For nearly half a century, a Houston nonprofit has quietly helped women and girls understand their health, make decisions and speak up for themselves. The Women’s Fund offers a useful reminder that healthcare does not begin and end in the examination room. Sometimes it begins with knowing what question to ask next.

There is a particular kind of silence that can happen in a doctor's office.

The physician has finished explaining something.

Perhaps a diagnosis.

Perhaps a treatment.

Perhaps three different options, each with risks, benefits and names that sound as though they were invented during a particularly difficult game of Scrabble.

Then comes the question:

“Do you have any questions?”

And sometimes the answer is:

“No.”

Not because everything is clear.

But because the patient isn't quite sure what she doesn't understand.

Or what she is allowed to ask.

Or whether the doctor has time.

Or whether the question that is bothering her is somehow a silly one.

That small moment gets surprisingly close to the philosophy behind a Houston organization that has been working on women's health since 1979.

The Women's Fund for Health Education and Resiliency isn't a hospital.

It doesn't diagnose disease.

It doesn't prescribe medicine.

Its basic proposition is much simpler:

Women and girls are better able to care for their health when they have reliable information, practical skills and the confidence to use both.

That sounds obvious.

In practice, it isn't.

A Houston Story That Began in 1979

The Women's Fund began as The Women's Fund for Health Education and Research.

According to archival records held by the University of Houston Libraries, Jacqueline and Wayne Goettsche established the organization in February 1979 with a seed endowment. They were concerned both about inadequate research funding for women's health and about medical findings derived largely from male research subjects being applied to women.

The timing is worth remembering.

In the late 1970s, the idea that medical research should routinely investigate important biological differences between men and women was far less embedded in biomedical research than it is today.

The fledgling Houston organization set out to do two things:

support research specifically related to women's health;

and help women understand emerging medical information.

A fundraising barbecue that May drew nearly 100 people from Houston's medical and civic community and marked the organization's formal launch.

It was a very Houston beginning.

Medicine.

Philanthropy.

Community.

And apparently barbecue.

First, They Funded Research

For almost three decades, The Women's Fund helped finance women's-health research in Houston.

From 1980 through 2008, the organization says it provided nearly $1.4 million for local research before shifting its emphasis away from direct grantmaking and toward health education.

Its archival records show that between 1980 and 1992 alone it awarded 73 grants related to women's medical research and services.

The subjects over the years included areas such as cancer, cardiovascular health, osteoporosis and women's emotional wellbeing.

But eventually the organization changed direction.

Instead of primarily helping scientists produce information, it increasingly concentrated on helping women use information.

That distinction is more important than it might initially sound.

Knowing Something Isn't the Same as Being Able to Use It

Modern medicine produces extraordinary quantities of information.

Almost anyone with a smartphone can now search for symptoms, treatments, medications and diagnoses within seconds.

The problem is that access to information isn't the same as health literacy.

Health literacy includes the ability to find, understand, evaluate and use health information when making decisions.

And another closely related concept—often called patient activation—adds something else:

the knowledge, skills and confidence to participate actively in one's own healthcare.

The CDC summarizes a substantial body of research suggesting that people with higher patient activation tend to have better health outcomes and healthcare experiences. It also notes that patient activation can be increased through interventions.

That helps explain why a seemingly modest intervention—teaching someone how to ask questions, evaluate information and communicate with a healthcare professional—can matter.

The difficult part of healthcare is not always obtaining the information.

Sometimes it is turning information into action.

The Women's Fund Changed With That Idea

Today, The Women's Fund describes its mission as providing Houston-area women and girls with tools to become better advocates for their health.

Its programs combine conventional health education with skills including:

self-efficacy;

decision-making;

goal-setting;

communication;

resourcefulness;

and resilience.

That combination is interesting.

The organization isn't merely saying:

Here are the facts about heart disease.

It is also asking:

What helps a woman actually act on those facts?

Can she ask her physician a difficult question?

Can she make a health decision under pressure?

Can she find reliable resources?

Can she recover when circumstances disrupt her plans?

Can she communicate what she needs?

Those may sound more like life skills than medical interventions.

In many ways, that's the point.

What Does Resilience Have to Do With Health?

“Resilience” has become one of those words used so frequently that it can sometimes lose its meaning.

The Women's Fund uses it rather practically.

