Little prevention for women, few tests and above all treatments designed mostly for a male population.
Gender Health Gap: the gender gap in the medical field
The gender gap also exists in the medical field and is called, with the English term, Gender Health Gap. This is confirmed by European data on women’s health according to which, among other things, Italy brings up the rear, ahead only of North Macedonia, Serbia, Romania, Bosnia-Herzegovina, Moldova, Albania, Georgia and Turkey.
The European ranking of women’s health
To lead the Women’s Health Indexdrawn up by Hologic, a leading company in the diagnostic sector, based on a survey of a sample of 147 thousand participants from 143 different countries, is theAustria. For the third consecutive year, Vienna is therefore confirmed as the best place for the care offered to women, especially in terms of prevention. On the other hand, the country launched a specific program on gender medicine in 2017, implementing 40 specific measures on women’s health. Next are the Germany, Denmark, Poland and the Czech Republicwhich also rank in the Top 10 worldwide.
Gender Health Gap: poor access to care
What is striking is the fact that, while efforts are being made to reduce the Gender Pay Gap, i.e. the difference in pay between men and women for the same tasks, no progress has been made on the health front in the last two years. As stated in the report, in fact, from the Covid pandemic of 2020 to today “women are not in better conditions”. Data indicates that “one in four women has problems that prevent them from carrying out normal activities”as he explains Euronews. This therefore also leads to economic repercussions.
Italy brings up the rear for the Gender Health Gap
The same Euronews reports how a country like the United Kingdom is unable to offer the female population standards adequate to those of the European average. Based on the research, 32% of British women report feeling discouraged compared to 26% of the EU average. Around 39% even say they are stressed the day before a visitwhile in the rest of the Old Continent the figure stops at 34%, which is already high. Italy, however, is not doing any better, as it is in 32nd place in the European ranking, behind not only France, Spain, Belgium, Greece and Portugal, but also most of the countries of the former Yugoslavia, the Baltic republics and, among others, Hungary, Bulgaria and Malta.
Why is Italy behind?
«Hologic’s investigation is certainly important and thorough. It is very disheartening, however, to see how women in Italy still feel so little cared for. It is clear that there is still a lot to do, both in terms of training healthcare personnel and reorganizing clinical and therapeutic pathways. And this happens despite Italy is the first country in the world to have a law that requires considering gender differences in medicine», explains Elena Ortona, director of the Gender Medicine Center of the Istituto Superiore di Sanità, founded in 2017. This is also echoed by Antonella Vezzani, national president of the National Association of Women Doctors. «Unfortunately there is also (and still) a strong prejudice against women which is reflected in the way in which their female health is managed: beyond their reproductive function, they are not yet treated for their specificity.”
Because women are less well looked after
«For example, it is true that women live longer, but they are also affected by chronic disabling diseases, especially in the years they live longer than men – explains Vezzani – Generally at a senior age they can count on lower pensions, because they have been paid less, and they are lonelier. These also represent risk factors for health. Furthermore, they have a protective attitude which leads them to take more care of their family members than themselves.”
The “bikini syndrome”
Finally, the so-called “bikini syndrome” weighs heavily: as the magazine recalled last month Naturewe need to invest more in search for drugs also suitable for women, without limiting themselves to the field of female fertility – continues the president of Aidm – In clinical trials, in fact, women are little included for many reasons: having a hormonal cyclicity that changes over 28 days It is difficult to study the effects of a drug. There is also some concern about subjecting them to unstudied drugs, due to the potential effects on the fetus. Even when they are included, they are often not examined as a group in themselves, to check the possible consequences of a drug only on a female population. So an important change is needed at multiple levels.”
The Gender Health Gap: what it translates into
The numbers speak clearly, even outside the Italian borders: only about half of European women have had a blood test in the last 12 months. Only 1 in 5 have received cancer screeningone in 4 has undergone checks for diabetes and only one in 10 for sexually transmitted diseases or infections such as HIV, cancer and infertility. «There is still a large Gender Health Gap to fill. I think health care for women and girls has been seen as an afterthought,” explains Janet Lindsay, CEO at the Wellbeing of Womenan English charity that works to reduce gender differences in healthcare.
Same disease, different symptoms and treatments
“The cardiovascular diseases represent a paradigmatic example of gender differences. They, classically considered a male problem, are, however, the main cause of death among women, due to various factors, the most relevant of which are underestimation and difficulty recognizing symptoms, often different from the male ones. This leads to delays in diagnosis and therapeutic treatments and consequently a worse prognosis. L’myocardial infarctionfor example, often in women it does not manifest itself with the classic pain in the left arm, but with nausea and shortness of breath and is easily interpreted as a problem of the digestive system”, underlines Ortona of the ISS.
The hidden curriculum (in the ward)
«From this point of view, Covid has helped: we saw, for example, that women got sick less, but they could be more exposed to the so-called long Covid – observes Vezzani – This makes us understand the importance of changing the diagnostic-therapeutic pathways, introducing gender knowledge for specific pathologies and eliminating the so-called “hidden curriculum”: this is what happens when young doctors adopt the same procedures in use in the departments, perhaps for some time, without adapting to new discoveries, somehow also conveying gender prejudice».
Improve diagnosis, reduce diseases
«Another important example of gender differences is represented by colon cancer. In fact, a higher incidence has been observed in men than in women, but women seem more inclined to develop a more aggressive form of this neoplasm in the ascending right colon – explains Ortona – This location, unlike that in the descending colon , presents some important characteristics, including false negatives due to the greater difficulty of detecting the presence of occult blood in the feces.”
Gender medicine in Italy: what is missing
«As already mentioned, a lot of work still needs to be done to arrive at a real and concrete application of an approach to health that is attentive to gender differences. Certainly the 4 areas of intervention in which we need to commit and invest are: 1) scientific research; 2) the training of students and the updating of healthcare personnel; 3) communication and dissemination to the population; 4) the organization of diagnostic-therapeutic and healthcare pathways. The National Plan for the application of gender medicine describes the strategic objectives and actions to be implemented for each of these 4 macro-areas. However, what must be considered is that we need to invest to carry out these actions and to make our national system increasingly fair and appropriate. Only by making specific funds available could we reach the other countries that according to the Women’s Health Indexdrawn up by Hologic, currently surpass us”, concludes Ortona.
