International Women’s Day 2024: How can we #inspireinclusion in healthcare?

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International Women’s Day 2024: How can we #inspireinclusion in healthcare?

As many as 80 per cent of women healthcare workers and 20 per cent of patients have experienced some form of discrimination from the healthcare system.

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This International Women’s Day, those working tirelessly to progress global recognition of women’s efforts toward social, economic, cultural, and political issues continue to fight the good fight by focusing on inspiring inclusion and the various ways women, specifically, can help to do so.

In healthcare, there are many sex disparities that women continue to face, from a lack of funding for clinical research to being overlooked and dismissed as patients. A shift is now occurring, though, as more and more women in healthcare continue to inspire inclusion in a way that benefits all aspects of healthcare for women in Canadian society.

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Carmen Wyton, Chair of the Women’s Health Coalition of Canada, understands the growing need for more accessible healthcare, the advocacy required to make real change, and how International Women’s Day is an excellent opportunity to open the lines of communication regarding women and the healthcare system.

“It’s such a great time to create a collective amplification around issues that are holding women back, and in our case, it’s health,” said Wyton. She later continued, “We want to make sure that we do our part to amplify all of those messages, empower women, and encourage women to take more authority over their health experiences.”

Improving care barriers for women

Research has shown that as many as 80 per cent of women healthcare workers have experienced some form of discrimination, with patients seeking out appropriate healthcare experiencing their own bias at a rate of roughly 20 per cent. In terms of patient discrimination, it’s proven that many women do not receive the same type of care as men when both have the same health condition. In some cases, these biases lead to poorer health outcomes because of a lack of evidence-based care.

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Wyton and many others in the healthcare industry believe that, while unintentional, these biases foster an unstable environment for women seeking the care they need. She gives an example of Indigenous women being subject to these biases when they seek care for pain conditions, such as pelvic or abdominal pain, and the discrimination they’re forced to deal with when trying to receive adequate care.

“We know that Indigenous women—and you know what, all women can face this—it’s just more prevalent in Indigenous women—when they go to the hospital in emergency, and they’re complaining of extreme pain, abdominal pain, pelvic pain, the skepticism they will face about being a drug seeker is going to be a bias that is going to be there almost every single time. So, that’s where the conversation starts, and it’s wrong,” Wyton said.

She continues, “We have to start changing that narrative so the first assumption isn’t where you come from or how old you are; the first question, not assumption, needs to be, ‘tell me what you’re feeling, tell me what you’re experiencing.’ There is conscious and unconscious bias in every level of healthcare. Embracing the bias and putting practices in place to contravene them is the responsibility of system managers, whoever they might be.”

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Sharlene Rutherford, President and CEO of the Royal Alexandra Hospital Foundation, on behalf of Women’s Health Collective has also seen issues with getting adequate evidence-backed care within the healthcare system when it comes to women.

“A woman can make all the right decisions about her health and still be betrayed at her doctor’s office or in the emergency department. Gender bias in health exists—not out of malice but a combination of pervasive old habits by some in the medical community and an historic lack of knowledge, generally, about women’s health. The result is female patients continue to be misdiagnosed, neglected, dismissed as complainers, accused of being overanxious, mislabeled as depressed, or told their symptoms are all in their heads,” Rutherford said in an email to Healthing.

Addressing research disparities

Research focused on women’s health issues is scarce in comparison to men’s health and the health of the general population. In fact, even though women make up 51 per cent of the overall population, the funding dedicated to women’s health research sits at only seven per cent.

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Leslie McCarley, President and CEO of Women’s College Hospital Foundation, on behalf of Women’s Health Collective Canada, found that disparity in research, advocacy, and community continues to halt progress for women’s health, hindering the development of advancements that could improve the quality of life for women in the country diagnosed with various health ailments.

In an email to Healthing, McCarley said, “There is a gap in Canadian healthcare that women have long been falling through—and we need to be there to prevent these omissions and bolster their care.” She continues, “Inclusivity in healthcare goes beyond just access to care, encapsulating inclusion in research, education, advocacy, and community—which is our aim through Women’s College Hospital Foundation and Women’s Health Collective Canada. Women make up 51% of the population, yet only 7% of health research funding nationally focuses on their specific needs. We are working to change that.”

The way women experience health disorders is also often different than men. The prevalence rates, symptoms, and progression of certain diseases are not the same for both sexes, leaving a vast hole that needs to be addressed regarding health research.

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Cally Wesson, President and CEO of BC Women’s Health Foundation on behalf of Women’s Health Collective Canada, acknowledges just how important it is to individualize care based on sex by improving sex-focused health research in the country.

