The 28th of May is the International Day of Action for Women’s Health, an international observance that is celebrated every year since its inception in 1987. The day is aimed at improving women’s health, raising awareness about women’s right to health, and promoting gender equality in the healthcare sector. Women have historically been excluded from healthcare and often lack empowerment to take control of their health. It is not only important to understand this disparity, but take action towards remedying this gendered gap. Women have a fundamental right to their health and the more this is recognized, the more equitable and effective the healthcare field will become.
Though there are multiple areas of health that depict gender-based disparities, the exclusion of women and overrepresentation of men in medical research studies and clinical trials can be considered a critical systemic issue. Women are often left out of clinical research due to their increased complexity and inconsistency as study subjects. Because women generally experience greater hormonal variation than men and are thus also more different from each other than men are from each other, their presence in clinical studies poses additional confounding variables. This then creates a need for additional resources and examination of these factors that many researchers do not want to devote time and money to when they are not required. Though reluctance to spend additional time and money unnecessarily is understandable, it is proven to be necessary when consequent findings based solely on male test subjects are applied to women in practice.
Just as it is recognized that men and women are physiologically different, it must also be recognized that medical findings based on the study of one sex cannot be generalized and applied to both. Continuing to abide by this gender bias in research poses detrimental to women’s health. For instance, there is far greater research done on coronary artery disease in men than in women, yet women experience higher rates of morbidity and mortality. Similarly, there is little information on drug efficacy in women throughout the pharmaceutical industry because of safety concerns for women in clinical trials, yet the safety concern is no longer present when prescribing a woman a medication that has only been tested on men. The gender bias in medical research not only lacks recognition but poses a true danger to women’s health. This deeply rooted barrier in medical research and practice must be dissolved in order to truly move forward in creating an equitable healthcare environment.
Inadequate recognition and inclusion of gender-related biological distinctions are not the only factor contributing to gender-based inequality in health. Gender is also recognized as a social determinant of health, contributing to these health inequities on a sociocultural level as well. In many countries, social norms dictate that women’s focus be on reproduction and household care, rather than education and employment. This in itself promotes inadequate health education for women and exacerbates the issue of women lacking control over their own health. Exclusive medical focus on the female reproductive role also endorses the exclusion of women from medical research under the veil of risk prevention and inherently guides the view that every other aspect of women’s health does not require the same caliber of health services. It is important to recognize that every other aspect of health that is considered important for men is just as important in women and that women’s health should not be so narrowly focused on reproduction. This closed view prevents women from achieving essential, comprehensive health services and receiving quality services in every class of wellbeing.
Women’s fundamental right to health includes equal rights to opportunities and access to essential health services. Though this access is inhibited by issues of infrastructure and sociocultural perspectives, it is also exacerbated by a lack of inclusion of women in the field of medicine itself. This gendered exclusion stems from both direct and indirect causes. Directly, only 30% of researchers worldwide are female, meaning men hold more leadership roles in research and science. Unequal representation of women in these roles then exacerbates the cycle of gender bias in medical research and inadequate advocacy of women’s right to health as doing so would push men out of these important roles. Indirectly, social factors affect women’s ability to take action against this bias and inequality. Many countries do not have proper maternity leave, so mothers cannot afford the time to handle both high-demand leadership roles in medicine and assumed home responsibilities. Likewise, in countries where women are discouraged from entering the workforce and expected to take care of their home and children, social norms do not allow for them to obtain the leadership roles necessary to take action in putting women’s health in the hands of women.
With many social determinants working against the breaking of traditional gender norms and the cycle of gender bias being sustained by systemic healthcare issues, the first step to eliciting change lies in empowering women to take control of their health. One of the biggest roadblocks in doing so is fostering a strong sense of confidence and comfort in discussing women’s health. Primarily in poorer communities, young girls sometimes do not have a proper female role model to discuss these topics with them. For instance, girls who do not grow up with a female figure in the house may be uncomfortable discussing topics such as menses, hormones, and sex with only men. Likewise, men may not know how to teach these topics as biologically, they cannot pose as a physical example. It is important to create role models of women that look and have similar life experiences as the young girls that need to feel comfortable in discussing their health so they can be taught to hold their own health in their own hands.
Action for women’s health cannot be truly successful if women do not feel comfortable handling their health in the first place. In order to empower women to have control over their health, women need to be given a voice and a safe space to learn about their health and speak in a healthcare setting free of social judgment. Eat Better South Africa (EBSA) is a community-based non-profit organization working to aid the local public healthcare systems by improving the health of local community members, through the implementation of nutrition education programmes that empowers community members to improve their health by making the best dietary choices available to them. EBSA aims to create this comfortable environment to empower people, particularly women, from impoverished communities to improve their health through nutrition education and support. The EBSA program runs for six weeks and promotes a diet that is low in carbohydrates and high in healthy fats which has been shown to be effective in preventing and treating metabolic disorders such as Type II diabetes. Programs like EBSA are taking this first step in empowering women to take charge of their health, creating the necessary safe space for the discussion and education necessary to evoke change.
The Noakes Foundation (TNF) is a non-profit organization challenging the science, and is dedicated to advancing understanding of the role of nutrition in health and disease. TNF that relies on donations to fund its research and educational initiatives, aimed at advancing understanding of the role of nutrition in health and disease and promoting healthy weight and metabolic health. Supporting TNF and EBSAcan make a difference in the fight against the global obesity crisis.
This International Day of Action for Women’s Health, strive to take action against these gender biases and inequalities in healthcare. Speak up for women’s right to health to raise awareness for this important social issue and encourage others to take action towards shaping medical inclusivity across the globe.
National Institutes of Health (NIH). NIH Inclusion Outreach Toolkit: How to Engage, Recruit, and Retain Women in Clinical Research. Available at: https://orwh.od.nih.gov/toolkit/recruitment/history
Holdcroft, A. Gender bias in research: how does it affect evidence based medicine? Journal of the Royal Society of Medicine. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761670/
United Nations Educational, Scientific and Cultural Organization (UNESCO). Just 30% of the world’s researchers are women. What’s the situation in your country? Available at: https://en.unesco.org/news/just-30-world%E2%80%99s-researchers-are-women-whats-situation-your-country
Pujol-Busquets, G.; Smith, J.; Bach-Faig, A.; Fàbregues, S.; Larmuth, K. Community Assessment for a Low-Carbohydrate Nutrition Education Program in South Africa. Available at: https://www.mdpi.com/2072-6643/15/1/67
About the author – Grace Elizabeth Carreno
Grace is a third-year undergraduate student at the University of Florida in the United States, studying Health Science and Sociology. She is a pre-medical student, intending to attend medical school and pursue a future career as a pediatric physician. She is currently interning with The Noakes Foundation, learning about public health in Cape Town, South Africa and the nutritional approach to chronic disease in under-resourced communities led by Eat Better South Africa. Grace is passionate about global health, inequality, women’s rights, and medical equity. She hopes to dedicate her future career towards understanding the social determinants of health that underlie healthcare inequalities contribute to the development of chronic disease. Through the Eat Better South Africa program and lifestyle teachings of the Noakes Foundation, she believes women are empowered to take control of their health, creating a healthier community and fostering equality across the board in the field of health.