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5 Things About Gender Disparities in Care to Remember as National Women's Health Week Ends

Allison Inserro
Terry Kohl, a real estate agent in New Jersey, battled what she thought was indigestion for 6 months and went repeatedly to a gastroenterologist for what she thought was a case of “grumbly gut.” Her "indigestion" led to a coronary artery bypass surgery soon after a trip to Rome left her breathless. Read about how women experience health and healthcare differently as National Women's Health Week draws to a close.
Terry Kohl, a real estate agent in New Jersey, battled what she thought was indigestion for 6 months and went repeatedly to a gastroenterologist for what she thought was a case of “grumbly gut.”

Now 72, it wasn’t until she went to Rome to sing for Pope Francis with her church choir in 2015 that she realized she was short of breath climbing hills. Upon returning home, her internist sent her to a cardiologist. Three days later, she was having a triple bypass.

“I wasn’t ever thinking of my heart,” said Kohl, who underwent cardiac rehabilitation and is doing fine today.

As National Women’s Health Week comes to a close, here are 5 ways women experience health and healthcare differently than men.

1. Heart Disease
Think of a disease that targets women and breast cancer leaps to mind. However, heart disease affects more women. According to the American College of Cardiology (ACC), 1 in 3 women will develop heart disease at some point in their lifetime, versus 1 in 8 for breast cancer.

Kohl’s missed symptoms are not uncommon, according to the ACC, which said women experience different warning signs of heart trouble than men, including nausea, dizziness, stomach pain, indigestion, trouble sleeping, fatigue, and more.

For women, the risk of heart failure rises after menopause and escalates even more after age 65; according to data from ACC, women aged 75 to 84 years are 3 times more likely to have heart failure than those aged 65 to 74.

Compounding the problem is that even though both sex and gender differences in cardiovascular disease (CVD) and its treatments have been well documented, women continue to be less represented than men in clinical trials of drugs to treat CVD. Among proposed reasons for this phenomenon are the recruitment of younger patients, inclusion criteria that tend to select men, and exclusion criteria that are more common in women.

ACC also said women are less likely to receive the same advice, guideline-recommended treatments, and aggressive interventions as men. Women are also less likely to take part in cardiac rehabilitation after a heart attack.

2. Cost of Healthcare
The impact of high healthcare costs is felt by both sexes, but according to a recent survey from the Kaiser Family Foundation (KFF), the burden falls most heavily on women. On average, women earn lower wages, have fewer financial assets, accumulate less wealth, and have higher rates of poverty.

KFF's findings include:
  • 1 in 4 (26%) women versus 1 in 5 (19%) men have had to delay or forego care in the past year due to cost
  • 1 in 5 women have postponed preventive care (19%), skipped a recommended test or treatment (20%), or made medication tradeoffs such as not filling a prescription or cutting dosages (17%) because of cost
  • 1 in 4 women report that they have had problems paying medical bills (25%) in the prior year and 1 in 3 are currently paying off medical bills (33%)
The Affordable Care Act (ACA) has helped to reduce the rate of uninsured women. In 2013, the KFF women’s health survey found nearly 1 in 5 non-elderly women were uninsured, but by 2017, this had dropped to 1 in 10. However, uninsured rates are higher among subgroups of women, particularly those who are low-income and Latina.

The ACA covers preventative services for women, which can help reduce healthcare costs for most women with insurance, including contraception, preventative healthcare (well-woman visits), sexually transmitted infection counseling, cervical cancer screenings, HIV screenings, breast cancer screenings, and domestic violence screening.

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