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Kate Dyson


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The role of ageism in the gender health gap

It’s taken decades, but finally, we’re all talking about the gender pay gap. But another gap that may prove trickier to close, is one that receives much less air time — the gender health gap.

Women are routinely underrepresented in clinical trials, medical research and the resultant data. But to what extent does ageism have a role to play in this?

In 2017 the All-Party Parliamentary Group on Women’s Health (APPG) released its first-ever inquiry on gender bias in medicine.

In a survey of over 2,600 women with endometriosis and fibroids, the APPG found that 42% of the women found their cases were not handled with dignity and respect whilst being treated. 62% were not satisfied with the information they received about treatment options, and nearly 50% weren’t told about the short or long-term side effects arising from these options. Great.

According to the Centre for Ageing Better’s State of Ageing 2020 report, health and wealth inequalities between men and women are at their highest amongst people in their 50s — meaning that women are entering later life significantly worse off than men.

For example, a girl born today can expect to spend over 21 years of her life with a disability, compared to less than 17 years for men. Furthermore, data show that musculoskeletal conditions, such as arthritis and back pain, are more common in women than men at every age — one in five women aged 45-54, increasing to almost half (47%) of women aged 85 or over compared to under a third of men in this age group.

The report also concluded that health and wealth are inextricably linked. It said: “While there has been some progress in securing women’s equality, the fact women are still disadvantaged in the labour market and the gender pay gap and health gap result in more women than men living in poverty in later life is surely a reason to continue the struggle.”

Women are often told that these symptoms are often part of the normal ageing process and they should just accept it as a natural stage of life.

It turns out that there’s an inextricable link between ageism and the gender health gap.

We asked Dr Shahzadi Harper, founder of the Harper Clinic, which specialises in perimenopause and menopause, PCOS, premenstrual stress disorder and healthy ageing, for more information.

She told Jude that “sometimes women are dismissed because of their gender, sometimes because of their age”, so when it comes to a gender health gap, older women face something of a double whammy.

“There are so many studies that focus on men, for example, when it comes to heart conditions and attacks,” she said.

“Often women have different symptoms to men but are not made aware of this. This can result in them being turned away from A&E or not even attending when they need to.

“There’s definitely a lack of awareness of female health symptoms because the narrative we are always given is that of male health, so women are losing out.”

Dr Harper added that older women’s health concerns are also often dismissed as “natural” and part of the ageing process, they’re putting up with things they really shouldn’t be.

“For menopause, perimenopause, pelvic floor issues and bladder leaks, women are often told that these conditions and associated symptoms are often part of the normal ageing process and they should just accept it as a natural stage of life.

“But that doesn’t mean to say that women have to suffer or put up with certain symptoms. Often, under the guise of things being ‘natural’, their concerns are dismissed, when instead, if we looked after these women, we could prevent osteopathic issues, heart disease, dementia and bladder leaks etc. Furthermore, women don’t talk about these issues themselves, because they’re not ‘sexy’ or they deny their symptoms.”

In a statement to the House of Commons, Nadine Dorries, Minister for Patient Safety, Suicide Prevention and Mental Health, said that “for generations, women have lived with a healthcare system that is designed by men, for men”.

She argued that despite making up 50% of the population, women have been underrepresented in research and that despite living longer than men, women spend a greater proportion of their lives in ill health and disability, with mounting geographic inequalities in women’s life expectancy.

Ms Dorries said that to mark International Women’s Day and respond to the issues, the Government would be creating the first government-led national women’s health strategy for England.

To support this, she announced a call for evidence stating that the Government wants to hear “from as many women as possible, from all ages and backgrounds”.

The call for evidence ran from 8 March to 13 June 2021. The Government is currently analysing the feedback received, however, it is expected that it will publish the new strategy later this year.

According to a 2021 article published in the peer-reviewed medical journal, The Lancet, the answer to closing the gender health gap lies in a combination of policies and laws to address the inequities and discrimination facing older women, as well as educational interventions and campaigns specifically tailored to decision-makers and health-care professionals.

The article concludes: “Stereotypes, prejudice, and discrimination towards older women must be eliminated within our institutions and positive change made through collective action designed to raise awareness of the harms.

“In so doing, multilevel strategies to address gendered ageism can be implemented that reduce inequities and improve the health and wellbeing of older women.”

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