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The gender gap in healthcare: Where are we at?

Historically, the medical system has chronically discriminated against women. One blatant example is that until the mid-1990s, women were routinely excluded from clinical trials. For a long time, our bodies were considered to work in the same way as men’s or, more recently, were seen as too difficult to study due to our hormonal cycles. This resulted in a lack of funding for research into conditions that primarily affect women.

This gender gap wasn’t created because men had any ill intentions towards women. After all, every man has girls and women in their life for whom they care deeply and want the best possible care. Rather, for a long time, men simply didn’t think that gender differences could have much of an impact in research, pharma or healthcare. And thus, male norms often went unquestioned.

Thankfully, significant progress has been made over the last couple of decades, but a lot of catching up is still needed. The gap is still present, and we need to quickly come up with solutions to be more inclusive.

Over the years, it has become clear that sex differences are substantial. Women respond differently to drugs and vaccines than men, and present different symptoms for the same diseases.

Sex matters 
So why is it so crucial to address women’s health? Over the years, it has become clear that sex differences are substantial. Women respond differently to drugs and vaccines than men, and present different symptoms for the same diseases: the early warning signs of a heart attack are not the same in both sexes, for instance.

Women are also more likely to get some diseases, from auto-immune and neurological conditions to Alzheimer’s and depression. In her book Invisible Women, Caroline Criado-Perez argues that even today, and even for diseases that are more prevalent in women, researchers still often study male cells only: ‘Women are 70% more likely to suffer from depression than men, for instance, but animal studies on brain disorders are five times more likely to be done on male animals.’ Another example stated by Harvard Health is that 70% of those affected by chronic pain conditions are women, yet 80% of pain research is conducted on males.

And then, of course, there are conditions that affect women only, such as endometriosis. Even though one in ten women suffers from endometriosis and this causes severe pain and complications, it takes an average of eight years to be diagnosed. When it is, there is a lack of effective treatments, with the research still very much in its infancy.


Women’s bodies: too complicated? 

A lack of sex-disaggregated data is harmful for women, who clearly have different needs to men. As I mentioned, an argument put forward to exclude women from clinical trials was that our bodies are simply too complicated: we can get pregnant, our hormones fluctuate, we go through the menopause. How can reliable data thus be collected?

But we should not shy away from these factors. Rather, these sex differences need to be systematically included from the start of medical research. Women need to be tested at different points of their menstrual cycle, for instance, since drugs can affect them differently depending on the time of the month. Taking into account these factors matters at every level, from safety and dosing to efficacy of treatment.

We’ve seen a surge in projects that address women’s health over the last couple of years, as awareness of women’s issues continues to grow.

A gender gap present worldwide 

The healthcare a woman receives is very different depending on where she lives. In some developing economies, often the infrastructure is not in place to provide the services a woman needs. She might not be able to access the most basic healthcare, let alone screening for breast cancer or a diagnosis for endometriosis. Clearly, it is a priority to provide funding to build up the healthcare systems in these countries.

Yet make no mistake: the gender gap in healthcare is very much present in developed economies too. The CDC, for example, states that four out of five pregnancy-related deaths in the US are preventable. Here in Switzerland, where we have one of the best healthcare systems in the world, it’s still a challenging topic.


Where are we at? 

At H4, we create partnerships and support entrepreneurial projects that focus on innovation in care and health. As such, we constantly come across new ideas and initiatives in the health sector. We’ve seen a surge in projects that address women’s health over the last couple of years, as awareness of women’s issues continues to grow. That said, these make up less than a fifth of all projects presented to us.

We also find that many projects involving robotics are still designed very much with men in mind. For instance, exoskeletons – or wearable robotics – could be a huge help to nurses, who are predominantly female. Yet they are very often designed for men’s bodies, meaning they are uncomfortable for women to use – or worse, they can lead to injury. There are thus gaps in the market where start-ups could look to bring meaningful innovation for women.

In recent years, it has been encouraging to see some brilliant initiatives that focus on women’s needs. One example is Tech4Eva, an accelerator programme for start-ups focusing on women’s health. Another is the work of Prof. Carole Clair and her team at the Unisanté Health and Gender Unit, which studies the influence of sex and gender on health and equips professionals with the knowledge and skills they need to fight health inequality. And there are inspiring companies like Aspivix, breaking new ground in gynaecology. I very much hope to see more fantastic ideas centred around women’s needs in the years to come.

Dominique Truchot-Cardot
Head of Source Innovation Lab at Institut et Haute École de la Santé La Source
Dominique Truchot-Cardot is Head of Source Innovation Lab at the Institut et Haute École de la Santé La Source. Since 2014, her focus has been on training caregivers and developing community-based care initiatives.

Dominique has relentlessly pursued innovation in the field of digital health. She created the Hand on Human Health Hub (H4) – the very first hands-on matchmaking initiative in caregiving and healthcare training, with support from the canton of Vaud and the Fondation La Source.

Dominique previously worked as Head of Clinical Nutrition Unit at the Annecy Genevois Hospital Centre. She is a medical doctor by training, having graduated from the Faculté de médecine Cochin-Port Royal (Paris Descartes University) and obtained an MA from Sciences Po Paris.


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