Ireland’s history in validating and prioritising women’s health is disproportionately lacking with the scandals of the past century sadly emphasising the fragmented connection.
From the recent CervicalCheck Scandal in 2018 and the death of Savita Halapannavar in 2012 to the historical controversies of the mother and baby homes, the Thalidomide scandal and more, the disconnect in hearing and acting on the health priorities of women is reprehensible.
As such, women reasonably feel unheard, unseen and thereby dismissed when discussing and actively looking for help when it comes to their health. And yet, while women are notably more proactive about their health, which varies depending on their stage of life, they also actively report complications in accessing the care they need which can be associated with stereotypical views held by healthcare practitioners, resulting in poor or wrong diagnosis and treatment. They are less likely to be treated for pain than men, with their symptoms not taken as seriously or a diagnosis not adequately given.
Intrinsically, when women feel set aside in such a manner their relationship with their health suffers, with the belief that their pain or symptoms are not sufficient enough to be an issue. They battle a stigma and discrimination while acutely seeking the basic human right of healthcare.
In a report titled Strategy on Women’s Health and Wellbeing in the WHO European Region, the World Health Organisation says women see themselves as less healthy than men, they report more ill-health yet regularly forego care for financial reasons and that equal access to our health services remains problematic for minority, migrant, refugee or asylum-seeking women. The evident gender gap in accessing healthcare is joined by socio-economic factors. These include where women are born, live and work, and whether they have sufficient income and housing. They also relate to their access to various supports, with their diet and lifestyle being additional considerations.
These disparities in women’s health can be seen in clinical research, in trials, and in adverse reactions to medication – with women 1½ times more likely than men to develop unfavourable effects to prescription drugs. There is a notable lack of research into the specifics of women’s bodies, with women historically seen as a vulnerable group and excluded from research for their purpose of being potential mothers. Clinical trials are often based on a stronger cohort of men and medications used by women, most notably for example the pill, are often based on male bodies.
The WHO recognises that despite a somewhat increased presence of women in certain clinical trials, participation is “especially low in studies in which safety, safe dosage range and side effects are determined. This results in a lack of awareness among healthcare professionals about the importance of sex-specific differences in disease manifestation and response to treatment throughout the life-course, which can cause problems in diagnosis and treatment.”
The gender bias sitting drastically in our waiting rooms has created considerable inequalities in how women are seen, understood and treated, with substantial blocks in how they access healthcare. Lacking patient education expands women’s knowledge gap in understanding their own health issues. Female reproductive health, mental wellbeing and maternal health are all subjected to a bias and stigma which result in a higher incidence of negative experiences. Outside of the female reproductive body, the health of women is also unbalanced in terms of chronic diseases, violence against women and the health and wellbeing of older women.
The WHO recognises that gender stereotypes have consequences for women’s health in terms of self-confidence and wellbeing. Within the report they suggest, in particular, that concerns about physical appearance may cause girls and young women to develop eating disorders and other mental illnesses, such as depression and anxiety. Moreover, stereotypes and sexism pave the way for certain forms of oppression, such as sexual harassment and gender-based violence.
In reflecting on women’s health we must recognise the national conversation surrounding the 2018 referendum on the Eighth Amendment to legalise abortion, and the broad and necessary discussion this encouraged in advocating for women’s health. This advancement, along with the tragedies of scandals that blatantly ignored or disregarded the issue of women’s health, has underpinned certain aspects of progress in strengthening targeted healthcare for women. What is needed is a continuous and vast narrative on understanding, appreciating and acting on the needs of women across a range of supports to include marginalised women and those of all ethnicities and backgrounds.
The Global Strategy for Women’s, Children’s and Adolescents’ Health 2016-2030 advocates, at an international level, “to end preventable deaths among all women, children and adolescents, to greatly improve their health and wellbeing, and to bring about the transformative change needed to shape a more prosperous and sustainable future”. In line with international and European action plans, there are a small number of women-specific national strategies which focus on women’s health in maternity, reproductive health, breastfeeding and sexual health with further non-gender specific health and wellbeing strategies encompassing women and men.
With the hope that the established Women’s Health Taskforce, prioritising gynaecological health, menopause and mental health, will offer proactive solutions, opportunities and services for women, we are cognisant of our overwhelmed and understaffed health service, compounded by long waiting lists. The dedicated women’s health fund has the opportunity to progress a programme which actively supports under-represented female healthcare issues. But for women to engage with such programmes, tackling the bias encompassing these aspects of women’s wellbeing is necessary, including pregnancy and birth-related issues, reproductive health and mental health.
To address the inequities of the gender health gap is to give women a voice. Empowering women to take control of their health assists them in successfully navigating and challenging the stigma and bias they face in reproductive and female-centred health issues. In addition, addressing and confronting the public perception of women’s health is to tackle these biases and vast misconceptions from the outset thereby improving women’s physical and mental wellbeing. As is recognised by the WHO, engagement of women to ensure they are at the centre of change is a defining factor for success.