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Studying Nurses, Furthering Women’s Health

The year was 1976; women had been using oral contraceptives for about 10 years. Researchers at Harvard Medical School, recognizing there were unknown effects to long-term use of the Pill, planned an investigation of suspected links between oral contraception and certain chronic diseases.

First, however, they needed tens of thousands of women who would commit to being part of a long-term study. What stable population of subjects would faithfully answer very personal questions about their health over time?

The answer: nurses. As medical professionals, nurses could offer accurate responses to detailed health-related questions. With an appreciation for the value of medical research, nurses could be relied upon to commit themselves to a lifelong study that would further the understanding of women’s health issues.

Thus began the Nurses’ Health Study, which along the way has broadened its focus, extending beyond birth control to examine various issues related to women’s health. Every other year since 1976, nurses have completed questionnaires on such diverse topics as diet and exercise, and medication usage.

Nurses who participate in the study do so voluntarily, and their privacy is treated with the utmost respect. Appropriate subjects, solicited through State Boards of Nursing, are identified only by numbers. (Researchers arrange a complex system to ensure no one can match medical information to personal contact information.)

The response of nurses over the past 25 years has been tremendous. The first questionnaire in 1976 was answered by 120,000; the study has boasted an average 90 percent return rate for each survey since.

In addition, many nurses have donated biological specimens for study, including blood and cheek-cell samples. And when the researchers decided to study the effect of selenium on the prevention of certain cancers, more than 68,000 nurses sent in toenail clippings so the physicians could analyze how well their bodies absorbed the mineral.

Over the years, the Nurses’ Health Study also has worked with other research projects to combine resources on specific areas of interest to women’s health. For instance, partnerships have been established with the Framingham Heart Study, one of the first studies to examine coronary disease in women, and with the Iowa Women’s Health Study, which looks at the issue of cancer in older women.

In 1989 , the Harvard researchers began a second version of the Nurses’ Health Study, which now runs simultaneously with the first study. Nurses’ Health Study II follows a new generation of nurses, examining reproductive issues that could no longer be addressed by the original study’s older population. Researchers in the second study also are following the health of the nurses’ children, looking into issues such as how adolescent health is impacted by birth weight, and diet and exercise.

As participants faithfully have answered the bi-annual questionnaires, certain health-related matters specific to nursing also have come to the forefront for further study. The questionnaires now include questions on such topics as care giving, work-related stress, and social relationships. Recently, the researchers have looked at important nursing-career related health issues, such as the link between night-shift work and certain cancers.

In 2001 , Harvard Medical School published a book outlining the important findings and recommendations gathered over the course of the studies. Titled Healthy Women, Healthy Lives, the book offers information on diet and exercise, contraception and childbearing, menopause, and the effects of personal behavior on the prevention of chronic diseases. As one of the largest and longest-running studies of women’s health in the world, the Nurses’ Health Study has had a phenomenal impact on women’s health research.