And when one woman uses her power, she can change the course of history.
Melinda French Gates, it's great to have you. Why do you think women's health is the issue of our time?
This is an area that is completely under-researched and underfunded. Women's reproductive health, postpartum depression, cardiovascular disease.
How is this not a national crisis?
It took me three doctors to get the right treatments for where I was.
Even Melinda Gates couldn't get the right treatment.
Right, women aren't getting the answers that they need, and that just shouldn't be. We were just supposed to deal with this and let it be unseen. No, this is real for us. Now it's time to talk about what's going on for women.
This show is sponsored by United Health Group. We know women live longer than men, but did you know they spend 25% more of their lives in poor health? How can that be? Well, it's that women's care is often treated as isolated moments instead of a lifelong experience. That's why United Health Group is working to reshape women's health with a more connected approach to care, supporting women through every stage of life from adolescence to menopause and every moment in between. This year United Health Group was the first to expand coverage for doula care nationwide, helping more women access personalized support before, during, and after birth. And through community partnerships and in-home care, United Health Group is helping women with the greatest needs detect and prevent diseases like cancer and heart disease earlier. Because women's health is more than any single diagnosis or moment in time. It's about care that follows women throughout their lives.
Hi everyone. I'm so excited to welcome you to the very first episode of our podcast, Healthful. It is the podcast focused on women's health, and we have a very special guest today, Melinda French Gates, and she joins us in this effort to bring more attention to women's health. It's great to have you.
Thanks for having me, Nora.
You have just announced something new, something big, something bold. Why do you think women's health is the issue of our time?
Because we are half the population, and yet as you just said, this area for women's health has been underfunded, and when something's underfunded, then it's under-researched. And so women aren't getting the answers that they need, and that just shouldn't be. We're half the population.
I know, and when I think about that, we're half the population, and yet only 10% of the taxpayer money at the National Institutes of Health goes towards women's research. What are the long-term consequences of that?
Well, the long-term consequences are we live our lives. We know women live an average of 9 years in poor health as compared to a man, and I think we thought in our heads that those 9 years are oh, at her end of her life cuz she lives longer. No, a lot of those years are in your most productive years. And so if women could get answers, then they won't step back from their career, but we're having far too many women say, 'I'm right at the peak of my career, but because of these really tremendous health issues I'm dealing with, I have to step back to take care of myself.' That just shouldn't be. That's not good for them and their families, but it's also not good for the nation or our economy. It's not. I mean, I sort of wonder now thinking about this and then someone who has gone through menopause, is this what's holding women back from some of these senior leadership roles? It could be one of the things holding women back. We know that one in 10 women step back from the workforce during their years of perimenopause or menopause because of severe symptoms that they're experiencing. What was your experience?
My experience was I started in my early 40s in perimenopause, and I kind of couldn't believe it because I just finished having my last child in my late 30s, and I thought, 'Are you kidding me?' And thank goodness, I have older friends, and we would walk every Monday, and hearing their stories kind of eight or nine years ahead of mine, I knew what to watch for. But it was kind of unbelievable to me that even in this, you know, unbelievably privileged situation I'm in where I feel like I can get some of the best health care, it took me three doctors to really diagnose what I was going through and to get the right treatments for where I was. Even Melinda Gates couldn't get the right treatment.
Right, and it wasn't because anybody was doing the wrong thing, it's because of what I now know, which is only a third, 1/3 of OBGYNs in this country are trained in menopause. Why shouldn't it be that not only all OBGYNs, but all primary care doctors, all nurses, all mental health practitioners understand and see the symptoms of perimenopause?
I know you have called for a menopause revolution, but that is part of just this larger funding that you have put behind women's health. Explain what that is.
Well, the recent funding I did in women's health, the 215 million dollars, part of it goes to women's reproductive health, which I've been working on for a long time. I doubled down. But the piece on menopause is really to signal this is an area that is completely under-researched and underfunded. I mean, why is it that we have one study, one hormonal study that we that was read, thank God it was done, it was read incorrectly, now we're re-reading the study, but why weren't there 30 studies done starting 30 or 40 years ago? Why did we leave this behind when yet all women go through it? So, I love what you're doing, which is we need to share our stories, we need to share information, but quite frankly, we also need to put more money into research so that we do look at these very specific things that women go through.
