The gender health gap

Last year the government published their proposal to address the gender health gap in the UK with the first Women's Health Strategy for England. It's a great step in addressing an issue rooted in history, not only in the UK, but across the world. However, for any woman who's ever been brushed off, misdiagnosed or misunderstood when faced with a health problem, the concept might be great, but does it help with the seemingly small issues as well as the big ones? Does it help people or problems?

What is the gender health gap?

In an overarching sense, the gender health gap is the difference between how quickly men and women are diagnosed, the outcome of their treatment and their initial access to healthcare. That’s a very real thing, so it's great that the government's strategy:

"Sets bold ambitions to tackle deep-rooted, systemic issues within the health and care system to improve the health and wellbeing of women, and reset how the health and care system listens to women."

The plans speak about addressing female specific health problems and expanding women’s health-focused education and training for incoming doctors, amongst other core objectives. It's hard to know how that will really play out, but let's aim for high hopes and positive results.

Women’s health problems and health problems happening to women

Speak to any woman who feels as though she hasn’t really been heard however, the challenge is as much about listening to women (or people?) and understanding their wellbeing experiences as a whole as it is about issues that specifically relate to their gender. Sometimes a woman’s health problem is a woman’s health problem, but sometimes it’s just a problem that’s happening to a woman and that needs to be understood as well.

For example, we know that women present very differently when it comes to heart attack symptoms to men. Johns Hopkins Medicine says:

"While the classical symptoms, such as chest pains, apply to both men and women, women are much more likely to get less common symptoms such as indigestion, shortness of breath, and back pain, sometimes even in the absence of obvious chest discomfort."

A lack of awareness of this information means that women are still twice as likely to die after a heart attack than men, even though this knowledge has been in the public sphere for years. There's a perception that heart failure is male condition, these symptoms are less recognised and therefore they don't receive equal treatment in a situation where time is of the essence.

That's not a women's health problem - it's a health problem that is happening to women.

A historic health problem

Since the days of Aristotle, women have been at a medical disadvantage, but we don’t need to go back that far. It wasn't until 1993 that Congress made it law to include women in clinical research in the USA - prior to that (from 1989), it had been NIH policy, but it was not a legal requirement.

A particularly curious revelation in 2016 even revealed that the federal approval of Addyi, the first-ever drug to treat female sexual dysfunction, was tested in a study that enrolled 23 men and only two women. In effect, the drug for the sole use of women was tested on a population of 92% men. Make of that what you will.

Arguably, across the last 500 years we can see a handful of major advances in women's healthcare. One of them is the contraceptive pill (fantastic, but not ideal for everyone and not without consequence), and the speculum - an item which, broadly speaking, dates back to the Roman empire - was updated to medical grade plastic in 2017. Those enjoying their cervical smear tests across the UK are nothing short of delighted (although we are extremely grateful that cervical smear tests are available - please make sure you have them).

Of course, to some extent this is a slightly glib statement, but any woman who has had a chat with a medical professional and been told it’s ‘probably their hormones’ will tell you that actually, it isn’t always. Even if it is, it still needs to be considered with due reverence. For example, menopause is currently a hot topic and we are delighted to hear it. Menopause needs to be a proper consideration in healthcare because all women will experience it after a certain age. However, anecdotally, there seems to be a danger of it becoming a new scapegoat for every woman's health problem; if you’re under 40 it’s probably your hormones, if you’re over 40 it’s probably your lack of hormones.

Speaking to the whole person

So, what’s the point of discussing all of this? It’s all in the public domain, so why write about it in a space reserved for spas and wellbeing?

We have written before about the potential that complementary therapies have for improving the nation’s health, and highlighted that spa treatments have a big role to play in supporting both mental and physical health for all people and at all stages of wellness. There’s another way in which we can learn from this often underestimated industry however, and it could contribute positively to levelling out inequalities in the way that women’s health is approached.

Spas don't have the answer to all the world’s, or all women’s health concerns, but they do one thing that perhaps provides something of a starting point. It’s not groundbreaking, it’s not even all that clever, but it’s deeply, empathetically human - they begin with the idea of treating the whole person - not just the symptom.

So perhaps, as part of the grand plans and impressive investment in women’s health - all of which is fundamental and essential - we could do something else as well. Perhaps we could listen to women, and treat each one as a whole person?