The COVID-19 pandemic triggered a 25% increase in prevalence of anxiety and depression worldwide, with young adults and women hit the hardest, according to a scientific briefing released by the World Health Organization. Yet there’s still much that’s not understood about women’s health research and how it impacts their mental and physical health.
To help close the knowledge gap, the University of Colorado Anschutz Medical Campus has put a stake in the ground to prioritize mental health.
Using a portion of The Anschutz Foundation’s historic $120 million gift to CU Anschutz in 2018 to invest in top talent and future innovations, the Ludeman Family Center for Women’s Health Research has established an endowed chair in support of research dedicated to women’s mental health. In partnership with Neill Epperson, MD, Robert Freedman Endowed Professor and Chair of the Department of Psychiatry, the Ludeman Center recruited an outstanding leader, Tracy Bale, PhD, to increase the center’s expertise in women’s health and sex differences research.
“We could not be more thrilled to have partnered with the Ludeman Center to bring Dr. Bale to CU,” Epperson said. “Her research on the preconception and prenatal origins of health and disease has galvanized our understanding of how risk factors for mental illness and other stress-related disorders can be passed from one generation to the next.”
‘Opening a new chapter in women’s health’
Bale joined CU Anschutz in July 2022 to serve as The Anschutz Foundation Endowed Chair in Women’s Integrated Mental and Physical Health Research, professor and director for InterGenerational Stress and Health and director for Sex Differences Research in the CU Department of Psychiatry. In these roles, she continues her work building translational research and community engagement centered around women’s mental health and the impact of stress and trauma across the lifespan.
“The Anschutz Foundation believes that the health and wellness of all people is improved by understanding the health differences between men and women,” said Ted Harms, director of The Anschutz Foundation. “We are proud partners in bettering human health and paving the way for a new frontier of healthcare.”
“Thanks in large part to The Anschutz Foundation’s investments, CU Anschutz has become a magnet of talent and has set the example of what transformative philanthropy can do,” said Judith Regensteiner, PhD, director of the Ludeman Center and the Judith and Joseph Wagner Endowed Chair in Women’s Health Research. “With the recruitment of Dr. Bale, we have increased our expertise at the intersection of physical and mental health, opening a new chapter in women’s health research.”
Understanding health sex differences
Bale, a longtime advocate of women’s mental health research and its role as a critical component of overall health, said she sees her CU appointment as more than a personal vested interest in women’s health and sex differences. To her, the science has an intrinsic value in human health, she said.
“With the recruitment of Dr. Bale, we have increased our expertise at the intersection of physical and mental health, opening a new chapter in women’s health research.” – Judith Regensteiner, PhD
“As scientists, we have a responsibility to take the information we learn and get it back out to the people whose tax dollars paid for us to learn something,” she said. “We want our work to have meaning and impact. If we get out into the community and engage with the people we’re meant to help, it will deepen our understanding of health, medicine and science.”
The Ludeman Center is regarded as one of the best places nationwide to conduct research that includes women and considers the distinct but linked concepts of sex and gender differences – particularly in cardiovascular disease, diabetes and mental health – as it impacts physical health. With Bale’s endowed chair appointment, she will focus on the connection between mental health and physical health to better understand sex differences.
“Men and women are very different in how they respond to medication, how they metabolize medication and their risk factors for different diseases across the lifespan,” she said. “When it comes to mental health, we need to look not just under the lamp post but outside it to make new connections between the brain and the body.”
Enhancing the science; closing the gaps
Currently, there are no known biomarkers of mental health, which makes connecting the dots between mental and physical health even more challenging. “We need to better understand the biology,” Bale said. “We don’t just need the next great drug. We need to understand how that drug works, how it can change your mood and who the drug will work best for.”
Bale specializes in traumatic events in children and how it can impact their mental health as adults. When talking about the long-lasting mental health effects of stress from COVID-19 including social isolation, it can be especially bleak for children of vulnerable populations who live in under-resourced areas, she said.
“There’s a huge equity piece tied to mental health,” she said. “When you take kids who are already behind and now you make them more behind because of external circumstances with the pandemic when schools were closed and their caretakers weren’t at home and they had no internet access, there is further trauma imbedded by these accumulating experiences, not to mention the impact of isolation.”
Scientists can learn a great deal from stress and adversity when examining its effects at the germ cell level and the mechanisms involved in altering brain development, Bale said. Her hope is to identify biomarkers of disease risk and resilience, especially in vulnerable populations.
Identifying adversity; offering support
“One reason why I was so interested in coming to CU was the opportunity to engage with the Ludeman Center and campus programs having a direct impact on our local community,” Bale said. “Vulnerable communities need support, advocacy and connection, and in order for these communities to get the resources they need, we have to start at a very young age and look at all the factors we know to be important for mental health.”
In an adverse childhood experiences (ACEs) study by Kaiser Permanente, epidemiological evidence showed that the more adversity someone experienced, the higher the health risks for diseases such as obesity, diabetes, hypertension and mental illness. Out of 10 adverse childhood experiences such as the death of a loved one or physical abuse, people were more at risk of developing severe health problems if they had four or more adverse experiences. Genetics also play a large role for families of certain backgrounds who may develop varying mental and physical health risks.
“As scientists, we have a responsibility to take the information we learn and get it back out to the people whose tax dollars paid for us to learn something.” – Tracy Bale, PhD
“There’s a lot of biology coming back to the science that we need to understand when it comes to timing of stress and adversity,” she said. “Are there biomarkers we can define? Can we take what we already know about the differences in male vulnerability in gestation and female vulnerability outside the womb to identify potential risks for neurodevelopment disorders? There are key differences related to sex chromosomes but also to hormone changes across the lifespan, especially when we look postpartum and at women transitioning to menopause.”
Building community; making an impact
In the short time Bale has been at CU Anschutz, she has made huge strides in building relationships with research colleagues and school and community partners. Her goal is to complete a “listening tour” during her first year to find out what mental health groundwork has already been established that could benefit from more reflection and integration of women’s health.
“A significant portion of the funding from The Anschutz Foundation to support my position is tied to outreach and engagement,” she said. “I’m very interested in building richer, community-based programming for vulnerable populations who could really benefit from understanding women’s health.”
There is also opportunity for Bale to engage with policymakers, local schools and city and community leadership on the importance of women’s health research. The more occasions for research mentorship and community involvement, the more visible the Ludeman Center becomes as the go-to center for information on women’s health research.
“You can’t have impact if you don’t have resources to make said impact,” she said. “The dedicated resources provided for this endowed chair position is what makes this type of mental and physical health research, training and community-based engagement possible.”
Guest contributor: Danielle Davis, Office of Advancement.