Men and women experience healthcare differently. According to statistics from across the globe, there is still a significant disparity in the quality of care women receive in the healthcare setting.

There are numerous reasons for this which include a lack of education of both doctors and the population, subconscious sexism from medical staff and a lack of resources and funding that cater to the unique and diverse needs of women. This inequity in healthcare between men and women and the subsequent gap that stops women from accessing the care that they need is termed the gender health gap.

For International Women’s Day this year, we run through the latest research and current statistics to explore the different circumstances in which the gender health gap exists and the probable reasons for the divide. Furthermore, we look at what changes are being made by governments to bridge the gap, working towards the highest-quality and accessible healthcare for all.

Examples of the gender health gap

There is a significant deficit in the understanding of women’s health conditions by the medical community. This could be due to 1) a lack of research on women-related health issues and 2) a lack of education. This misunderstanding often leads to the dismissal and misdiagnosis of women’s symptoms and health conditions. Furthermore, the unavailability of facilities and medical specialists for conditions that are specific to women lies at the core of women’s frustrations regarding their healthcare.

Women’s voices on their experience in the healthcare setting

A mass survey done by the UK to address the need for women-focused healthcare highlighted the exasperation and struggles many women experience when talking to healthcare professionals. 85% of the individuals said they felt like they were not being listened to by their doctors, with 72% of these responses referring to when they were discussing symptoms with their doctor.

The responses revealed that, upon initial contact with the medical professional, most women were told their symptoms were exaggerated or normal and then received a wrong or no treatment plan. This is particularly prevalent for women seeking a diagnosis for endometriosis.

Endometriosis—the struggle for a diagnosis

 Endometriosis is a condition that causes tissue that is usually restricted to the lining of the uterus to form outside the uterus. It is a condition that affects approximately 176 million women worldwide. And yet, it takes an average of 8 years for a woman to obtain a correct diagnosis for the disease. In the US, it takes an average of 10 years to be correctly diagnosed.

A study of the in Austrian patients with endometriosis highlights the normalization of pain in women suffering from gynecological conditions. This could be a large contributing factor to the delay in obtaining a correct diagnosis.  An MDPI review by Sims et al., in the International Journal of Environmental Research and Public Health, discusses how inherent stigma surrounding endometriosis could be a significant driving factor in the delay in care. As a result, both within and outside the healthcare setting, women felt that their symptoms were downplayed and overexaggerated, emphasising the sense of shame surrounding their condition.  Stigma surrounding the disease could hinder women from accessing the care that they need, as they may feel their pain or symptoms are not severe enough for appropriate medical care.

A recent breakthrough in research

Outside of social barriers, the complex pathology of endometriosis has called for an urgency in funding this area of research.  Recent advances in the diagnosis of the disease have shone a light at the end of the tunnel for women who have been suffering with this painful condition. New molecular subtyping using simple salivary tests could be the future of diagnostics, however, is currently used with caution in the clinic. But this brilliant breakthrough gives women hope for the future, in that they will no longer have to wait years for a diagnosis from their doctors.

Endometriosis is just one condition that highlights the struggle women face in accessing the care they need. Amongst others, severe menopause symptoms, PCOS and other chronic conditions are prevalent issues in which women need more support from their healthcare providers.

When looking at emergency care in men and women, there is a striking contrast between the care that men and women receive.

Differences in access to emergency care and pain medication

A review in the International Journal of Environmental and Research and Public Health  (IJEPRH) discusses the differences in access to emergency care and pain medicine between men and women.

A study described in the review show that women have an increased risk of receiving inadequate emergency care compared to men with comparable injury levels. This includes men being treated with a higher priority by paramedic staff and more likely to access further care at trauma units compared to women. In another study with 26,861 patients, similar results were found, with women being less likely to receive treatment in trauma centres, despite injuries being comparable.

One study showed that there is a significant disparity in access to pain medication in women compared to men. The study consisted of 981 patients with acute abdominal pain. They found that women with similar pain scores to men were less likely to receive analgesic treatment from healthcare staff.

The reasons for these disparities are complex and could be multifold. This encompasses gender stereotypes and gender biases which could be conscious or subconscious. Such biases and stereotypes include the assumption that women exaggerate their pain or the extent of their injuries. These harmful biases lead to worse healthcare outcomes for women, further widening the gender health gap.

