Even though women have a longer average life expectancy than men, they often experience worse health outcomes. Women are less likely to receive female-specific care and spend more of their lives in poor health. They have difficulties not just with getting the right diagnoses and care but also being heard by healthcare professionals to begin with. The Women’s Health Gap is not just a women’s issue, it affects everyone. The time has come to start highlighting this glaring oversight in the healthcare industry to finally move towards changing the status quo.
According to a report by the McKinsey Health Institute in collaboration with the World Economic Forum, women spend 25% more of their lives in poor health and with degrees of disability. In fact, women spend an average of nine years in poor health. This affects their ability to be productive at home, in the workforce, and in the community. This also reduces their earning potential. The report points out that addressing the drivers of the gap would not only improve the health and quality of life of millions of women but could also boost the global economy by $1 trillion annually by 2040.
Drivers of the Gap
Lack of Female-Specific Research and Care: Megan Greenfield and Lucy Perez, partners at McKinsey & Co. write, “one of the most substantial barriers women encounter in healthcare is the absence of diagnostic and treatment practices designed specifically for their physiological needs.” Although women make up one half of the world’s population, have outnumbered men in the United States since 1946, and account for 80% of consumer purchasing decisions in the US healthcare industry, “modern medicine was developed with male physiology as the default.”
The problem arises from the very beginning, starting at the funding and research stage. The US Congress first passed a law requiring the inclusion of women and minorities in clinical research relatively recently, in 1993. Researchers at Harvard Medical School found that as recently as 2019, “women accounted for roughly 40% of participants in clinical trials for three of the diseases that most affect women – cancer, cardiovascular disease, and psychiatric orders – despite representing 51% of the U.S. population.” They also call to attention concerns about the lack of information regarding medications and other interventions during pregnancy, “since pregnant people are even more commonly excluded from trials.” Furthermore, only 11% of the National Institutes of Health’s (NIH) budget was allotted to women-focused research in 2020.
Academia plays a sizable role in adhering to the status quo as well. A survey of over 40 medical schools in Canada and the United States found that 70% of the schools did not formally include sex-or gender- specific content in their curriculum. One survey of Ob-Gyn residency programs found that only a third (31.3%) reported having a menopause curriculum.
Inequalities in Care: Studies have shown that women utilize more healthcare services than men. However, McKinsey’s analysis found that the gap in care delivery contributed 34% to the women’s health gap. Aside from the scarce gender- and sex-specific research and care, traditional social norms have led women to diminish their pain and kept them from seeking timely medical treatment. When women do seek necessary care, “they’re not validated with regards to their concerns; they’re gaslit; they’re not understood. They feel like no one is listening to them,” says board certified neurologist, Dr. Ilene Ruhoy, who despite having a medical degree struggled to get doctors to order a brain scan for a tennis ball-sized tumor that was pushing her brain to one side.
A 2022 survey with 5,000 women participants aged 18 to 64 found that 29% of women reported being dismissed by a healthcare provider compared to 21% of men and 15% of women said their provider did not believe them compared to 12% of men. It must be noted that women also face “unique obstacles” when seeking healthcare, including “logistical barriers” due to their “roles as caregivers, and financial barriers, as women on average earn less than men,” as reported in an analysis by The Permanenete Journal. Therefore, they have less time to focus on their health and seek the care they require. Cost is another significant barrier to care, as “healthcare spending and insurance premiums have historically been higher for women,” reports Tia Health. In the United States, women pay an average of $135 more for out-of-pocket expenses than men and $55 of it is for conditions that mainly affect women.
Disparity in Treatment: A study by PubMed Central states that “women experience significantly longer diagnostic delays compared to men.” As a matter of fact, “it takes longer for women to be formally diagnosed, even when comparing across a common set of relevant symptoms.” Similarly, another study showed that women are half as likely as men to receive pain medication even after they have had coronary bypass surgery because doctors do not take their complaints seriously.
NEJM found that women were “up to seven times more likely than men to have a heart condition misdiagnosed and be discharged during a heart attack.” Despite the fact that 45% of women (20 years or older) are living with some form of cardiovascular disease, the leading cause of death in women, in 2019, only 4.5% of the National Institutes of Health’s (NIH) budget for coronary artery disease was targeted at women. Research suggests that “women are being widely overmedicated—and suffering excess side effects,” due to the common practice of calculating drug doses based on mostly male subjects. Some of the side effects include but are not limited to headaches, nausea, bleeding, and seizures.
Why is Investing in Women Beneficial Economically?
Investing in the betterment of women’s health not only improves women’s quality of life, but also allows them to participate more actively in the workforce and earn a living for themselves and their families, as described by McKinsey’s analysis. McKinsey also reports that economic growth over the past 70 years has been closely tied to women’s increased labor force participation, thus, it is no surprise that the gap limits individual women. Lack of focus on dedicated research and care directly affects the global economy by impairing women’s economic participation and productivity.
Closing the gap could add nearly $400 billion in annual GDP to the global economy and close the burden gap by almost 27 million disability-adjusted life years (DALYs) each year. This translates to 2.5 additional healthy days per year for each woman in the world.
How Do We Close the Women’s Health Gap?
·More Investment in Gender- and Sex-specific Research: It is crucial to weave women’s health and gender- and sex-specific differences into the medical curricula as well as residency and fellowships. It is also prudent to acknowledge inherent gender biases in clinical care in order to rectify “inherent equity disparities.” The healthcare industry must allocate greater funding for research on women’s health and establish higher standards for clinical trial representation.
In 2024, The Department of Defense (DoD) announced plans to invest $500 million over the next five years for women’s health research, aiming to address health disparities faced by women, including conditions that affect women uniquely, disproportionately, or differently. This is in alignment with President Biden’s Executive Order on Advancing Women’s Health Research and Innovation that was signed in 2023. This is a crucial step forward and we need more federal, medical, and educational commitments to narrow the gap.
Developing Gender- and Sex-Specific Treatments: We know that men and women often exhibit different symptoms of diseases and responses to treatments. Therefore, as explained once again by Megan Greenfield and Lucy Perez, we need new guidelines and protocols designed specifically for women and female patients, while ensuring their adequate representation in clinical trials in order to verify the effectiveness and safety of treatments across all genders and sexes.
Increasing Provider Education: Current and future researchers and healthcare professionals of all specialties need to “be equipped with accurate and updated knowledge of biological differences, including sex-specific manifestations of symptoms” so that it can be incorporated into their standard diagnostic and treatment practices for women. Systemic change can only be reached when this becomes baseline.
Women deserve the same high-quality and evidence-based care from the healthcare industry as men. We need to move away from the one-size-fits-all approach when it comes to women’s diverse healthcare needs and adopt a more holistic approach, led by collective action and ongoing investment. Bridging and eventually closing this gap will not only result in better outcomes for women but will have a beneficial cascading effect on society.
Comments