The ‘gender health gap’ shortens lives and costs billions
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The writer is a medical anthropologist, health psychologist and senior researcher at University College London
Nearly everyone knows pain. Pain that makes us gasp or blots out our ability to think can be frightening. But enduring it the most are women, who are much more likely to experience pain that is recurrent, severe and long-lasting.
Despite this pattern, women across the world are less likely to receive good treatment. They are told that their symptoms aren’t plausible, that it’s “all in their head”, that they’re too emotional, too weak, too heavy, too thin. Many receive neither treatment nor cure, but symptom management at best.
During my research on people living with pain, I have heard the same stories again and again: healthcare professionals telling patients that their symptoms are “just part of being a woman”, and that, tacitly implied, they do not warrant medical attention. We all maintain the notion that healthcare is intended to help and heal. But the truth is, there is a difference in how men and women are supported by healthcare systems and providers.
This has become known as the gender health gap — a situation which is quite literally depressing for the individuals affected. Worse, it shortens lives and costs us billions. The negative impact is staggering. The World Economic Forum estimates that if we were to close the gender health gap, by 2040 the global economy could get an annual boost of at least $1tn.
Meanwhile, women are dying early. The McKinsey Health Institute and the WEF calculate that on just two metrics — treatment of endometriosis and menopause — women globally will annually lose 75mn years to early death, disability and suboptimal health by 2040. For every woman, that’s about 500 days, or around a year-and-a-half of her life.
In my research on fibromyalgia, an illness associated with debilitating pain and fatigue that affects mostly women, I have seen the credibility of patients’ experiences called into question more times than I can remember, including in their encounters with doctors. And the millions of women that suffer from these painful conditions can attest to the hard, frustrating work it takes to be taken seriously.
Chronic pain makes people isolated and stigmatised. Again, the gender health gap comes into play, with 53 per cent of women who experience pain reporting a belief it leads to them being seen as “weak”, compared with 45 per cent of men, according to the Haleon Pain Index, a global longitudinal study.
We must urgently improve healthcare for women at the point of diagnosis. But treating pain or managing chronic disease is the endpoint of the pipeline. The problem with the gender health gap starts much earlier, during medical research and clinical trials, which often focus on male patients and so deliver treatment and outcomes with a bias built in.
Once again, chronic pain is a good example: 70 per cent of people living with it are women and studies show that they feel pain more often and more intensely than men. In sharp contrast, 80 per cent of pain studies are conducted on men — or on male mice.
Over the decades, studies have repeatedly shown these gender disparities persisting: men are more likely to be prescribed painkillers while women have to make do with psycho-pharmaceutical interventions. And as pain is often caused by conditions that are challenging to detect and assess, many women live for years with excruciating pain.
The evidence is clear, and the gender health gap’s impact — both financially and in terms of human suffering — is shocking. Doctors must listen to women; the public and private sector have to collaborate for better-tailored research and clinical trials. If we recognise and understand the problem, we are taking a first step to solving it.