For all society’s talk about how much women count, the systems that underpin healthcare don’t count us properly at all. The net result is a women’s health gap at odds with advances in medicine. Something doesn’t add up.

Friday, March 8, 2024, is International Women’s Day, a day that champions gender parity. Yet despite headline achievements in the fight for equality, the small print shows that women spend 25% more time in poor health than men. Almost half of that burden occurs during our working years, limiting our ability to earn money, build careers and support our families. It’s hardly the platform for equality we need.

The drive for gender parity is contingent on our health. If we don’t level the playing field there, hard-won progress made elsewhere will inevitably be undermined. So if we’re going to maximize pathways to equality of opportunity, we need to make health a priority focus.

Recent analysis from McKinsey says the women’s health gap is a ‘trillion dollar opportunity to improve lives and economies’ – a claim that says as much about our current failings as it does the size of the opportunity ahead. According to the report, closing the gap will bring more women into the workplace, lifting many out of poverty, and creating a ripple-effect in quality of life.

So how do we do it? A good start point might be to redefine our focus. Think ‘women’s health’ and your mind will probably leap to the obvious – menstruation, pregnancy, gynecology, menopause, etc. However, women’s health is much more than reproductive or gynaecological health, so to limit our focus to those areas only wholly underrepresents the health challenges we face.

According to McKinsey, women-specific conditions like maternal or gynaecological health account for just 5% of the women’s health burden. More than half of the total burden (56%) is caused by general conditions that are either more prevalent in women or manifest differently in women. Conditions like headache disorders, depression and autoimmune diseases affect women disproportionately, whilst women are also more likely to become disabled during their lifetime. They’re also more likely to be obese, and are a higher risk for heart failure or heart attack death.

So why the variation? Why do women spend 25% more time in poor health when only a fraction of their health burden comes from diseases specific to their gender or sex? The answers largely boil down to the usual suspects; gender disparities in access to health services, gender bias in patient care, and variation in the effectiveness of – or access to – medical treatments. However, two other factors quietly contribute to the disparity:

Limited sex- and gender-specific research

Studies indicate a systemic deficit in disease understanding in women’s health correlates with a lack of sex- and gender-specific research. Nature analysis published last year reveals that conditions which disproportionately affect women – like migraine, headaches, CFS and anxiety – attract much less research funding than other diseases. According to the report, women’s health is “undervalued and understudied”.

Women are also underrepresented in clinical trials. It shouldn’t surprise us – they weren’t allowed to participate in trials until 1986. But it’s something we need to put right if we’re to better understand the sex-related biological differences that influence health, and develop more effective medicines for women.

Gaps in data

The shortfall in research inevitably leads to gaps in data, inhibiting evidence-based decision-making. According to McKinsey, many of the epidemiological and clinical data sets widely used today ‘fail to provide a complete picture of women’s health because they undercount and undevalue the health burden’. As the report warns: “when women’s health is invisible, there are missed opportunities to improve lives.”

An example of this can be seen in metastatic breast cancer (MBC), where flaws in the way cancer registries are built means we cannot accurately count the number of people with MBC. Consequently, data is incomplete, compromising everything from drug development and policy decisions to treatment choices and experience design. It’s just one reason why people with MBC feel undervalued: when no-one can count you, it’s hard not to feel like you just don’t count.

Gaps in data are delaying progress in women’s health right across the board. Communications can, of course, play a role in driving change, shining a light on disparity and reinforcing the value of lives reshaped by disease. Our recent initiative with Europa Donna – The Cancer Currency –does exactly that. Designed to ensure that women with MBC are counted and valued, it’s the perfect message for International Women’s Day.

Women count. We’ve got the tools to close the women’s health gap and maximize opportunities for gender equality. Let’s make it count.

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