But how does one go about closing this gap of 75 million years of life? And why should this gender health gap issue even be discussed?
The heavy impact of health burdens on women’s lives has ripple effects for broader society. It is not about the individual or a single sex, but for all of humanity, everywhere.
It is not about a single society, city, country, or continent.
It is not about any religion, culture, race, or creed.
This is the reality everyone must know and accept: Despite living longer than men, women spend 25% more of their lives in poor health.
What Does it Mean to Close the Gender Health Gap?
Closing the gender health gap means:
- Increasing the diagnosis of women’s health conditions.
- Giving an extra seven healthy days a year to 3.9 billion women in the world today, or an average of 500 days over a lifetime.
- Around $3 in economic growth for every $1 invested in women’s health there would be, as stated by the report from the Forum and the McKinsey Global Health Institute.
- Boosting the global economy by $1 trillion by 2040 from fewer early deaths and health conditions.
- A greater capacity for women to contribute to the economy and society.
The societal success story of increased life expectancies for men and women, although a very commendable achievement, is not the full picture.
The puzzle pieces of the gender health gap are still missing and incomplete.
What is the Evidence of the Gender Health Gap?
Before the evidence of the gender health gap is collected, first it needs to be quantified. What are its parameters? How do we go about measuring this gap, and finally how do we rectify it?
In May 2024, a study funded by the Bill & Melinda Gates Foundation was published in The Lancet, to quantify differences in the leading causes of disease burden between females and males across ages and geographies.
The study quantified the health gap in terms of disability-adjusted life years (DALYs).
The results of the study were as follows:
- Women live longer than men, but spend more of their lives in poor health.
It found that women were more likely than men to experience low back pain, depressive disorders, and headache disorders, while men had higher DALY rates for mortality-driven conditions: COVID-19, road injuries, and ischaemic heart disease.
The report concluded:
“The notable health differences between females and males point to an urgent need for policies to be based on sex-specific and age-specific data. It is also important to continue promoting gender-sensitive research, and ultimately, implement interventions that not only reduce the burden of disease but also achieve greater health equity.”
Here are FIVE Women’s Health Conditions That Have Gone Undiagnosed:
1. Women are More Prone to Die of Heart Attack
The main cause for deep-rooted inequalities is that women are being underdiagnosed, undertreated, and underserved, said Dr. Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist.
A study published in The Lancet Regional Health – Europe found that women were more likely to die after being admitted to hospital with a severe heart attack, but they were also less likely to be prescribed medication to prevent future heart attacks, such as statins.
Previous research has found women were 50% more likely than men to be given an incorrect diagnosis following a heart attack.
This research found that women who were finally diagnosed with the more serious type of heart attack, STEMI, had a 59% greater chance of an initial misdiagnosis compared with men. Women who had a final diagnosis of NSTEMI had a 41% greater chance of a misdiagnosis when compared with men.
Additional analysis by the researchers, which has not been published, showed that together this amounted to around women having a 50% higher chance of being initially misdiagnosed than men.
2. Endometriosis: The Missed Disease
Endometriosis affects 10% of women and girls of reproductive age with diagnosis taking more than 7 years – and even longer for Black women. It is also referred to as “the missed disease” because of the inconsistencies in its diagnosis and management.
In a documentary Below the Belt by the American filmmaker Shannon Cohn, the struggles of women who are suffering the unbearable pain of endometriosis are highlighted. The documentary also exposes widespread problems in our healthcare systems that disproportionately affect women.
It addresses topics such as societal taboos, gender bias, misinformed doctors, and financial barriers to care. The film reveals how “millions are silenced and how, by fighting back, we can improve healthcare for everyone.”
She has also been vocal about her personal struggle with the condition since she was 16 years old. She revealed that for 13 years, none of her healthcare providers believed her. She was told that her symptoms were imaginary or simply being a “woman” or that her pain was exaggerated.
The first step to solving any problem is believing that it exists. Even now endometriosis has remained largely ignored in government policy and research funding globally.
3. Autism
Autism is only for men and boys. This modern-day health myth has to be debunked.
When it comes to diagnosing autism, reports show that girls are often diagnosed later than boys, and though efforts have been made to close this health gap, the ratio of men to women with autism diagnosis still remains 3:1.
This delay in diagnosis leads to a lifetime of compounding challenges and struggles for women where they are always misunderstood or overlooked.
Autism is still underdiagnosed in girls and women. That can compound the challenges they face. Being autistic, but not diagnosed, can lead to a lifetime of struggles and being misunderstood for women.
