Ignored & Underrepresented: The Impact of Excluding Women in Healthcare Research
Tlalit Bussi Tel Tzure is the Vice President of Business Development and Global Marketing for the Medical Device Company, IceCure Medical.
Women make up 50% of the global population, yet women are still unfairly reflected in healthcare research. This has huge implications for the quality of care and can have life-or-death consequences.
As a result of women being less represented in healthcare research, there are fewer treatments available for women-specific diseases. In addition, because women are unfairly represented in clinical studies, general disease treatments may be less effective for women or have high side effects. In some cases, there may be no treatment at all, as disorders have been simply ignored!
In honor of International Women's Day, I'd like to draw attention to this important healthcare issue. In order to enable change, we must first understand the problem.
Women are different from men.
Women's bodies function differently than men's. There are obvious reproductive differences that impact women throughout their life—fertility and pregnancy issues, menopause as well as other gynecological disorders and cancers of the breast, ovaries and cervix that affect women.
However, when it comes to certain "gender-neutral" diseases such as sleep apnea or heart attacks, women can go undiagnosed because they don't have similar "textbook" symptoms compared to their male counterparts.
In these cases, there is no "one size fits all" diagnosis and treatment for men and women.
As we advance in the 21st century, why is healthcare research for women still lagging behind men?
The healthcare challenge for women.
1. Clinical research is male-directed.
Medical research, by default, is male led. For example, The Physician's Health Study examined the effect of aspirin on cardiovascular disease involving 22,000 patients. Not a single one of them was female! Women of childbearing age were even banned in the 1970s from being enrolled in phase I clinical trials. This means treatments have been developed whose effectiveness and safety are unknown in women.
2. Gender imbalances persist in peer-reviewed publications and research advancement.
Studies have found that there are stark gender imbalances when it comes to the authorship of clinical trials and research articles, with males being far more likely to publish than females. This can result in a lack of representation of women's perspectives, leading to clinical research that is male-directed and may fail to adequately address the particular needs of women.
Further evidence of this gender imbalance can be seen in the inequities in peer review and research advancement, with fewer women obtaining leadership roles in key decision-making roles.
3. The disparity in research funding is glaring.
A funding analysis by the U.S. National Institutes of Health (NIH) showed that research funding was disproportionately allocated to male-led studies at the expense of those that affect primarily women. As a result, there is less focus on the development of treatments and therapies tailored to the needs of women, leading to poorer outcomes for women.
For instance, one study found that women were significantly less likely to receive an initial diagnosis of heart failure than men, even after adjusting for differences in age, race and other factors. The researchers attributed this disparity to the lack of attention paid to the needs of women in healthcare research and clinical practice.
Similarly, studies have found that women are more likely to suffer from long-term health problems related to medical conditions such as diabetes than men. Yet these disparities have often gone unrecognized and untreated due to the lack of research focused on female patients.
It is clear that there are huge disparities in care as a result of these integral issues—so what can we do?
What can we do, and what are we doing?
We must see a better representation of women in clinical studies.
Clinical studies must ensure women are represented, which means we must create and implement policies ensuring gender equity in study design, recruitment and analysis. Since a 1993 NIH ruling, federally-funded drug trials and other clinical research have been required to include female participants. They must also determine whether the treatment being tested affects females differently than males.
Unfortunately, recent data shows that there is still an integral gender gap, with more men participating in clinical studies, especially in the critical early stages of drug development when doses and drug safety are evaluated.
We must promote inclusivity in healthcare research.
We must do more to support researchers and institutions to adopt more inclusive practices when it comes to sex and gender disparities in healthcare research.
Measures should be taken to ensure that all voices are heard in the research process, including through the allocation of funding specifically for women-specific diseases that are comparable to male diseases. Since funding often comes down to politics, supporting organizations like the Society for Women's Health Research that advocate improving research policy on biological sex differences in disease and treatment is key.
To increase the inclusivity of women in healthcare research, we must support researchers and institutions to address the gender gap by elevating the role of women as primary investigators in clinical trials and providing mentorship, support and funding for women's health issues.
Additionally—and I can say from first-hand experience—increasing the representation of women in specialties, such as interventional radiology, can create a more balanced healthcare research landscape. Professional organizations such as the Society of Interventional Radiology and the Cardiovascular and Interventional Radiology Society of Europe are launching initiatives like "Women in IR" and educational grants to achieve this.
Recognize the power of women to drive change.
We must remember the future is female.
On a day such as International Women's Day, it is important we remember to work together to ensure our voices are heard. Patients, activists and community organizations have an important role to play in advocating for greater inclusion and representation of women in medical research. This is one of my main motivations for working in a company such as IceCure—so I can take an active part in advancing women's healthcare needs.
Inclusion and representation in healthcare research are crucial for the fair development of treatments and therapies. Only by accurately addressing the needs of all can we deliver better care for all.
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