Where do you see that now because you have the ability, you know, through Pivotal, your new new new venture, where you're making investments and philanthropy, correct?
Where do you see that? I mean, where do you see the bias? And why has there been such a bias in terms of whether it's private funding, commercial funding, if you will, philanthropic funding, or then even taxpayer funding? Why do you think there's such a bias?
Well, I think you have to look at where power has sat over the last hundreds of years, right? It has sat in the hands of men. And so, I'm not saying they did anything wrong or something ill, but when they looked at issues, we made a false assumption that a man's heart and a woman's heart were the same thing, or that the way a man's bodies work, well, maybe the woman weighs half as much, so, okay, we'll just, you know, we'll retry take the medicines.
And that's just not true. It's a false assumption. And so, I think because women in the past didn't hold the research or didn't hold the positions of power to say, 'No, no, we need to look at this differently, or let's look at these specific women's issues.' We just didn't fund it. So, we did finally get around to funding things like prostate cancer. Super important, right? Funding moved there, uh advocacy moved there. Now, there are solutions for men, now men get tested for it, right? But, had you had a woman with that much power back then, I think we would have looked at these issues earlier.
And so, what else are you doing in terms of your new funding? I know that you're doing a lot on maternal health.
Mhm. I'm doing a lot to look at maternal health and how we wrap mental health services into maternal health. Because there's this myth out there that only if you've maybe already had depression, do you then experience postpartum depression. That's just not true. We know that one in five women have a mental health condition that gets kicked off during pregnancy. And so, if we wrap in mental health services from the get-go into maternal health, we will serve women so much better.
I know this has been called in some by some people the fourth trimester. You know, so those of us who have had children, we know of course about the three trimesters. And then, you know, a lot of the care then gets focused on the infant, as it should. And then the mother obviously caring for the infant, which is a lot of work.
It's a lot of work.
It's a lot of work. And because there's such huge hormonal changes, and if you are breastfeeding, then your estrogen level goes through the floor, then women will naturally experience some depression. But there doesn't seem to be the attention, as you said, on women's mental health.
That's right. We don't catch women. So often, women don't go back in for their next appointment, particularly if they're in a low-income setting. I was just in Louisiana and Alabama looking at this, trying to understand what's going on. A woman often doesn't go back into the system until it's time for the 6-week checkup for her baby. Well, at 6 weeks, if she has been experiencing mental health challenges or depression, you're in severe depression by then. And that affects her ability to tune to that baby as well. It's horrible for her. And then, pulling her out is so difficult. Whereas, on the flip side, I saw a clinic in Alabama where there are wrap-around services. The day the woman walks in and thinks she's pregnant, they start looking for mental health issues with her. Maybe they she doesn't experience them at first, but maybe at 5 or 6 months she does. They immediately make sure she has services and they do all the follow-up all the way through and they watch her immediately afterwards, too. And so women are having much healthier birth experiences, which is good for the mom and good for the baby. It's possible.
Yeah, but that's the exception of a clinic like that. I mean, that's so rare, right?
But it needs to be the norm and it is not expensive. One of the things we do is we force people today in our health care system, men and women, but let's take maternal health in particular. You go to one person and then you go to another person, then you go to a different doctor. But when you put them all in one clinic, they're all right there. It's actually less expensive to have them all in one place.
Yeah. This just happened. 37 major medical organizations, including the American College of Obstetricians and Gynecologists and the American Heart Association, put out a framework for closing women's health gap and they are calling on Congress to invest $20 billion over the next decade. As an advocate for women's health, I mean, what would your message be to Congress?
Absolutely, go for it. You need to go for it. This is important. We care about half our population. We care about our moms because they care about our children. We care about moms and women because they contribute to our workforce in amazing ways, but it's time. It's just like we stepped up to cancer. Look at the cancer treatments that have come, right? And we're still on the forefront of what's to come. We start investing now, this is going to pay dividends for literally centuries down the line for families.
