ISSUE. The U.S. primary health care system does not effectively meet women's needs as they age and transition through stages of life. GOAL. Describe gaps and barriers in women's primary health care and propose a framework for transforming the system so that it can meet the needs of women of all ages, races/ethnicities, and socioeconomic backgrounds throughout their lives. METHODS. Literature review, expert interviews, and an all-day expert convening with innovators, primary care providers, advocates, policymakers, and payers. FINDINGS. Major gaps and barriers inhibit the primary health care system from meeting the physical, behavioral, and social needs of women across the life course, including: gaps in medical training; barriers to utilization and delivery, including biases, time constraints, lack of focus on social factors, and competing professional and personal obligations; access barriers related to language, culture, and lack of a regular source of primary care; underrepresentation of women in health care leadership and policymaking; and the politicization of women's health issues. CONCLUSION. We propose a framework for transforming primary health care for women of all ages and at all stages of life that provides comprehensive care, delivers sex-specific, sex-aware, and gender-sensitive care, and adeptly manages and coordinates care for an array of health experiences.
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