I started to see through all my travels how interconnected and interlinked women's health was to women's power. You know, if women want to be whatever they want to be in society, you first have to have your health because to do well in society, you have to be well.
Hello, everyone. I love a hello back. Thank you. Thank you. Thank you all so much for joining us today. We are here and joined by Melinda French Gates, which is absolutely incredible and honored to be here with you today.
I am going to say the phrase that I'm so excited to say, which is Melinda French Gates, welcome to Nice Talk.
Thank you so much for sitting down with me today. We are all so excited to talk to you about your work with your foundation Pivotal and power as it relates to women's health. For those in the audience who may not be familiar, you've been spearheading philanthropic efforts across a variety of causes for 25 years and in 2015, you started Pivotal, which is a group of organizations founded to accelerate the pace of social progress for women and young people. My first question for you is, what got you so interested in women's health?
Well, I was already working on health writ large and then women's health at the Gates Foundation, which I co-founded. And I started to see through all my travels how interconnected and interlinked women's health was to women's power. You know, if women want to be whatever they want to be in society, you first have to have your health because to do well in society, you have to be well. And so when I founded Pivotal in 2015, it was really because we were working on those issues outside of the US for women, and I wanted to work inside the US because I could see that women had gone to a certain place in society in the US, and that was great, but we still had our even larger ambitions and dreams, and there was so much more to do here in our own country.
Mhm. Was there a specific moment or sort of inflection point you can remember where you realized that you really wanted to invest in this?
I was actually out meeting with women actually on the continent of Africa in many different countries, and women talking about the timing and spacing of the birth of their children. And they said literally, "When we can time and space the births of our children, we can care for them, we can feed them, we can put them in school, and we can run our own businesses. We can do what we want to do." And I thought, "Well, we know women's health is women's contraceptive in their reproductive lives, but I started to realize here in the US we needed to focus on even so much more because women go through these major transitions in life, and yet we don't really address all of them or even look at them and speak about them in society, and that just shouldn't be."
And in an op-ed for the New York Times this June, you wrote, "In medicine, men's bodies are treated as the default and women's as an afterthought." As crazy as it sounds, for decades women were routinely excluded from clinical trials, leaving huge gaps in knowledge. Can you talk a little bit about how you wanted to address that with the work that you're doing with Pivotal?
So, one of the reasons I wrote that men's bodies are default is because it's the truth, right? Women for so long weren't the medical professionals, we weren't the scientists, we weren't the ones moving the funding. So, we studied men's bodies, but we didn't necessarily study women's bodies in the way that we should have. And so consequently, our health system got set up for men. Okay, nothing wrong with that except that there's half the population that are women. And if you assume that a woman's body is a man's, it's just a false assumption. We are completely different biological systems. We are learning, for instance, in cardiovascular disease that our hearts are wired differently than a man's in terms of all of the arteries and capillaries and everything around. It's part of why we misdiagnose women's heart attacks, right? Because we experience different systems. Well, if that's true, wouldn't you think then we would learn a lot more about the system of a woman's heart and what might be possible?
So with Pivotal, you're focusing on two critical chapters in a woman's life, the reproductive years and midlife, which includes menopause. What does focusing on those chapters though look like in practice?
In the reproductive years, what I'm doing is doubling down on investments I had already been making in that space over the course of many years, but as we know today in the state of the system in the United States, we have taken a major step back on women's reproductive health because of the Supreme Court decision. And so consequently, there are reproductive health contraceptive deserts in the United States. And so I'm making sure that there's more access to reproductive health tools because more than 65% of Americans believe in contraceptives, think women should have access to them. So I'm doubling down there. But then I'm looking at this part of life that is so often invisible for women, which is perimenopause and menopause. Every woman goes through it, but it's sort of unspeakable, untreatable is the way we've looked at it in the past, and that just shouldn't be. There of course there are treatments. Now, there need to be a lot more treatments in my opinion, but we need to not only be able to talk about women's experience there, we need to make sure they're getting good access and the right care. So, today the truth is only a third, 1/3 of OB/GYNs are trained in perimenopause and menopause. 1/3 1/3. So, my investment to the Menopause Society is to get all OB/GYNs trained. Let's train primary care specialists so they understand the symptoms of menopause and perimenopause, and let's train health care professionals so that anywhere a woman touches the health care system, her symptoms are recognized, acknowledged, and she's sent for the right care. I can see in the audience when we heard 1/3 everyone was taken aback.
Shocking to me when I learned it. No wonder women are saying I'm having to go to four and five doctors until they're even helping me understand that what I'm going through is actually perimenopause, and there's something that can be done about it.
Melinda, I want you to take me back to 2015 when you were starting Pivotal. What were your initial goals for the organization, and I also want to hear about some exciting things that you've been able to accomplish in that time, and also what you still feel needs to change.