Factors effecting the gender health gap

Socioeconomic status and the health gap in the UK

As explored, although women make up half of the population, their experiences in healthcare settings differ vastly from men. This gap is even more apparent across different household income brackets and social classes. Analysis by the British Medical Association shows that the life expectancy between women widens across the socio-economic statuses of the UK population. Both men and women living in more deprived areas of the country have lower life expectancies compared to those living in more affluent areas. There is a wider gap in life expectancy between women who lived in more deprived vs least deprived areas, compared to men. Furthermore, women with lower household incomes also experience a higher prevalence of mental health disorders.

Women who live in more deprived areas and have lower household incomes have poorer health outcomes. This could be attributed to a multitude of systematic issues, a lack of funding, increased healthcare costs in countries where healthcare is not free and a lack of education.

Non-medical factors influencing health outcomes

Globally, background and living conditions have a significant impact on the quality of healthcare accessed by both men and women. The social detriments to health (SDH) are defined by the World Health Organisation (WHO) as the ‘non-medical factors that influence health outcomes’. This includes education, working life conditions housing and early childhood development. As indicated by the statistics previously mentioned, the WHO states that across all countries, the lower the socio-economic status, the worse the health outcome.

Providing more education to both the public as well as healthcare professionals can be essential to saving lives.

Access to breast-cancer screening in Saudi Arabia

Educating the public is a key factor in ensuring that diseases which could be detected early, such as cancer, can be treated – therefore resulting in better health outcomes. A study in IJERPH analysed the impact of socio-economic status and levels of education in two different population of women in Saudia Arabia.  The results showed that women who were richer and more educated were more likely to access breast cancer screening services compared to women who were less educated and from poorer communities.

Therefore, along with ensuring medical staff are educated on women’s health, educating women on their bodies and health is vital to improving health outcomes. However, it is also vital that governments provide enough resources and health support to poorer parts of the population.

An aim to close the gender health gap

WHO aims

The gender health gap poses a major challenge for health outcomes for women, as well as exerting a significant strain on health services. It is essential that the disparity is first and foremost recognised.

In 2008, the WHO launched a commission on SDH to address the health inequities that vulnerable populations experience globally. The commission aimed to support and bring awareness to countries about SDH, and how they can best address the issues to close the health gap between richer and poorer populations.

The commission also discusses the importance of gender equity and how education is of vital need to empower women to gain autonomy of their own health. They provide governments with recommendations, which included the implementation of robust frameworks and policies surrounding funding of resources, setting up interventions, educational programs, and vocational training for women about healthcare.

Furthermore, in 2016 the WHO launched a strategy on women’s health and well-being in Europe. This assessed the landscape of women’s health and the effect of gender discrimination on the healthcare system and looked at frameworks to tackle these issues.

Government strategy

An example of actions taken by governments to address the gender health gap can be seen in the UK. In response to the national survey about women’s experiences in healthcare,  an initiative called the ‘Women’s Health Strategy’ was set up in 2022 to tackle the gender health gap and provide women with the support they need in the healthcare setting. This included a clear and defined plan to boost healthcare outcomes in women within 10-years. Changes include:

• A reduction in appointment waiting times.
• Investment to support the health service workforces.
• Setting up funds for women’s reproductive health.
• Supporting women struggling with menopause by increasing access to hormone replacement therapies.

Similarly in the USA, a women’s health research initiative was launched in 2023 called the ‘White House Initiative.’ Its main aim was ensuring funding was available for research in women’s health, urging ‘innovation and investment to close research gaps and improve women’s health.’ This includes interacting with scientific and private companies as well as the public sector to advance women’s health.

Initiatives like these aim to encourage research carried out on topics that, up until now, have been significantly understudied. This includes menstrual health and gynaecological conditions, menopause, and the effect of other illnesses on women’s health specifically, e.g., the impact of COVID-19 on women’s health conditions. Importantly, it establishes new policy and robust frameworks to be put in place to attempt to close the gender health gap and improve health outcomes for women. These strategies provide hope for a future in which the gender health gap no longer exists.

Future research

Women make up half the population, but research shows that women do not experience the same level and quality of healthcare that men do. There needs to be more funding for research to understand women’s health issues and how different illnesses affect women’s health specifically.

The theme for this year’s IWD is ‘inclusion’. In this article, we looked towards those parts of the population that experience lower economic statutes and poor education who are even further marginalized by the healthcare system. A surge in raising awareness and governmental strategies have triggered an urge to provide more funding for women’s research as well as facilities and resources to the communities that need it the most, as seen in the US and UK.

MDPI makes all its research freely available and accessible. MDPI’s journals such as Women and IJERPH publish the highest quality research, which include topics on women’s health. If you would like to read more, or publish your own work, you can access a full list of journals here.