PoWHER as “a group of people that study process and the health system and policy and what roles those factors have on health outcomes.” These factors are the foundation of medical care and have large impacts on the success of patients’ health.
While interviewing Dr. Dalton, she shared a funny story about how the acronym “PoWHER” was created. She explained that the faculty had a competition to come up with an acronym, and out of a predominantly female group of staff, the only male member came up with PoWHER.
How PoWHER came to be
The creation of PoWHER happened because Dr. Dalton noticed a lack of research on healthcare methods, specifically in Obstetrics and Gynecology. She mentioned that a lot of people studied things like proteins, medical conditions, and even the physiological aspects of labor, but no one studied health care for women as a whole; and how needs changed based on social determinants. Dr. Dalton stated, “In women’s health in particular, and OB/GYN specifically, there aren’t that many people that studied health care.” Following this observation, she built PoWHER in the obstetrics and gynecology department at Michigan Medicine to help overcome this research deficit.
Research and goals
At PoWHER, most of the research conducted is not done in a typical personal-patient clinical setting—the type of research that most people may think of when they think of medical research. Instead, they, “leverage” existing data and look at how different state policies or hospital policies affect patient outcomes; they are researching the “big picture.” In particular, PoWHER looks at the disparity in outcomes and how factors like income, race, or geography affect them. For example, one study conducted by PoWHER looked at different prenatal care requirements among 17 different countries. They compared socioeconomic status and geographic location and it affected the prenatal requirements. The study found that family planning and housing security were commonly left out in prenatal care education.
In the future, Dr. Dalton hopes to look at a broader life span in PoWHER’s research. She says that right now, about 80% of their research focuses on early life or the people who are typically at “reproductive age.” For instance, much of the research has been conducted on prenatal and postpartum women. To add to that, Dr. Dalton also hopes to be able to translate the inclusivity of their research into the program. Since some of their work studies people who have a feminine identity but don’t necessarily have female anatomy (or vice versa), she wants to be able to “find the right language to describe themselves” as a group of researchers. This research will help ensure that everyone who has a feminine identity will receive quality care, not just people who are anatomically defined as women.
Dr. Dalton’s achievements
Along with her accomplishments of founding PoWHER, Dr. Dalton also received the University of Michigan’s MICHR Distinguished Clinical and Translational Research Mentor Award in 2017 and received the endowed Timothy R. B. Johnson MD, Global Women’s Health Professorship in 2019. The University of Michigan states this Professorship is “awarded to an individual who shares in the commitment of being a voice for women throughout the world; a voice for them in important conversations that impact their care and a commitment to fighting for their reproductive rights and improved health wherever they live.” She has also conducted two clinical trials and is an author or co-author of 352 medical publications. Some of her work includes publications on early pregnancy loss, the effects of abortion bans, and pregnancy outcomes for transgender people.
PoWHER in Ann Arbor and beyond
PoWHER is not only helping the people of Ann Arbor, it’s helping women everywhere. Dr. Dalton’s research shows how the medical field needs to be improved to help women of all backgrounds. This research is helping us understand fields of medicine that have been neglected in the past. By conducting studies that compare healthcare and medical practices in different countries, cultures, and backgrounds, the research expands far beyond the city limit. The power of PoWHER!
Feature Photo: Von Voigtlander Women’s Hospital in Ann Arbor, by Veronica Sorter