Its programs aim to help women and girls develop skills for coping with circumstances that threaten health and wellbeing while retaining a sense of agency.

The organization links resilience to greater self-efficacy, decision-making, communication and use of community resources.

The important qualification is that resilience should never become a polite way of telling people to cope better with systems that are failing them.

A woman facing inadequate healthcare access, poverty or serious illness does not simply need a more positive attitude.

But resilience can still be valuable when defined as:

the ability to navigate difficulty with information, support and some sense of control.

That seems much closer to what The Women's Fund is trying to teach.

Teaching Girls Before They Become Patients

One of the organization's most enduring programs began in 1999.

The Women's Fund worked with health professionals, community advisers and groups of teenagers to develop What About Me? A Girls' Guide to Health, aimed initially at girls around ages 11 to 14.

A curriculum was subsequently created around the guide, and the organization later partnered with schools and youth organizations to deliver the material.

The concept is simple but thoughtful.

Health education does not need to begin after someone becomes ill.

Adolescence is when girls begin making increasingly independent decisions involving:

nutrition;

exercise;

relationships;

mental wellbeing;

reproductive health;

body image;

risk;

and eventually interaction with the healthcare system.

Teaching a girl to understand her health may therefore be partly about biology.

But it may also be about teaching her that her questions matter.

That lesson can last rather longer than any particular health pamphlet.

There Is Evidence Behind That Broader Idea

Health literacy is associated with how people manage their own health.

A 2024 systematic review specifically examining middle-aged women found that women facing greater health-literacy challenges generally showed poorer self-management across several areas of health. The authors concluded that improving women's ability to access, understand, evaluate and use health information is an important strategy for strengthening self-management.

Another 2024 systematic review looking at women with benign gynecological conditions found evidence linking lower health literacy with poorer patient-reported outcomes, although the researchers also emphasized limitations and inconsistency in the underlying studies.

In other words, the evidence isn't telling us:

Take a health class and you will live longer.

Science rarely gives us anything quite so tidy.

It does suggest that understanding health information—and feeling capable of participating in healthcare decisions—is not merely a nice educational extra.

It is part of healthcare itself.

Sometimes the Problem Is the Information

Healthcare professionals have another responsibility too.

It is easy to speak about “health literacy” as though the patient alone has a deficiency.

But communication is a two-way problem.

If medical information is unnecessarily complicated, poorly explained or presented in a way that people cannot realistically use, the failure may lie partly with the system delivering the information.

A 2025 systematic review of organizational health literacy emphasized that healthcare institutions themselves have a responsibility to make information easier for people to access, understand and apply.

That changes the question.

Instead of:

“Why doesn't this patient understand?”

we might also ask:

“How could we explain this better?”

The Women's Fund sits in an interesting space between those two sides.

It cannot redesign the healthcare system.

But it can help women become better equipped to navigate it.

The Question Matters as Much as the Answer

Consider another increasingly important concept in healthcare:

shared decision-making.

Instead of a physician simply announcing a treatment, the doctor and patient discuss the available options, relevant evidence, potential benefits and harms, and the patient's own circumstances and preferences.

That sounds straightforward.

But shared decision-making only works if the patient can participate.

Research suggests that communication strategies matter particularly for people with limited health literacy.

A 2023 systematic review found that verbal explanations alone can be inadequate when communicating medical risks and benefits. Visual aids and carefully designed risk communication can improve understanding, although the evidence remains incomplete.

A Cochrane review examining breast-cancer screening decisions found that enhanced shared-decision approaches could improve women's knowledge and reduce decisional conflict, while also concluding that better-quality research is still needed.

Again, the message is not that patients should become amateur physicians.

It is that healthcare works differently when a woman understands enough to say:

What are my options?

What happens if I wait?

What are the benefits?

What are the risks?

Is there another reasonable approach?

What would you recommend if this were your sister?

That last question may not appear in the medical textbook.

It has nevertheless survived remarkably well in real life.

Health Education Without a Hospital Appointment

The Women's Fund now delivers its work in several different formats.

Its Women's Health Advocacy Program uses curriculum-based education.

Smart Lunches bring health professionals into workplaces and community settings.

Doc Talk sessions feature medical professionals discussing topics ranging from healthy aging to breast cancer and maternal health, often in partnership with Houston's Health Museum.

