Gender disparities & global health burdens: Why women bear the brunt unequally

Did you know that women are significantly more likely than men to suffer from depressive disorders, migraines, and osteoarthritis

These conditions contribute to a higher overall disease burden for women globally, revealing a critical health gap influenced by both biological and social factors.

This article examines the causes of health disparities between genders, looking at biological differences, societal norms, and healthcare practices that burden women.

We will investigate various conditions where these disparities are most pronounced and discuss potential solutions to bridge the gap, aiming for more equitable healthcare worldwide.

Understanding gender disparities in health

According to the 2021 Global Burden of Disease Study, women are more likely to experience certain health conditions that significantly impact their lives.

For example, women report 348.3 more disability-adjusted life years (DALYs) per 100,000 for depressive disorders and 332.9 more DALYs for migraine than men, highlighting a significant gender disparity in health burdens [1]​​. 

Osteoarthritis also shows a pronounced gender disparity, with women experiencing this condition at almost twice the rate of men, particularly post-menopause, due to decreased estrogen levels, which affect bone density and joint health.

Biological and social factors

Biologically, differences in hormone levels between genders can influence disease susceptibility and symptoms. For instance, the fluctuating levels of estrogen in women are linked to higher rates of migraines and more severe symptoms. 

Socially, gender roles can significantly impact how individuals access healthcare and manage their conditions. 

Women often face longer diagnosis times and are less likely to receive aggressive treatment strategies for conditions like heart disease [2] due in part to the atypical presentation of symptoms that differ from the established ‘male-centric’ models of illness. 

Specific conditions highlighting disparities

Cardiovascular diseases (CVD)

Heart disease is the leading cause of death globally, but its impact on women is often underestimated due to differences in symptoms and treatment responses between genders. 

Women are more likely to experience non-traditional symptoms of heart attacks, such as nausea, shortness of breath, and back pain [3], which can lead to underdiagnosis and delayed treatment. 

Additionally, according to the European Society of Cardiology, women are less likely than men to receive guideline-recommended therapies for heart disease, contributing to poorer outcomes post-heart attack [4]​​.

Mental health

Depressive and anxiety disorders are more common in women than men. Biological factors like hormonal changes related to menstruation, pregnancy, and menopause can increase susceptibility. 

However, societal factors also play a significant role. Women are more likely to experience poverty, violence, and sexual abuse, all of which are risk factors for mental health issues. 

Despite their higher need, barriers including stigma, lack of mental health services, and gender insensitivity in health care provision impede their access to effective treatments [1]​​.

Autoimmune diseases

Autoimmune diseases strike women far more frequently than men; approximately 75% of those affected by autoimmune conditions are female. 

Conditions like lupus, multiple sclerosis, and rheumatoid arthritis show marked gender disparities in prevalence. 

This disparity is influenced by hormonal factors regulating immune function, with estrogen playing a significant role in immune enhancement. 

Despite the high incidence, there remains a significant gap in research focused on understanding these diseases in women, leading to gaps in effective treatment protocols and preventive measures [1]​​.

Societal influence and healthcare access

Impact of societal norms

Cultural attitudes toward gender significantly influence how diseases in women are diagnosed, treated, and perceived. These societal norms can lead to the trivialization of women’s health complaints, often perceiving them as less serious or psychosomatic. 

For example, women with chronic pain are more frequently given sedatives rather than pain medication compared to men, who are more likely to receive painkillers for similar symptoms. 

The cultural stereotype that “women are more tolerant of pain” further complicates this bias, leading to under-treatment and misdiagnosis [1]​​.

Healthcare bias

Studies consistently show that women are less likely to receive aggressive treatment or be referred for diagnostic tests compared to men. 

A study indicated that women with heart disease are less likely than men to undergo cholesterol-lowering therapy and to receive coronary artery bypass surgery after a heart attack [5]. 

This discrepancy stems from a historical bias where most clinical trials predominantly included male participants, skewing medical standards and treatment protocols away from addressing female-specific health outcomes [1]​​. 

These biases in healthcare not only perpetuate gender disparities but can also lead to poorer prognoses for women, emphasizing the need for a gender-sensitive approach in medical research and practice.

Regional disparities

In sub-Saharan Africa, women are disproportionately affected by HIV/AIDS, with prevalence rates significantly higher compared to their male counterparts. 

This disparity is exacerbated by factors such as gender-based violence and limited access to preventive education and medical treatment [1]​.

During adolescence, girls begin to experience higher rates of conditions like depression and anxiety. 

As women age, they face increased risks of developing chronic conditions such as osteoporosis and low back pain

Post-menopause, women’s reduced estrogen levels significantly impact bone density, increasing the prevalence of osteoporosis

Such conditions affect women’s health and quality of life, emphasizing the need for age-specific healthcare interventions that cater to their changing health needs throughout their lifespan [1]​.

Strategies and global initiatives

Organizations like the World Health Organization have implemented initiatives promoting gender-sensitive research and policy-making. 

National policies are also adapting; for example, countries like the US and Canada have introduced guidelines requiring women in clinical trials to ensure that medical treatments are effective for both genders​. 

How can you help bridge the gender health gap?

Individuals can be pivotal in advocating for and supporting gender-equitable healthcare policies. Here are a few ways to contribute:

  • Education and awareness: Stay informed about gender disparities in health and educate others. Increased public awareness can drive policy change.
  • Support non-profits: Engage with and support non-profit organizations that work towards women’s health rights and gender equity in healthcare.
  • Advocacy: Participate in advocacy campaigns that push for research and healthcare practices that include gender differences.
  • Community engagement: Volunteer in community health initiatives that aim to improve access to healthcare for women, especially in underserved areas.

We have discussed the significant gender disparities in global health, with conditions like cardiovascular diseases, mental health issues, and autoimmune diseases disproportionately affecting women. 

These differences arise from a complicated interaction of biological, social, and healthcare-related factors.

Moving forward, it is crucial to continue advocacy, research, and policy-making incorporating gender-specific data. 

By maintaining focused efforts, we can strive to close the health equity gap, ensuring comprehensive and effective healthcare for both men and women, ultimately improving health outcomes for all.

[1] https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(24)00053-7/fulltext
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018605/
[3] https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack/heart-attack-symptoms-in-women
[4] https://www.escardio.org/The-ESC/Press-Office/Press-releases/Women-with-heart-disease-are-less-likely-to-receive-life-saving-drugs-than-men
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834856/ 

Photograph: bnenin/Envato
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