At Independence Blue Cross (IBX), we’ve made a powerful commitment to advancing health equity in the communities we serve. That starts with acknowledging health inequities wherever they exist.
In our previous health equity blogs, we’ve discussed challenges in such diverse areas as behavioral health, maternal health, breastfeeding, health literacy, and LGBTQIA+ health. In this one, we’d like to focus on women1 — a population that has historically experienced, and continues to experience, inequities in health care.
We comprise half of the U.S. population, but:
- Our health care experiences are not as positive as they should be.
- Our health needs have not been studied as thoroughly.
- We often find it harder to access care.
It’s time to close these gaps.
Symptoms Ignored in Health Care Settings
Women often have their symptoms downplayed or dismissed by health care professionals. This is an objective, well-established phenomenon that affects the care women receive. Even women physicians experience this. I’ve experienced it myself.
This is not meant as a criticism of health care professionals. There are still imbalances in our society that stem from patriarchal norms. No matter what our gender is, we’re all exposed to cultural biases our whole lives that can unconsciously color our attitudes and decisions.
And these biases clearly come into play in the health care arena. According to a Kaiser Family Foundation study:
- 29 percent of women aged 40 – 64 said their doctor didn’t listen to their health concerns, compared to 21 percent of men.
- 19 percent of women noted that their doctor had made assumptions about them without asking.
- 13 percent said their health care providers had blamed them for their health problems.
- These negative experiences were even more common among women aged 18 – 35, women of color, women in lower-income households, and women who were uninsured.
Gender biases also affect the care we receive. For instance, compared to men, women are less likely to be prescribed medication to manage chronic pain or recommended to receive knee replacements.
Moreover:
- Only 35 percent of women aged 40 – 64 say they were informed what to expect during menopause.
- It wasn’t until August 2024 that the Centers for Disease Control and Prevention began recommending anesthesia for women during intrauterine device (IUD) insertion, which can be extremely painful.
- And the U.S. has a higher maternal mortality rate than most other developed countries, especially among Black women.
These are all good indicators that women’s health needs are not being prioritized the way they should be.
Overlooked in Medical Research
Before 1986, women were very rarely included in clinical trials. Maybe researchers assumed that we’d respond to treatments the same way men do. However, that’s not the case. For example, we generally experience more negative drug reactions than men.
In 1986, the National Institutes of Health began encouraging researchers to include more women in medical studies. However, even today, we’re still underrepresented. And research into women’s health has also been chronically underfunded, especially when it comes to older women. So, in many areas, not nearly enough is known about our health needs.
Critical Health Issues Go Underdiagnosed
Cardiovascular disease is the number one cause of death in both men and women, but research shows that it is underdiagnosed in women. The reasons for this are complex. But, for example, the symptoms of heart attacks often differ between men and women. Both sexes usually experience chest pain, but women are more likely to also experience nausea, sweating, vomiting, and neck, jaw, throat, abdomen, or back pain.
Women also have different risk factors for heart attacks. For example, if we’ve had endometriosis, preeclampsia, or gestational diabetes, we’re at a higher risk of heart attack, chest pain, or blocked arteries.
And if underdiagnoses occur with something as prevalent and well-understood as heart disease, other health conditions are also likely to go underdiagnosed in women. Health professionals who do not take gender differences in symptoms and risk factors into account may make diagnostic errors, or send female patients home with no diagnosis at all.
Women are also underdiagnosed with:
- Endometriosis, a serious and painful condition in which cells that are supposed to form inside the uterus begin to grow in other areas where they do not belong.
- Attention deficit/hyperactivity disorder (ADHD), which manifests differently in women than in men.
- Serious mental illness, which is almost twice as common among women. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), seven percent of U.S. women have one or more behavioral health disorders versus four percent of men.
Unequal Access to Care
There is a lot more that could be said about inequities in women’s health care. But for now, I’d just like to make a few additional points:
When you factor in our all-too-common experience of not being listened to in health care settings, it’s no surprise that we often neglect or defer our own health needs.
We must advocate to have our symptoms taken seriously and get the treatments we need. We must push for better inclusion in medical research. We must prioritize our health despite all the barriers we face. And we must work to create a society in which our health needs are valued and respected.
1For the purposes of this article, by “women” I mean cisgender women. It’s well documented that transgender, nonbinary, and gender non-conforming individuals experience their own significant health inequities, and we’ve discussed that in other blogs.
