Historically, females were excluded from clinical studies, resulting in a health care system that adversely affects women. Congress required women’s inclusion in clinical studies and research in 1993 through the National Institutes of Health Revitalization Act. Since then, women have continued to face difficulties in medicine due to a lack of data.
“The fact that women’s health care has received less attention, research and funding, has deeply impacted women’s health outcomes today,” Communications director of the Society for Women’s Health Research, Monica Lefton, said. “Until about 35 years ago, essentially all health research was conducted on males, largely due to a belief that studying females would be difficult or provide inaccurate results due to females’ hormone levels and menstruation patterns. Therefore, women were often viewed as small men, and conclusions found in male research were generally sized down and applied to females as well.”
Lefton highlighted the impact of women’s exclusion from clinical studies prior to the act’s passing. She said insufficiencies in data have led to “more questions than answers” regarding women’s health.
“Today, we are continuing to make up for the decades during which females were excluded from research, and, in doing so, we still lack an understanding of many diseases and conditions that differently, disproportionately or exclusively affect women,” Lefton said.
Margaret Master, interim executive director of Healthy Mothers Healthy Babies Coalition of Georgia, described the development of women’s healthcare as multifaceted and said disparities are both pervasive and complex.
“In society, there’s a lack of investment in health and research and understanding,” Master said. “We need to be mindful of that and the effects that will occur… A lot of what causes lack of well-being in our society today is chronic conditions, as well as the effects of the social determinants of health. It’s important to recognize that it’s not just one discovery that can improve health. It’s part of systems of care. It’s part of economic well-being, housing policy, community health workers and access to care.”
Medical conditions
The American Society for Microbiology found that scientific biases and historic exclusions from clinical research have exacerbated inequities in women’s healthcare, data and treatment.
“Unless we take the time and put in the effort to look at what makes it different for each person, I think we’re going to miss some major potentials for treatment,” University of Georgia and Augusta University professor of Medicine, Theresa Rohr-Kirchgraber, said. “Certain medications work better in women than in men and vice versa. At the end of the day, it’s really about what we do to find answers that help everybody.”
According to Texas A&M University, women have different symptoms, reactions, susceptibilities and progressions of illness. Lesser-known symptoms can make diagnosis more challenging or prolonged, Master said.
“If disease progression is different or if symptoms present differently in women, some symptoms are misinterpreted or dismissed,” Master said.
Griffin Tullis, a Government Affairs Associate for G2G Consulting, an agency that leads Women’s Health Advocates, highlights inadequacies in women’s healthcare.
“Eighty percent of autoimmune disease patients are women, but research still remains underfunded,” Tullis said. “Women are two times more likely to die after an ER visit for heart disease, yet heart disease research often overlooks sex differences, so how it affects women differently. Women make up two-thirds of Alzheimer’s patients, but sex-specific research is very limited. We could go through most [illnesses] that we know are not truly studied on sex-based differences, which is a huge thing.”
Rohr-Kirchgraber believes women’s involvement in research allows for diverse perspectives, leading to more effective care.
“As we have gotten more people from very diverse backgrounds involved in healthcare and research, that makes a difference because at the end of the day…we want to look into medical problems that we are familiar with,” Rohr-Kirchgrabe said.?”As we get more diversity, we get more exposure [and] every little bit makes a difference in the long run.”
Economics and funding
Tullis believes affordable and accessible healthcare is indispensable within current society.
“Women leave the workplace, due to health [or] health issues,” Tullis said. “For example, when they give birth. All things like that predominantly affect women, and the marketplace loses out. The global economy misses [around] $2 billion annually. It’s a crazy number where it’s basically if we address these women’s health issues, the chronic issues, specifically that eventually will lead to them leaving the workforce.”
According to the NIH, women’s surgeries are often given less coverage than male-comparative surgeries. Tullis believes this contributes to medical biases.
“Women’s surgeries are reimbursed at a lesser rate than male-equivalent surgeries,” Tullis said.?”If [doctors] are not paid to do these [surgeries], specifically, then they’re going to do more male-related surgeries. I think that automatically keeps the disparity in there if the payment is not worth it.”
