Do Women Get the Same Healthcare as Men?

The answer is no. Women typically need more healthcare because of the demands of family planning and pregnancy. Did you know that women typically pay more in

healthcare premiums than men in our country?  According to Kaiser Family Foundation, gender rating by insurance companies (resulting in increased premiums for women) is allowed in 40 out of 50 states. Compared to men, more women (one in four) have to delay or forgo care due to cost (Pew Research Center, 2016). Many bankruptcies are related to medical costs and over 50% are filed by female-headed households (according to the 2007 clinical research study reported in October 2009’s The American Journal of Medicine).
 
With both parents typically working, along with the high divorce rates and female- headed households, the impact of pregnancy and childcare weighs heavy on the health of females. We advocate the importance of strong family values in America, but we don’t necessarily practice it as a nation. For example, there are many healthcare benefits of parental leaves including lower rates of postpartum complications, depression, and newborn and infant mortality, along with higher rates of breastfeeding and childhood immunizations, not to mention all the psychological and social advantages. Yet in the U.S. there is zero mandatory paid parental leave on a national level compared to an average parental leave of two-months for 41 other nations. The 41 countries that exceed the U.S. with paid parental leave include Western European countries, as well as countries such as Turkey, Canada, Japan, Latvia, and Mexico (http://www.pewresearch.org/fact-tank/2016/09/26/u-s-lacks-mandated-paid-parental-leave/). Although we currently have 3 states (CA, R.I., and N.J.) that have a mandated paid parental leave, we don’t know what healthcare reforms will take place in this new political environment and how they will impact parental leaves and overall family healthcare. This is a heavy burden for many Americans, but especially women in this country.
 
Gender differences in health and the use of health services are a long-standing concern for the U.S. medical system, especially with older women. In the population of Americans aged ≥65, there is evidence that women received fewer physician services than men with similar health needs. This was discovered in a study of 9,164 Americans (aged ≥65) through the Health and Retirement Study (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2965695/). One area identified is that older women were twice as likely to live alone as men. Thus, women with healthcare problems may be more isolated, limiting their ability to obtain medical care.
 
Another area that identifies the disparity in healthcare for women is embedded in the caregiver role (with family and friends).Women spend more time with the sick, disabled, and elderly, which is a valuable service to society, and too often an unpaid one. In addition to not being reimbursed for these caretaker services, women often have to give up full-time jobs in order to carry out these services, which result in a loss of healthcare benefits. Women sacrifice their own healthcare for the health of their loved ones.
 
There are some misconceptions when we claim that we have the best healthcare in the world. Americans who are wealthy or have good insurance coverage have access to the best healthcare in the world. But it is not a healthy system for the rest of America, who are either poor, lack good coverage, or middle-class Americans who have serious and costly health conditions that can result in financial ruin (http://www.usnews.com/opinion/articles/2014/05/30/no-the-us-doesnt-have-the-best-health-care-system-in-the-world).  There is an especially heavy burden on women: Nearly three in ten women have had problems paying medical bills in the past year (28%). As a result, the average quality of healthcare in the U.S. is significantly worse than that in comparably wealthy countries.  The U.S. ranks 29th in longevity, with most European countries exceeding us, as well as Canada, Israel, and New Zealand. (https://www.oecd.org/unitedstates/Health-at-a-Glance-2013-Press-Release-USA.pdf).
 
In addition to routine healthcare, women face other challenges, which impact their mental and physical health. These include domestic violence, sexual harassment, and rape. According to U.S. Department of Justice Centers (https://www.nsopw.gov/en-US/Education/FactsStatistics) and the Centers for Disease Control and Prevention (CDC), 4.8 million women experience domestic violence annually, 2 million women are raped annually and 1 out of 3 women experience sexual harassment in the work setting (http://www.cdc.gov/violenceprevention/nisvs/).  The Violence Against Women Act has assisted women with the various treatments linked to these crimes. But again, we don’t know what healthcare changes we will be experiencing in the future. Will women lose this assistance and have to cover their own costs for rape? Even in the current environment not all medical costs are covered; women who have been raped still have to cover their own medical costs (in some circumstances) for pregnancy, sexually transmitted diseases, or counseling. It is challenging to determine the exact medical costs for these crimes, but the estimated overall cost of rape alone is $127 billion annually
(http://endsexualviolence.org/where-we-stand/costs-consequences-and-solutions).
 
When it comes to healthcare, women are also confronted with gender stereotypes, often being told that they are being dramatic, irrational or too emotional when reporting symptoms. Before you dismiss this issue, try “walking a mile in someone else’s shoes.”  Being put into this position it is not only frustrating, but frightening. This gender gap often happens with treatment for pain. Just ask a woman who suffers with a chronic condition, such as fibromyalgia (https://thinkprogress.org/when-gender-stereotypes-become-a-serious-hazard-to-womens-health-
f1f130a5e79#.bhkmwxuha). Many women have stories. I had a female client who was told she was being “hysterical” and to practice some relaxation; she went to another doctor and was diagnosed with a serious cardiac condition called atrial fibrillation. My own mother’s Sensorineural Hearing Loss (SNHL) was chalked up to anxiety, related to menopause. Because her symptoms were dismissed as emotional, she was given a tranquilizer and as a result, she has been deaf in one ear for over 40 years. A female friend had classic symptoms of colon cancer, which were labeled as psychosomatic, and was left untreated for nearly a year. When my daughter was ill as a child and I persisted in getting her diagnosed and treated, I was told that I had psychosocial issues and she was being a “cry-baby.” She went untreated for 7 months with low-grade bacterial meningitis until we found providers who listened to female patients and their advocates. So, it is not just the female patient who experiences gender bias, but it also occurs with female caretakers and advocates.
 
We need to pay better attention to what is happening in the healthcare field to women.  According to the American Psychological Association, “some doctors believe that  “psychosomatic symptoms” has become the modern-day equivalent hysteria -- a catchall term for physical symptoms that cannot be explained.” http://www.apa.org/monitor/2013/07-08/symptoms.aspx). It was only in 1980 that “hysteria” was removed from medical manuals. It is well documented in cardiology that, for years, women suffered with complications of heart attacks because their symptoms present differently than in men and were, therefore, unrecognized and ignored. Changes in this thinking about women’s health issues can begin with changes in medical training as well as including female subjects in clinical trials, since in the past they were overwhelmingly comprised of men.
 
It would be helpful for women to document their experiences. These experiences are called “illness narratives” and the stories can help others in understanding the path to attaining help, as well as assist providers in determining the right diagnosis. One women with an autoimmune disease that took years to diagnose sums it up sadly, but beautifully: “One of the hardest things about being chronically ill is that most people find what you’re going through incomprehensible—if they even believe you are going through it at all. In your loneliness, your preoccupation with an enduring new reality, you want to be understood in a way that you can’t be.”
(http://www.newyorker.com/magazine/2013/08/26/whats-wrong-with-me).
When you start the conversation about this topic, the floodgates open. So share your stories; it will help improve women’s healthcare in this country!