The health gap in Tasmania

There’s a big difference in how men and women experience health. Women spend 25% more of their lives in poor health relative to men, and they experience greater degrees of disability.

In fact, women spend an average of nine years in poor health. And that affects our ability to be present and/or productive at home, in the workforce, and in the community. It also reduces our earning potential. 

A new report by the McKinsey Health Institute says there are three main reasons for the different experiences of women and men: treatments for women are less effective, women experience worse care delivery, and we don’t have the data we need about women’s experiences of health to provide the best quality health services. They call this the gender health gap.

Women’s health needs are complicated. Some of our health needs are related to our sexual and reproductive health. And some are specific to our sex – for example endometriosis, polycystic ovary syndrome, menopause. But actually, the biggest health burden reported by women are conditions such as autoimmune diseases, depression and anxiety, headache disorders – conditions that anyone can get, but which are more common among women or affect women differently.

What does this look like in Tasmania? Let us show you some health statistics:

Women are struggling to deal with chronic health conditions in the context of cost-of-living pressures, very low incomes, poor access to services and transport, and isolation. We need services that provide health support and can also be responsive to the barriers women face to accessing health services.

Why are we in this situation that women don’t get the health care they need?

The first reason is because there has long been a gender bias in the science.

Historically, men have led the study of medicine and biology. They’ve also been the subjects of that study. Until quite recently women weren’t included in tests in drug trials because it was thought that we would distort the results because we menstruate. (Not all of us do, we would note.) But the researchers thought it was ok to exclude women because they thought male body was the normal body; women’s bodies were seen as abnormal variations on that theme.

Even when scientists have tested on animals, the bulk of tests have been done on male specimens.

And researchers didn’t ask questions about how different drugs might work for different sexes because it was assumed that organs and systems worked the same for men and women, other than women’s ability to have babies.

In fact, in America, the Food and Drug Administration only issued the instruction that women were to be included in clinical evaluations of medicines in 1992. In the 2020s they are still chastising pharmaceutical companies for the under-representation of women in trials for treatments for a wide range of cancers.

Excluding women is a big omission because men and women do experience important differences in health. For example, it is now known that certain asthma and cardiac medications don’t work as well for women as they do for men.

Men and women experience heart attack symptoms differently. We all know the most common symptoms of a heart attack, right? Pain in the left arm, pressure in the chest. But women may experience other symptoms that are typically less associated with heart attack, such as shortness of breath, nausea/vomiting, and back or jaw pain. But we all memorised the men’s symptoms because for too long heart attacks were seen as a men’s health concern.

There’s also a lot of evidence that suggests that there is a lot of gender bias in how pain is measured. And that women’s pain is routinely under-investigated and under-treated.

The second reason women don’t get the health care they need is because there is very limited funding for research into women’s health.

And the third reason women don’t get the health care they need is that a lack of data means we underestimate how severe or prevalent women’s health issues are, which feeds the cycle of under-investment in research or innovation.

When women’s health needs are invisible, there are missed opportunities to improve lives, especially for women and girls who are members of communities that are more at risk of poor health outcomes.

Most of our women’s health funding goes towards sexual and reproductive health when that is only 5% of our health burden. 51% of the health burden for women comes from chronic conditions that anyone can get, but that are more common among women or that affect women differently – things like autoimmune disease, depression and anxiety.

Imagine if our health services were funded to reflect that reality. Not by reducing funding to sexual and reproductive health services, but by increasing funding to other areas.

And imagine what a difference that would make economically for women - nearly half of the health burden affects women in their working years.

Imagine if we had the health services we needed to stay in school and in work, to study, to earn money, to look after our families without pain and stress. 

Imagine if we could expand our conversation about health equity to think about how people's experience of gender, sexuality, disability, race, even things like their visa status, also affect their health.

That might sound pie in the sky but providing a pension to everyone over a certain age would have sounded pie in the sky to our great-grandparents. We can set goals and achieve them.