Women’s health has moved from the margins of healthcare policy to the center of the national conversation. Fertility rates are falling. GLP-1 medications are reshaping how we think about metabolic disease. Maternal mortality remains unacceptably high. Rural hospitals are struggling to keep maternity services open. And all of these challenges are competing for attention at the same time.
At the same time, there is unprecedented energy flowing into women’s health. New investments, scientific breakthroughs, and growing public attention are creating real momentum. But progress is rarely linear. There are wins, and there are losses. Few people have a broader view of both than Dr. Dorothy Fink.
In this episode of The Preprint, Dr. Neel Shah sits down with Dr. Dorothy Fink, endocrinologist, federal health official, and Director of the Office on Women’s Health at the U.S. Department of Health and Human Services, to explore how women’s health priorities are shaped inside one of the most complex institutions in American government.
Dr. Fink reflects on her path from academic medicine to federal service, what the Office on Women’s Health actually does, and how a clinician’s perspective informs her approach to policy. Together, they discuss metabolic health, the promise and limitations of GLP-1 medications, and whether medical innovation can outpace the food environments that contribute to chronic disease.
The conversation also explores some of the biggest questions facing women and families today: declining birth rates, access to fertility care, rising maternal mortality, the future of maternity payment reform, and the challenges facing rural communities as obstetric services disappear across the country.
At its core, this episode asks a bigger question: when women’s health becomes a national priority, how do we decide which problems get solved first? And how do we build on the wins while confronting the challenges that remain?
