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What Are Health Care Gaps and Why Do They Happen?

How often have you gone to the doctor for a health concern only to be dismissed? Have you ever been told that your feelings are inaccurate and not concerning when you think it actually is? These are health care gaps that we need to recognize and eradicate.

In an age where the average medical appointment is 15 minutes at best, how can a doctor:

·       listen to your concerns

·       give you a treatment plan

·       diagnose you appropriately

·       make you feel heard and comfort you

To me, this is a tall order to expect in under 15 minutes!

What is happening with us more often, is being reduced to an allopathic medication. A prescription is prescribed to treat the symptoms rather than going deep into the causes.  

No one wants to be sick. No one wants to have a cabinet full of prescriptions that feels like a Band-Aid for all problems. So, it is important to identify health care gaps to eradicate it completely. It starts with awareness so let us understand why we have such gaps in our healthcare system.

What is Gender Bias?

Extensive studies have shown that there are different biological and anatomical differences between men and women. For example, men tend to have larger organs and denser bones compared to a woman of the same height. Then there are the obvious hormone and reproductive differences.

Something that shows up in clinical trials is that the male body is ‘normal’ and ‘typical’ when it comes to research. The male body has been studied more extensively for medical purposes. So, information is applied to the female body with some slight tweaks. But extensive research has not gone into women’s health which reflects a complete gender bias.

Understanding gender bias in healthcare

Research and clinical trials date back to 500 BC. While the processes have evolved over centuries what is fairly new is the inclusion of women in these studies.

It might surprise you to know that it wasn’t until the 1970s that women became an active part of clinical studies. More so, for the ones associated to gynecology while skipping common healthcare problems that happen to both men and women.

What is even more shocking is that to this day we are still a minority at the research table. Heart disease is the number 1 killer of women attacking 1 in 3 women each year. Women are 50% more likely to die within one year after a heart attack.

Even with these high numbers, women only receive 17 cents per female for research compared to the $4 per man. Since our bodies are smaller on average than that of men means that we experience diseases differently.

Since research has been done on men, their presentation is classified as ‘typical’ whereas the way a woman presents is ‘atypical’ prolonging a diagnosis and laying the patient prey to further damage. We often go underdiagnosed as the benchmark set is more inclined towards how a typical male body reacts than that of female.

One of the main reasons that women have been excluded from medical research is because of the hormone fluctuations. As our hormones keep changing throughout a month, the process of diagnosis becomes complex. Since men don’t have drastic hormonal changes, they are deemed to give a truer and clearer outcome when it comes to results for testing.

Women’s hormone changes are thought to create inconsistency in the outcomes and make it harder to keep track of underliers. Since women aren’t the main focus of research, we are 50% more likely to be misdiagnosed. It is often seen that cancer goes undetected in women for over 4 years.

Who are drugs really made for?

Drug trials are another area women have been ignored. This goes back to the hormone changes making it harder for researchers to track outcomes.

It has always been a taboo to test on a pregnant woman for fear of what could happen to the baby. Because of this taboo women who were pregnant, or could become pregnant, during the trial were excluded. This taboo left woman-centric health take a backseat.

Since there has been little knowledge about women’s health, drugs have been prescribed in gender-neutral doses. This form of prescription ignores body size, fat, and muscle differences, along with hormone ratio differences.

Ignoring these differences has caused women to have higher drug reactions compared to men. It hasn’t been until recently that researchers found that women metabolize at slower rates than men.

Since women have not been included in many of the drugs developed to treat female diseases – men have been the main participants in these trials. Based on data collected from these drug trials, the FDA approved drugs have major side effects on women. On the contrary, the same do not reflect in male patients as the approvals were done based on trials on men.

In 2005, 8 out of 10 drugs were withdrawn from the US market due to the health issues they caused to women. This is an alarming revelation since women use on average 56% of the prescriptions prescribed each year.

How to bridge health care gaps?

In recent years, we have seen a lot of progress in the health and wellness realm in the form of products and apps. But we need to keep in mind that health and wellness and scientific facts are not the same things.

There are things we can do to optimize the 15 minutes we get during doctor consultation. When looking for a new provider, put them through the interview process.

Ask yourself, “how is this provider going to be able to help you meet your goals?” Create a list of symptoms and write down important questions before heading into the chamber.

There are differences between standard and functional labs and the ranges they use. Knowing what labs to request, and how to read them, will be a big game changer. Making sure that you are an active participant can make a huge difference in your treatment and your overall experience.

Conclusion

If you are interested to bridge health care gaps for yourself and learn more about self-advocating or have questions regarding health snags, we urge you to sign up for the HerHeartCo newsletter. We are here to answer all your questions at the center of the care experience.

 

References:

Gender bias in medicine – sage journals. (n.d.). Retrieved August 15, 2022, from https://journals.sagepub.com/doi/pdf/10.2217/17455057.4.3.237 

Bhatt, A. (2010, January). Evolution of clinical research: A history before and beyond James Lind. Perspectives in clinical research. Retrieved August 17, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149409/ 

Greater Investment in women’s heart disease research could yield big payoff. www.goredforwomen.org. (2022, July 11). Retrieved August 15, 2022, from https://www.goredforwomen.org/en/about-heart-disease-in-women/latest-research/womens-research-funding 

Hillman, S. (n.d.). I am a medical feminist. Sarah Hillman: I am a medical feminist | TED Talk. Retrieved August 15, 2022, from https://www.ted.com/talks/sarah_hillman_i_am_a_medical_feminist 

Holdcroft, A. (2007, January). Gender bias in research: How does it affect evidence based medicine? Journal of the Royal Society of Medicine. Retrieved August 15, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761670/ 

TEDxTalks. (2019, November 6). Gender bias creates a culture of disbelief for female patients | Colene Arnold | TEDxPortsmouth. YouTube. Retrieved August 15, 2022, from https://www.youtube.com/watch?v=U1XvFSoUhWI&t=720s 

Taking on gender bias in clinical trials: National Women’s Health Network. National Women’s Health Network |. (2020, December 30). Retrieved August 17, 2022, from https://nwhn.org/taking-on-gender-bias-in-clinical-trials/ 

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