Side-effects of undiagnosed autism:
Undiagnosed autism leads to a common lack of understanding of their social behaviours like being confused in social situations, inability to make friends as easily as others, and often ending up being targets for bullies.
Due to lack of awareness or answers available, they grow up with feelings of failure and thinking they have character defects. These self-perceptions can also be formed by the opinions of others in their lives.
Clinical psychologist Karen Saporito says:
“Females often mask and defy stereotypically autistic presentations, individuals and families must endlessly educate others and advocate for themselves or their children to receive the treatments, support, and accommodations they deserve.”
Clinical observations reveal many women who receive their autism diagnosis in adulthood have had various other diagnoses including anxiety disorders, depression and mood disorders, borderline personality disorder, obsessive compulsive disorder, and eating disorders.
Many celebrity women have come forward with their experiences of growing up being undiagnosed as autistic. Some prominent names are Hannah Gadsby, Australian comedian, Wall Street actress Daryl Hannah, British reality star Christine McGuinness, and former Australian of the Year Grace Tame.
If left untreated, these negative experiences growing up can lead to or interact with PTSD symptoms in adulthood. Parents and teachers need to take care to identify and understand autism in girls.
4. ADHD
Another neurological condition that frequently co-occurs with autism, and is similarly mis- or under-diagnosed in females, is attention deficit hyperactivity disorder (ADHD). In the US, less than 1% of women have a diagnosis of ADHD, but the number is growing rapidly, according to research.
As with autism, ADHD symptoms present differently in women, while historically, research focused on boys with the condition.
“Historically, research on ADHD has focused almost exclusively on hyperactive little boys, and only in the past six or seven years has any research focused on adult ADHD,” says Nadeau, an expert on the disorder in women and director of Chesapeake Psychological Services of Maryland in Silver Spring. “And the recognition of females [with the disorder] has lagged even further behind.”
In 2023, analysis of a data set found the rate of diagnosis among women aged 23 to 49 almost doubled between 2020 and 2022, which the study said supports findings that women tend to be diagnosed later in life than men.
According to Nadeau, this lagging recognition of girls and women is due to:
- Current diagnostic criteria – which remain more appropriate for males than females.
- Parent and teacher referral patterns – some deny that the disorder exists in females – or in anyone at all.
For advocates, the bottom line is this: Girls with undiagnosed ADHD will most likely carry their problems into adulthood, and left untreated, their lives often fall apart.
5. Autoimmune Conditions
Autoimmune diseases are the third most prevalent diseases after cancer and heart diseases in humans. They are triggered by genetics or environmental factors such as a viral or bacterial infection.
Examples of autoimmune diseases include lupus, psoriasis, multiple sclerosis, rheumatoid arthritis, and thyroid diseases. They stimulate the body’s immune defences to attack itself.
These diseases are chronic and require lifelong management, and some of them are incurable as well. With limited treatment options, they are extremely complicated and difficult to address.
Women account for the majority of people (80%) with autoimmune diseases, but it takes an average of five years for them to get a diagnosis, according to the American Autoimmune Association.
Why do women account for 80% of autoimmune diseased patients?
The answer is simple yet complicated. The answer lies in a molecule – Xist, pronounced like the word “exist” – which is found only in women. This was discovered by scientists at Stanford University.
Let’s understand this in a bit more detail:
It all starts with chromosomes. Chromosomes are tight bundles of genetic material that carry instructions for making proteins. Women have XX chromosomes, and men have XY chromosomes.
Xist inactivates one of the X chromosomes in women to prevent overproduction of proteins. However, at the same time, Xist gets triggered by environmental factors and impacts the production of auto-antibodies. These auto-antibodies, instead of defending the body from invaders as an antibody would, start targeting features of the body.
Although potential treatments are still a long way off, greater research and investment is required in understanding the fundamental mechanisms, which will then lead to developing therapies, early detections, and eventually prevention.
Conclusion:
The gender health gap is becoming an important topic to talk about. Every woman should be capable of receiving quality care at the right place and at the right time, whenever and wherever she needs it.
Only when these problems are solved will the gender health gap begin to shrink.
Better health outcomes of women’s health can only be achieved by raising awareness, taking a stand, and identifying the biggest disparities that are preventing governments from forming strategies and policies.
Initiatives should go into funding research specifically aimed at women’s health issues, by targeting and addressing the gender bias in misdiagnosing, lack of diagnosing, and ignoring serious health concerns of 50% of the world population.