I set up Pivotal Ventures, as I said, after the Gates Foundation already been going for quite some time working on global health. But with Pivotal Ventures, I just saw that we had so much more opportunity for women to step in their full power in the United States. And so, I wanted to study the barriers that were holding women back, and figuring out how do we not only not hold women back, but how do we accelerate their potential, right? Because we are seeing so many women working in society, not just being moms, which is a wonderful thing, but they want to start a business, they want to be a professor, they want to live out their full dreams. And so, I first started to work on one of the biggest barriers, which is paid family medical leave. We are the only the only high-income country in the world that doesn't have paid family medical leave. And when I go and interview men and women, but really men in the Nordic countries, where they've had it for over 30 years, they look at me like, "What do you mean the men don't take time off from work?" Like, of course I take time off from work as a dad, I want to spend time with my child. And consequently, it has changed society's view in those Nordic countries of a man's role in a child's life. You need to make sure that the woman can take time off to be the mom she wants to be, to tend to her health, the baby's health, and that the man can take time off. So, we were working at the federal level, we came within one vote of getting a federal paid family medical leave policy passed, we missed. But, from the work we and many, many, many partners have done, now 14 states in the District of Columbia have paid family medical leave. And guess what? More than 60% of Americans say it's the right policy for the US to have. So, it's time. We should demand it.
Something else that I'm really excited about is your collaboration with Olivia Rodrigo's Daisy Chainfields Festival. You just announced it a couple of weeks ago. It took social media by storm. We are all so, so excited about it. For anyone who doesn't know though, you matched the $10 million that Olivia Rodrigo raised for her music festival, bringing the total donation to million dollars. Tell us a little bit about how that collaboration came together.
Well, first of all, she's an amazing young woman and artist, right? To be 23 years old and already be thinking, how can I give back to the world? And so, she reached out to me maybe about 6 months ago about philanthropy. Like, you know, how you gone about it? How have you learned? She's a deep thinker, a deep learner. And she had already had this idea, which if you can believe, she pulled off in 8 months to get her other artistic friends, every one of them performed for free, and she said from the outset, every dollar raised by this concert is going to go to 10 women's organizations who are fighting for women's rights in the United States. And so, when I met with her and just saw how authentic and real and everything she's trying to do, it just felt like a natural to support that, right? I want to see every single woman who has a platform, who has a voice, which means all of us, to use those to lift up other women and to validate women's experiences so that we can get farther in society. We're half the population.
Melinda, I want to talk about the results of a recent study that Pivotal partnered with the global analytics firm Gallup on a new survey that explores how women's health is shaping women's ability to show up, participate, and lead, specifically in the workplace, at home, and in our communities. The results are out today. And I want to hear why Pivotal wanted to commission this survey. Like, why is it important to talk about it right now?
Well, we had come out with a New York Times op-ed several months ago talking about that we needed a revolution in menopause, in the way we treat it, the way we think about it, the information that women receive. And just the number of women that wrote in their personal stories about their experience, how unheard they felt, unseen they felt, how many doctors they went to. It was kind of shocking. And so I thought, "Okay, if this is true." I was hearing it from my friends, I had my own experience, which I can describe. I thought, "Let's see if it's true across society." And so we went out with Gallup and did this survey of 5,000 Americans. And quite frankly, after the comments I'd seen after New York Times, it wasn't surprising, but it was staggering. How much women were being held back because of our health care system. And I wanted to then say, "Okay, let's raise up this survey." We're using the survey to figure out, okay, where do we make investments, how do we get others make investments, but let's raise this survey up so everybody sees it and we validate women's experiences and what they're encountering today in the health care system.
We talked a little bit earlier about what you've been able to do with the study is really encourage women to not feel crazy. They feel like, "Okay, I'm not the only one that is going through this." The data is really showing it.
That's right. You're not alone. And your experience and your feeling inside your body is real and only you know it. So often we step into a medical environment and of course the doctor is more of an authority than we are, right? They've been to medical school, they've been a resident, they've been in practice. But when they don't validate your experience or you leave feeling like I wasn't heard or maybe they couldn't figure it out, you think, "Okay, should I go to another doctor? Is this really happening? Is the increased anxiety I'm feeling, is the depression I'm feeling from this or something else?" I mean, one of the things we learned from the survey and it was turned out it was true for me, too, back when I went through a perimenopause, women are starting into it often in their early 40s. A third of women say, even though they know what the symptoms are, they don't know they're in it. That was my experience exactly. But I went in seeking care because I started to notice these increased symptoms and feelings of anxiety, and I wasn't sleeping as well. And what happened was consequently, I'm in the peak of my career and I had already been meeting with presidents and prime ministers of countries and health ministers for many, many years. But I started to doubt myself. And it's that doubt, right? That anxiety. Well, no, it turns out when you have chronic sleep issues, which are because of perimenopause or menopause, or sometimes just increased anxiety or increased depression or feelings of heart palpitations, those are real things that they do affect your job. And that came out in the survey, too.
So many people in the audience are vigorously nodding.
I want to talk about some more of the findings from the study. Women are more likely than men to experience several serious physical and mental health conditions. The study found that one in four women rate their health as poor or fair, and nearly half of women are experiencing mental health conditions. What do those stats say about the state of women's health in this country?
That it is poor. You know, one of the things we also learned, even separate from the survey, is women are living nine years of their lives, nine years, in poor health compared to a man. It turns out, you might think, "Oh, well, those years are, you know, sometime earlier in her life." No, no, no, no, no. Those years are often in the prime of her career, right when she's gotten where she wants to be, running that business or teaching the way she wants to teach in academia, or, you know, having started a business or in a corporation, all of a sudden her health is poor. And guess what? She's also having to take care of an elderly parent and or a child, right? And so she's often not able to tend to her health. And those health disparities that exist for her in those nine years, they can lead to life-long consequences like dementia.