I just think about how systemic the inequalities are.
And you know, I wrote about this in my book We the Women when Pat Schroeder, you know, one of the first members of female members of Congress who had had a Harvard law degree when she was elected, you know, they said Denver housewife elected to Congress. People asked her how she could have young children and serve as a member of Congress and she said, 'Well, I have a uterus and a brain and I use both.' But it was because of Pat Schroeder, like if you've ever taken paternity leave, you can thank Pat Schroeder for that. It was Pat Schroeder who in 1993 as part of the bipartisan women's caucus passed a law that required the NIH to include women and minorities in clinical research. So, it required to include them in the research, but three decades later, we still have unequal funding. Like, how is this not a national crisis? We are not getting the care, we're not getting back what we're putting in as women in taxpayer dollars.
And this is why it is so important for us as citizens of a country and a democracy to say, 'This is what I'm demanding of my leaders.' I tell everybody, 'Advocate for yourself.' Not just at your doctor's office, super important, but advocate to your local leaders for what you need and advocate to members of Congress because they do listen, right? And saying this is important to all of us, that is how we move things forward in our country. That is our voice in action in our government.
When you announced in a New York Times op-ed your new round of funding that I think will bring your total funding to 600 million, is that correct? When you said women deserve better, were you surprised by the reaction that you got?
Very surprised. And in fact, we heard back from the New York Times themselves that they were extremely surprised at the number of writing comments. And when you looked at those, what they really were were women sharing their stories, sharing their experience. And what we heard resoundingly is I finally feel seen. The number of women that said I went to five doctors, I went to this specialist and that specialist. And oh my gosh, I mean this is why I love what you're doing. Storytelling is so important because in the past these stories were unheard or untold. It was like we were just supposed to deal with this and let it be unseen. No, this is real for us. Just like prostate cancer is real for men. It has come into the forefront. Okay, now it's time to talk about what's going on for women.
Right. Address it. We're in 2026.
We're building data centers. We can take care of these women's health issues.
We can and guess what women do? When you take care of women, they take care of everybody else. That is the truth. And for me, this is part of the reason I'm investing in women's health also is that when women have their health, they can live their full potential. They can go to the school they want to go to. They can start the business they want. They can serve in their Congress or state legislature. They can keep the job they want. They can advance in their career ladder. Our health is fundamental to us living our full potential and stepping into our full power.
Yes. And being able to serve not only our families, but the community.
And that's what women do. When you invest in her, she invests. We have great research. She invests in her family. And that benefits the community. She invests in her community. And guess what? That leads to economic effects for a country.
Mhm. Linda, let's talk about you. You're a Texas girl.
So, how did you end up at Duke?
I was lucky enough that I had a female math teacher who brought computers into our classrooms very, very early in my all girls Catholic high school. I fell in love with coding computers back then. And so luckily when I went to look to go to college, Duke had a brand new computer lab. It was a big donation that IBM had made, actually two labs. And they had very good professors in computer science and I said, 'I want to study there.' And that's how I went to Duke.
In economics and computer science. You then got your MBA from Duke.
How did you end up at Microsoft?
I was so lucky. I thought I was going to go work at IBM back in Dallas. I'd worked for them for two summers. I had a great summer job. But Microsoft had come to campus to Duke to recruit for computer scientists undergraduate. It was the first year they came to the MBA program to recruit. And because I had this double major undergraduate and then an MBA, I got a call back interview and when I went to their campus in Seattle, I just came home and I said to my parents, 'If they make me an offer, I'm moving. There's no chance I can't work for that company.' Like I could just see where they were going and what they were doing and it was young and it was vibrant. They knew they were changing the world and I wanted to be part of it. It was so exciting.
And weren't you like the only female with an MBA at Microsoft at the time?