There is also a women's health lecture series and a range of educational publications.

The organization's materials have historically been distributed without charge through schools, clinics, community organizations and other settings.

That approach matters because healthcare information delivered outside the clinic can sometimes reach people who don't routinely have easy access to medical advice.

The Women's Fund says it focuses particularly on underserved Houston and Harris County populations with limited access to health information.

A Small Organization With a Long Memory

One thing that makes this organization particularly interesting as a Houston story is its continuity.

Its historical records from 1979 through 2014 now occupy approximately 40 linear feet in the University of Houston's Special Collections.

They include board minutes, correspondence, research-grant applications, educational materials, photographs, newsletters and records of outreach programs.

That archival footprint tells its own story.

Houston has become internationally associated with medicine through institutions such as the Texas Medical Center.

But alongside the great hospitals and research centers has existed another layer of local health history:

volunteers;

small nonprofits;

educators;

community groups;

and women trying to translate medical progress into something useful at the kitchen table.

The Women's Fund belongs to that part of Houston's story.

What Does Impact Look Like?

Nonprofit organizations understandably publish their own measures of reach, and those figures should always be interpreted as organizational reporting rather than independent scientific evaluation.

Recent public descriptions of The Women's Fund say it serves roughly 7,500 women and adolescent girls each year and distributes approximately 5,000 free publications annually.

Charity Navigator currently gives the organization a 95% Four-Star rating in its assessed Accountability & Finance category.

Neither figure proves that a health class changes someone's long-term medical outcome.

Measuring that would require considerably more rigorous longitudinal evaluation.

But it does tell us that this is not merely a historical organization surviving on its past reputation.

It is still running programs, producing health information and working within Houston communities.

From Research Funding to Research Translation

There is an appealing symmetry in The Women's Fund's history.

In its first decades, it helped fund researchers trying to learn more about women's health.

Today, it spends much more of its energy helping ordinary women understand and use health information.

Those are different activities.

But they solve two halves of the same problem.

Medical knowledge has little value if we don't discover it.

And discovered knowledge has limited value if the people who need it cannot understand or use it.

Somewhere between the laboratory and the doctor's office sits the patient.

She may be frightened.

She may be busy.

She may have children waiting at home.

She may speak English as a second language.

She may have searched her symptoms online and now be absolutely convinced she either has nothing serious or approximately six fatal diseases.

She may simply need someone to help her sort out what matters.

Health education lives in that space.

Houston Has More Than One Kind of Medical Institution

Houston is understandably proud of its medical infrastructure.

The Texas Medical Center is one of the defining institutions of the city.

But healthcare doesn't consist solely of surgeons, laboratories and hospitals.

Cities also need institutions that help people navigate what medicine knows.

Some are large.

Some operate quietly.

Some teach a room full of teenage girls.

Some organize lunch-hour conversations.

Some print a health guide.

Some simply give a woman enough confidence to ask one more question before leaving the doctor's office.

That may seem like a modest contribution.

But sometimes the useful question is precisely what changes everything.

Lydia's™ Take

Most of us have left a medical appointment remembering the question we meant to ask about five minutes after reaching the parking lot.

It is a remarkably democratic experience.

Health education cannot remove every inequality from healthcare.

It cannot replace a good physician.

It cannot make every diagnosis less frightening or every treatment decision simple.

But it can change something important.

It can help a woman sit in the room as a participant rather than merely a recipient.

To understand enough to ask.

To question enough to understand.

To know when she needs more information.

And to recognize that saying:

“I'm sorry, I don't understand. Could you explain that again?”

is not an admission of ignorance.

It may be one of the most intelligent things a patient can say.

For nearly half a century, one Houston organization has built much of its work around that deceptively simple idea.

Medicine provides extraordinary tools.

But sometimes better health begins with something much smaller.

Knowing what to ask next.

Editorial Note

Lydia.com has no financial, organizational or promotional relationship with The Women's Fund for Health Education and Resiliency. This article was prepared independently as part of Lydia's™ Houston Living series and is intended to highlight an established Houston community organization and examine the broader role of health literacy, patient participation and health education.

References to The Women's Fund's reach and program outcomes are based on information publicly reported by the organization and third-party nonprofit sources unless otherwise stated.

What If Better Health Begins With Knowing What to Ask?