By now, you've heard the story: Susan G. Komen for The Cure, a once well-regarded breast cancer awareness and research organization, became a pariah seemingly overnight when it decided to stop funding breast cancer screening to low-income women through Planned Parenthood. The decision was a debacle. And now you might think twice about wearing that little pink ribbon on your lapel. But the organization has reversed its decision and let go of the executive behind that decision, and given the public outcry over this fiasco, it's not likely to mess with Planned Parenthood ever again.
Lost in the condemnation over Komen's unfortunate mistake is a conversation about the organization's broader goals and responsibilities -- the conversation about its complicated role in women's health.
For far too long, medicine and public health were dominated by men. When the Komen foundation was founded in 1982, for example, fewer than 1 in 6 American doctors was a woman. It's almost impossible to overstate the impact that that gender gap had on both the way the health community thought about women's diseases and the way healthcare was delivered to women. Diseases like breast cancer, cervical cancer, and complications of pregnancy were seen as "less important" because they only affected women. What's more, the deeper meanings, symbolism, and psychosocial impacts of these diseases were completely ignored.
That's the historical context within which we have to understand the importance of this organization. It shined a spotlight squarely on women's health and helped to kick-start a broader conversation. Growing into a multi-billion dollar enterprise, it painted everything with its trademark pink -- from Pink Grapefruit Tic-Tacs to the cleats of NFL football players. Komen generated needed awareness about the importance of early detection, and raised millions of dollars to fund important breast cancer research.
But Komen was so successful that it made breast cancer synonymous with women's health, and that's a problem.
Why? Because although a serious disease, in terms of morbidity and mortality, breast cancer isn't the most important disease among women. Women who die of cancer, for example, are more likely to die of lung cancer. In fact, lung cancer takes nearly twice as many women's lives as breast cancer does. And the #1 killer of women isn't even cancer, it's heart disease, which claims the lives of nearly six times as many women as breast cancer. And the leading cause of disability among women? That's depression. Again, not breast cancer.
The problem with organizations like Komen is that their scope doesn't scale with their success. The organization that started as one woman's goal to raise awareness and funds for the fight against the disease that took her sister's life has transformed, like it or not, into the flag bearer for women's health.
But rather than adapt to its de facto role, Komen has remained myopically focused on one, and only one disease. Therefore, while its expert marketing has been a boon for breast cancer awareness, it has had the detrimental effect of redefining the women's health conversation around those diseases, like breast cancer, that are unique to women, rather than those diseases from which women suffer most --relegating the conversation about women's health to a few exclusively female body parts.
Why should "women's health" include diseases that also affect men? Because diseases like heart disease and depression have different causes and consequences among women. What's worse, we know substantially less about how these diseases work, what brings them about, their downstream effects, or how to treat them in women. And organizations dedicated to raising awareness and funds to address these crucial issues find themselves consistently overshadowed by a giant pink balloon --because of Komen's marketing success, they have a hard time branding themselves as the legitimate women's health initiatives they really are.
As Komen performs the requisite housecleaning that should ensue after a debacle of this magnitude, now is the ideal time to remind the organization that its responsibilities to women's health extend beyond breast cancer. Otherwise, the women's health agenda will have found itself suffocated, choked by that ubiquitous pink ribbon.
Photo Credit: Fifth World Art