Lefton believes an increase in women’s health research can drive economic growth for future generations.
“Studying women’s health can benefit all of health care,” Lefton said. “In better understanding the nuances of sex and gender in disease progression or treatment, we can better personalize and tailor health care for all individuals across the country. Including women in clinical trials is an economic imperative: a Women’s Health Access Matters report in 2021 found that investing $300 million in women’s health would add $13 billion to our economy.”
Lefton believes equitable funding can improve healthcare coverage for conditions such as endometriosis.
“In 2022, the NIH budget allocated just $2 per patient per year for endometriosis research,” Lefton said. “By comparison, diabetes, which impacts a similar number of women as endometriosis in the U.S. [and also impacts men], received $31.30 per patient per year. There are still significant funding gaps and social stigmas when it comes to gynecologic health issues like endometriosis, and we must address these.”
One of the first steps to making progress is understanding the causes and effects of chronic illness, Lefton said.
“An estimated one in 10 women are living with endometriosis, but there is no cure for this chronic health condition,” Lefton said. “If we could better understand why people get endometriosis, we can work towards shortening the diagnostic delay many patients face, provide more effective treatment options and maybe one day find a cure.”
Advocacy
Tullis said advocacy work is essential for creating change, believing advocacy can increase a person’s desire to learn.
“Advocacy is important,” Tullis said. “[With] women’s health, people know about it, but they don’t know the details. [With] endometriosis, for example, people typically know what it is, but really not in depth. That makes a huge difference for just education. And then when these members of Congress go to make legislation or policy, they have a better understanding. I think advocacy is a huge, huge part of improving women’s health in the United States.”
Lefton believes advocacy empowers individuals to approach challenges and issues that are underrepresented.
“Women are their own best advocates and should be empowered to speak up for themselves any time they may feel something is being ignored or overlooked,” Lefton said. ”This may include talking to friends and family about health more openly, seeking a second opinion from a health care provider if you feel you are not being heard by your current provider or advocating for women’s health research by contacting your government representatives at the state and national levels.“
Similarly, Tullis believes initiating and engaging with government representatives can have outstanding benefits.
“I think if you’re passionate about an issue or if something is specifically affecting you, you are the expert in your own life and [with] government advocacy, the constituent and the people working in your state legislature, and the federal government represent you and they want to hear from you,” Tullis said. “It can maybe be intimidating to reach out, but that is quite literally their job. You deserve to talk to them, you deserve to have your voice heard. Send an email, make a phone call and just have the confidence to do it because nobody knows your own issue better than yourself.”
Additionally, Feminist Center for Reproductive Liberation grassroots organizing coordinator, Sin Reyes, believes involving younger generations in advocacy work reduces social stigmas by prompting informative and difficult conversations.
“[It is important] to learn how to advocate when you’re younger, you don’t want to wait until you are 50 and your issues have escalated,” Reyes said. “There could be a stigma like, ‘Oh, I don’t want to talk about this’ or ‘I [feel] shy about this or that because it’s taboo.’ But the only reason that it is taboo is because we don’t talk about it. So I encourage everyone to [advocate for themselves]. [People] want to not talk about [issues] because it makes it easier for them. But we need to start making it difficult so they start listening to us.”
Lefton believes increased representation is crucial for achieving comprehensive healthcare for all women.
“The lack of sufficient representation of women in clinical research has real-world consequences for women and their families,” Lefton said. “Without researching women across different populations and throughout their lifespans, women’s health care will always be left behind. We cannot expect women and their health care providers to be able to make the best health care decisions if they are given limited or incomplete information.”
Lefton believes there are changes and developments to be made within women’s healthcare.
“There are countless changes I would love to see happen within women’s health research in my lifetime,” Lefton said. “Beyond increasing federal funding for women’s health research and expanding clinical trial access to include more diverse populations of women. I would love to see greater awareness and education around women’s health–with more women feeling empowered to share their stories publicly and advocate for better care. Self-advocacy is a big part of ensuring equitable and positive health outcomes.”
news/bridging-the-gap-understanding-womens-health-care-disparities/”>Source link
