The science of women’s health

From the beginning, women at St. Paul’s have been a driving force behind compassionate care and medical innovation. True to the mission of the Sisters of Providence, women continue to lead the way to a bold, bright future at the new St. Paul’s at the Jim Pattison Medical Centre.

Female physicians, researchers, clinicians, nurses, and other health professionals are collaborating with each other, and with patients, to provide groundbreaking care for women across Providence Health Care (PHC).

Dr. Karin Humphries is an international leader in women’s heart health. She’s the scientific director of the Centre for Improved Cardiovascular Health at the Centre for Health Evaluation and Outcome Sciences (CHÉOS) and an epidemiologist with a passion for data – and for translating that data into improved diagnoses and treatments.

Humphries postponed her retirement last year after receiving a five-year Canadian Institutes of Health Research (CIHR) grant for a clinical trial to look at sex and gender differences in cardiac events. Her “CODE-MI” study focuses on cardiac troponin, a biomarker used to diagnose heart attacks. Women produce less of this than men even if the heart attack is of the same severity. As a result, they may be improperly diagnosed and treated. “With this lower biomarker and data from 30 hospitals across eight provinces, we hope to show that a system-wide change in practice can improve care and outcomes for women with cardiovascular disease,” Humphries says.

This is part of a larger effort in cardiology to narrow the sex and gender gap in cardiovascular disease. The results of the gender gap can be devastating: in one study, early heart attack symptoms were missed in 78% of women.

In the past, studies and trials had few, if any, women enrolled in them, and researchers assumed that what works for men should work for women. “We now know this is not always true,” says Humphries. “Patients have been key partners in my work. And with the improved integration between research and clinical care at the new St. Paul’s, we can really move this agenda forward.”

Dr. Kate Shannon is the executive director of the Centre for Gender & Sexual Health Equity (CGSHE) at PHC and the Canada Research Chair in Gender Equity, Sexual Health and Global Policy, where she researches gender equity, sexual and reproductive health, and policies and practices that reduce systematic barriers to care for marginalized communities.

Although women’s health and gender equity have received increasing national and international attention, Shannon says that many communities still face systemic barriers to safe, inclusive, and essential gender, sexual, and reproductive health services. These groups include people who are homeless and precariously housed, Indigenous and other racialized communities, migrant and refugee communities, LGBTQ2S+, and survivors of gender-based violence.

Formally established in 2018 as one of five academic centres at PHC, CGSHE is “a testament to the commitment of senior leadership to the critical priorities of women’s health and gender equity at St Paul’s, in BC, and across Canada,” Shannon says.

“Our work highlights the complex, interconnected ways that gender inequities shape health access and outcomes and the urgent need to advance gender-transformative health policy and practice.”

The new St Paul’s at the Jim Pattison Medical Centre will provide a critical space for CGSHE as a leading global academic hub that promotes and expands the hospital’s research, policy, and clinical practice in women’s health and gender equity.

Dr. Jasmine Grewal is the director of St. Paul’s Cardiac Obstetrics Clinic – the first program of its kind in western Canada and the only hospital in BC that offers specialty care to women who are at high risk of developing heart complications during pregnancy. Grewal collaborates with a multidisciplinary team that includes cardiologists, obstetricians, anesthesiologists, and nurses with expertise in pregnancy and heart disease to ensure that a patient’s journey to motherhood happens as safely as possible.

Pregnancy in women with heart disease can cause serious, sometimes life-threatening complications. Together with a pregnancy and heart team in Toronto, Grewal has published key research to improve patient care. Next steps include investigating interventions that improve pregnancy outcomes in the cardiac population, with St. Paul’s funding a $250,000 grant to further Grewal’s research into pregnancy and congenital heart disease.

“Childbearing is a key consideration in many women’s lives,” says Grewal. “They need to know if it’s safe to get pregnant, if they will require close follow-up, if they’re putting themselves at risk.” She adds, “We often work with women who didn’t think they could ever become pregnant. It’s so rewarding to be part of that.”

At the new St. Paul’s at the Jim Pattison Medical Centre, opportunities to enhance cross-specialty collaboration are being baked right into the design. Adjacencies between researchers, patients, and frontline medical staff will further expand and elevate the work of all our clinicians and researchers. “We’re leading the way,” Grewal says. “And as women, our voices are being heard.

Photography by Jeff Topham

Help us advance crucial research and care for women’s health. Make a gift to support these areas at donate.helpstpauls.com/heart, donate.helpstpauls.com/CGSHE and donate.helpstpauls.com/cardiac-obstetrics.