I was one of the very few. Their first hiring class of MBAs were nine guys and me. And I look back and I think, 'You know, there were some sharp elbows there.' Yeah. But again, I had mostly by the time I got to sophomore and junior year of college, I was mostly programming with guys. And I actually was quite a good manager early on. So it didn't surprise me honestly cuz early in the computer industry there were a lot of guys.
Yeah. I wanted to bring that up because I know of all of your work in philanthropy and I want people to remember too that you're a computer scientist. Like it's amazing to me and like a math genius.
Some people call me gearhead. The people who actually know me really well, like some of my girlfriends are like, 'Don't forget she's a gearhead at heart.' And it's true.
So you meet Bill Gates. You have three kids.
You leave working full-time at Microsoft. Then the Bill and Melinda Gates Foundation. You did that for how many years?
All over the globe. The number of trips I took to different countries in Africa and Southeast Asia, I kind of look back and think how did I do that? And also raising three kids who luckily have done, are doing I think quite well in life, you know, as their mom I would of course say that, but they're all 30 and under and yes, I've launched three young adults in the world.
You've spoken publicly about your divorce from Bill Gates with our friend Gayle King. And then you left the Bill and Melinda Gates Foundation. Was that a difficult decision?
It was a difficult decision in the sense that I absolutely love what the foundation does and what it stands for. I still believe in its work. I co-founded it. But I was ready. I was ready to be on my own. I had already started Pivotal Ventures in 2015 to work on societal issues in the United States particularly for women and families. And I felt like because of things going on in the United States with women's rights being rolled back, I wanted to really step on the gas and I was ready to do it on my own. And so I stepped fully into Pivotal Ventures.
In the news recently, Warren Buffett who of course had contributed greatly said for the first time in two decades he is skipping his donation to the Gates Foundation until he sees the findings of a review into the foundation's ties to Jeffrey Epstein. What do you think of that?
I think that those really are questions that really should go to the foundation. I'm not there anymore, so I can't speak to that.
Mhm. But do you support what Warren Buffett is doing or
This is Warren's life's work. So, it's Warren's money. He gets to vote with it and do with it what he thinks is best. So, he's making what he feels is the right choice for himself.
Mhm. And how do you feel now as someone who has done so much work for women's health when you get questions like these about your ex-husband and Jeffrey Epstein?
I feel like I want to talk about women's health.
Yeah, but there must be too because I even hesitate asking you about it, but it's in the news and you know, people want to know and there's an insatiable appetite. But there must be and I feel this way sometimes too, it's like, but I'm working on a project. I mean, how do you feel about that?
I feel we ought to be looking at those girls. I mean, to have girls who went through something so horrific who are now women, they deserve peace and justice. So, the fact there's focus on that, I think that's exactly right. They deserve peace and justice.
Mhm. How many now? It's now three decades worth that you've devoted your time, money, and energy to largely women's issues, not just in America, but around the globe.
When you think about how much of your energy you have poured into this,
what's your dream? Like if you could wave a magic wand,
My dream is that women can step into their full power, no matter where they live. So, if that's they want to start a business, they want to attend university, they want to get their business funded, they want to be a CEO, they want to be a teacher, they want to be a social worker, they want to be a scientist. That every single path is open to them equally, and they can get the funding that they want, they can do what they want to do in the world and what they deserve to do. That is my goal. And I think we have places where we've made progress, then we take a little bit of a step back, and then we make progress again. But this is my life's work and I'm excited when I see women creating change for others because at the end of the day, I do think women have a different lens on society. It's not a better lens, it's not a worse lens than men, it's just a different lens, and having them fully contribute their talents makes an enormous difference to society.
Mhm. You know, we are about to I want to talk about financial power.
Because we are about and I write about this in the last chapter of my book. We are about to have the greatest wealth transfer in American history. $54 trillion will pass to spouses in the next two decades, and women will be the primary beneficiaries of that. How do you see how women will use their financial power differently or how it may change America?