“Women’s health is unique. There are significant differences in how women and men experience health conditions. However, the scientific research guiding medical practices has historically overlooked the crucial impacts of sex and gender in prevention, diagnosis, and treatment,” Wesson wrote in an email to Healthing. “Furthermore, researchers with ground-breaking ideas for advancing women’s health often face barriers in securing initial funding, thus halting their progress.”

It’s not just a lack of funding that acts as a stop sign for the much-needed research into women’s health issues. Until the 1990s, women were often excluded from significant healthcare and medical research studies simply due to their different physiological makeup.

Many researchers had been reluctant to include women in these studies for two reasons: the ever-changing hormones women experience throughout the month and the slight chance that one of the female participants could become pregnant. That, in and of itself, has created an unconscious bias against women who require valuable science- and evidence-backed research to foster good overall health.

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“The long history of intentionally excluding women from medical research because of hormones, menstruation and potential pregnancy, amongst other factors, has created this knowledge gap, and the subordination of women in politics, wealth, and education are the same factors that have shaped modern scientific medicine as it evolved over time and which we have today,” said Rutherford.

She continues, “The result is limited specialist knowledge and treatment options across a broad range of conditions impacting women and, moreover, have resulted in many women’s health issues being considered taboo.  The wide-sweeping societal impacts of keeping women’s health issues taboo are extensively covered in a 2022 thought leadership paper by the Alberta Women’s Health Foundation titled Surveying The Silence, and remains a must-read for everyone.”

Wesson and the rest of the Women’s Health Collective Canada aim to correct the country’s approach to women’s health research.

“BC Women’s Health Foundation is launching Women’s Health Research Month, our annual effort to raise funds that support high-quality, high-impact research that produces innovative treatment and increased access to healthcare for women,” Wesson wrote. “An investment in women’s health research is a step towards new evidence-based solutions that can inform and transform the health and healthcare of all women.”

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Amplifying women’s voices in healthcare by cutting down biases

Sex bias has long been in place against women. Hysteria, for example, was used throughout the 18th and 19th centuries as an umbrella diagnosis for any woman who experienced feelings or emotions that the men around her deemed unwomanlike. It wasn’t until 1980 that the diagnosis of hysteria was removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a clinical guideline used to diagnose mental health disorders.

While that was a long-awaited and highly overdue step forward, it doesn’t change the fact that sex biases still hold strong today regarding healthcare for women.

Age is often used as an unconscious bias because healthcare providers can focus on menopause or other age-related stages of a woman’s life to jump to conclusions, disregarding the diagnostic process altogether. The same can be said for other questions based on biases, such as how much a woman weighs, to dismiss concerns for a quick-fix approach that glosses over the real issue at hand—the one that actually requires treatment.

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Research has also found that healthcare providers wait longer to provide adequate care and fail to take pain complaints seriously where women are concerned. These discriminatory actions from doctors and other medical professionals lead to them asking the wrong questions—questions that dismiss women in a way that could potentially lead to severe health outcomes.

Because of that, being a self-advocate when experiencing health issues is vital to the overall puzzle regarding inspiring inclusion in healthcare. That said, it’s not always easy to address the elephant in the room when healthcare providers are dismissive and focused on the wrong factors. According to Wyton, women must find their voice in a way that calls these biases out head-on.

“When a woman goes to the doctor complaining of fatigue or a state of unwellness, or mental health or pelvic pain, if the doctor automatically says, ‘How old are you?’ I encourage the women to say, ‘Ask me a different question. Don’t put me in a stereotype.’” Wyton said.

Women’s health groups, such as Women’s College Hospital, the BC Women’s Health Foundation, the Women’s Health Coalition of Canada, and the Women’s Health Collective Canada, work around the clock to break down barriers and biases that continue to create problems for women in the healthcare industry or those seeking appropriate care. However, they cannot do it alone. Wyton believes that it’s no longer adequate to whisper concerns. It’s time to get loud.

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“People in the network that I work with in the Women’s Health Coalition have a belief that in a way, feminism is regressing. We have been so focused on micro issues that we have lost sight of the greater sense of gender equity,” she said. “We have to remember that women represent half the population. It’s time for them to get loud and proud again because they are being overlooked.”

She continues, “We have to keep raising the bar because we stopped talking about it. It’s been 100 years since we got the vote, and we really haven’t moved much beyond that. So, it’s time for another uprising, and I think International Women’s Day is a catalyst to do that. I’m going to be uprising around equity in women’s health. I am causing an uprising.”

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