A look at the gender gap in multiple healthcare domains including clinical trials, research funding as well as testing and diagnosis
The difference in the anatomy between various genders implies that diseases and their symptoms may affect them differently. Moreover, some diseases affect certain genders more than others, while a few are gender-specific conditions. Thus, it is imperative to look through a gendered lens for a better understanding of diseases.
Equal representation of genders in clinical trials, and impartiality and unbiasedness in testing and diagnosis help in creating a healthcare system that addresses the needs of all genders.
Yet, various studies conducted in the U.S. reveal that in some fields of medicine such as oncology, psychiatry, neurology and cardiology, the disease burden was higher among women while their share in clinical trials was not proportionate.
In a study where 1,433 trials were conducted from 0.3 million people in the U.S. between 2016 and 2019, the average share of women was 41.2%. In psychiatry, where women comprised 60% of patients, the share of women participating in clinical trials was 42%. Similarly, the difference was significantly high in the case of cardiovascular diseases (41.9% female participants vs. 49% female patients) and cancer trials (41% female participants vs. 51% female patients)
Gender disparity is also observed in research funding. For instance, according to the National Institutes of Health (NIH) data, the 2023 research funding estimate for substance misuse (a condition more prevalent among men) was $2,583 million while that for depression (a condition more prevalent among women) was $664 million. Similarly, research funding in 2022 for HIV/AIDS, a disease more prominent among men (DALY of 0.361 million in 2015) was $3,294 million, while that for inflammatory bowel disease (IBD), a disease dominant among women (DALY of 0.475 million) was $203 million. (expand DALY somewhere)
To know more about the gender gap in clinical trials and research funding, click here
Women faced the challenge of a gender gap in testing, diagnosis and treatment, which arose from a lack of comprehensive research about conditions dominant among women and biases toward women in healthcare.
In a multicentre observational study published in 2023, it was revealed that the median time taken to diagnose IBD from the onset of a symptom was more prolonged in women than in men. For instance, it took about 12.6 months to diagnose Crohn’s disease (a type of IBD) for women, while it only took 4.5 months for men. Similarly, it took 6.1 months for women and 2.7 months for men, in the case of ulcerative colitis.
NIH data also revealed that funding given for women’s reproductive disorders was significantly lower than that for conditions with a similar disease burden.
Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic abnormality among women with a worldwide prevalence of up to 21%, depending on diagnostic criteria. Yet, while diseases with equal or lesser disease burden like rheumatoid arthritis, tuberculosis, and systemic lupus erythematosus, were awarded funds worth $454.39 million, $773.77 million, and $609.52 million respectively, the funding for PCOS research between 2006 and 2015 was limited to $215.12 million.
Thus, a limited understanding of disease further delays diagnosis, especially for diseases affecting women’s reproductive system.
In the Indian context, the taboo towards menstrual health in society, which extends to the health sector adds to this problem. Endometriosis, a disease that affects roughly 10% (190 million) of women and girls of reproductive age worldwide according to the WHO, is highly underreported in the country.
Despite persistent visits to multiple gynaecologists over a decade, my journey to obtain a proper diagnosis for endometriosis was marked by significant delays. My experiences of enduring intense menstrual cramps, accompanied by nausea and bowel disorders, were consistently dismissed by doctors who attributed them to natural menstrual processes. Prescription of painkillers became routine without a genuine effort to comprehend the severity of my discomfort or suggest diagnostic scans for underlying issues. Only after my insistence, despite initial reluctance from doctors, did I finally receive a diagnosis. Regrettably, by that time, the lesions within my ovaries had grown larger than the organs themselves.
Even with a diagnosis, treatment options remain limited due to the narrow understanding of this condition. While invasive surgeries like laparoscopic procedures and hormonal medications seem to be the only options, these treatments come with significant side effects and cannot guarantee the complete eradication of recurring lesions.
In an article titled, “Male-centric medicine is affecting women’s health” in The Hindu, the author explains that women are less likely to receive appropriate medications, diagnostic tests and clinical procedures even in developed countries such as Canada and Sweden as the stereotype of the “hysterical woman” continues to haunt women even when they need urgent clinical interventions.
Therefore, it is crucial to implement appropriate interventions, create awareness within the medical community to mitigate bias and push for gender-sensitive clinical trials and equitable allocation of research funding. These measures are imperative to ensure equal and unbiased healthcare for all individuals, regardless of their gender among other identities.
Fortnightly figures
- 10.3% was the decrease in India’s merchandise exports in May 2023 at $34.98 billion from $39 billion in May 2022. Imports contracted at a slower 6.6% rate to $57.1 billion, lifting the trade deficit to a five-month high of $22.1 billion. This is the sixth time in the last eight months that goods exports have declined year-on-year, although May’s decline was lower than the 12.6% fall recorded in April.
- 110 million people have had to flee their homes because of conflict, persecution, or human rights violations, the UN High Commissioner for Refugees (UNHCR) said. The war in Sudan, which has displaced nearly 2 million people since April, is but the latest in a long list of crises that have led to the record-breaking figure. Last year alone, an additional 19 million people were displaced, including more than 11 million who fled Russia’s invasion of Ukraine in the fastest and largest displacement of people since World War II.
- 1 lakh people were shifted to approximately 1,500 temporary shelters set up as part of the disaster management efforts by the Gujarat State against Cyclone Biparjoy before the cyclone made landfall. Cyclone Biparjoy caused widespread damage in Gujarat’s Kutch-Saurashtra region as it made landfall late on June 15, Thursday. The Gujarat government also shut schools and other educational institutions for the next day as the State received heavy downpours in the aftermath of the cyclonic storm.
- 4.25% was India’s retail inflation in May from 4.7% in April this year, a 20-month low. The price rise in food items faced by consumers moderated to 2.91%. This is the third successive month that inflation has remained below the Reserve Bank of India’s (RBI’s) upper tolerance limit of 6% after a prolonged streak above it. Base effects from May 2022 when retail inflation was over 7% also played a role in lowering the inflation rate this May.
- ₹1.13 lakh crore was the third instalment of tax devolution released by the Centre to States, according to the Finance Ministry. This surpasses the normal monthly devolution of ₹59,140 crore. The additional advance aims to enable expedited capital spending, financing of development/welfare-related expenditure and increased resource availability for projects and schemes of the States.
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