Well, I look at women in history like you do to try and learn the lessons forward. So, if you go back 90 years, how did we ever get women to the place where we could be in medical schools? We could get women's education. Started with a woman named Mary Lyons 90 years ago. She went around and she raised the money, a few prominent donors, but mostly she went town to town to town and she founded Mount Holyoke Seminary and she proved that women could learn at the same rate as men, just as equal in terms of what they were learning. And so that led to more places creating universities that would accept women. Then there was a donor who gave to Johns Hopkins Medical School with the premise that they had to admit women equal to men. Well, now let's look at what's going on in the medical profession. We're now graduating the same number of female and male doctors. So it starts by looking back and saying when one woman uses her power, she can change the course of history. So I look at the birth control pill. How did that come about? Right? It's McCormick. She made sure and once the birth control, the advent of the birth control pill, women could stay in universities and then women could work and they could time and space the births of their children. It fundamentally changed society. So I know that when
Women step into their full power, it can change the arc of history, and it makes me very excited about seeing that women are actually having this enormous wealth in their hands and I'm excited to see what they will do with it.
Yes. My little personal plug in 'We the Women', of course I write about Ms. McCormick and of course her husband had passed away and she inherited a lot of money and put that towards developing the first birth control pill as you said, and that has changed the course of history because 80% of women have used the birth control pill not just for birth control, women use it for other things as well. For hormonal reasons. Yeah, exactly, and that has changed. And so what do you think about that in terms of financial power? If you look at your philanthropy, if you look at Lorraine Powell Jobs, if you look at what MacKenzie Scott is doing, you see different types of donations, different types of philanthropy, right? And I think it's fantastic. Just like if you look at male philanthropy, there are lots of different types. So, I think with females we will see lots of types, but what I'm seeing these women do is speak their values through the way they are giving their money. And so, I look to both of those peers for inspiration, for sure. I also look at the generation of women who are coming up behind us. And what I know is that women when they're getting started often feel better if they're working in a small collaborative. So, I've been quite involved in a number of different collaboratives where we bring women together and they start to teach one another what can be done. And the more they go, the more bold they get and they realize, oh, I can be bold. And so, to me, that's incredibly exciting.
This show is sponsored by United Health Group. We know women live longer than men, but did you know they spend 25% more of their lives in poor health? How can that be? Well, it's that women's care is often treated as isolated moments instead of a lifelong experience. That's why United Health Group is working to reshape women's health with a more connected approach to care, supporting women through every stage of life from adolescence to menopause and every moment in between. This year United Health Group was the first to expand coverage for doula care nationwide, helping more women access personalized support before, during, and after birth. And through community partnerships and in-home care, United Health Group is helping women with the greatest needs detect and prevent diseases like cancer and heart disease earlier. Because women's health is more than any single diagnosis or moment in time. It's about care that follows women throughout their lives.
One of the things about this podcast is we want it to be in some ways interactive. So, we solicit questions. We call it the group chat. So, one of the questions we got, this was actually one of the most popular questions. How do you decide on which research efforts and organizations you will fund?
Mhm. It's a tricky question. It's an amazing opportunity I have, but I also know I can only do so much. So, I have to try and be very focused. One of the things I learned early from Warren Buffett, the advice he gave us back when I was co-founding the foundation and a little later was pick your bull's-eye and stay inside that target because once you do, you will build up knowledge and expertise and you can let some other things go. And so, I am all in on women. All in. And so, you know, where I work on women's power and I work on women's controlling finance. I also came to see I need to work on women's health because women's health leads to having economic freedom, which leads to power. So, I look at where the greatest disparities for women. What are we not funding? Well, we're not funding menopause, which starts for many women at age 40 and yet we still have these very vibrant lives ahead of us. I look at cardiovascular disease because it's the number one killer of women. Half of women's heart attacks go undiagnosed and we're starting to learn that our vascularity around our heart is different than a man's. So, I fund that. I'm going to fund a strand of research most likely around chronic illnesses because those disproportionately many of them affect women. So, I look in those areas and say where is there a need for good scientific research, where is it ripe, and who can I find to fund? And for me, it's all about funding great partners who are trying to move the ball forward.
Mhm.
Rebecca wants to know, does Melinda have a team to track and follow up on her donations and the intended usage of the money?
