Closing the gender health gap: the importance of a Women’s health strategy

by Neena Modi

Unequal health outcomes for women and discrimination have prevailed for too long – now is the time to make sure treatment is fairer 

Location: England
Published: Tuesday 8 March 2022
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The UK healthcare system has been designed around the needs of just half the population. Men have historically been treated as the default patient in clinical practice and medical research, and women’s health and healthcare needs have been marginalised.

Though many issues that have disadvantaged women are global, it is matter of national shame that the UK has the widest gender health gap in the G20. Women fare more poorly compared with men in relation to disease prevalence, access to healthcare, and outcomes after treatment. For example, women are less likely than men to have a heart attack correctly diagnosed, and are more likely to experience poor mental health.

Over 70% of medicines used in pregnancy have no, or insufficient, safety information, and in the last 30 years, only one medicine has been specifically developed for use in pregnancy. Tragically, the unwarranted exclusion of pregnant and breast-feeding women from the first wave of COVID-19 vaccine trials and the resulting absence of evidence on efficacy and safety, led to inconsistency in the advice issued by governments around the world, including in the UK. This contributed to vaccine hesitancy, and the unvaccinated status of pregnant women substantially increased their likelihood of adverse outcomes following COVID-19 infection.

This spring, the UK Government will publish England’s first Women’s Health Strategy to address these issues. The Women’s Health Strategy aims to improve women’s health, place their voices at the centre of their care needs, and improve their access to healthcare. The strategy will be informed by the findings of a call for evidence carried out by the Government last year, which received more than 110,000 responses from individuals and 400 from organisations, including the BMA.

Vision for the Women’s health strategy

The Department of Health and Social Care recently released a Vision for the Women’s Health Strategy for England, outlining key areas of focus for the upcoming Women’s Health Strategy. Many of the recommendations put forward by the BMA are included in the vision, particularly around the need for improved education for healthcare practitioners. We also referenced specific areas in relation to menstrual health and gynaecological conditions; fertility, pregnancy, pregnancy loss and post-natal support; menopause; healthy ageing and long-term conditions, and the health impacts of violence against women and girls.

BMA work around women’s health

The BMA has continually called on the Government to improve women’s health. We have published research challenging the culture on menopause for working doctors and produced reports on women’s mental health, cancer in women, violence against women, global women’s health, and reproductive health and wellbeing. We have also been involved in the campaign to end period poverty in the UK and successfully campaigned to secure sanitary product provision in hospitals across the UK, ensuring that all patients can obtain them free of charge.

The need for change

As a neonatologist who sees first-hand the impacts of women’s health on her baby, her family, and society, as well as herself, I am saddened but not surprised to learn that so many respondents to the Call for Evidence reported that they did not feel their healthcare practitioners had listened to them. Their comments show that taboos and stigmas, paternalism, misogyny, and lack of knowledge remain issues in women’s health. Many women feel uncomfortable speaking about female-specific issues with their healthcare providers, and many, particularly those with disabilities, reported difficulty in accessing health services. These findings and a considerable body of evidence, confirm what many have known for years, that significant change is needed across the society, policy, the healthcare system, and the research and development environment, to improve women’s health, and their experiences of care.

Improved healthcare for women requires change in several areas. Education of healthcare professionals is important, but so are changes in societal attitudes that are shown in stigmatisation and paternalism, and a continuing reluctance to ensure that women’s needs are addressed in biomedical research and development. 

Finally, adequate funding is essential to improve women’s health and healthcare. In the UK, funding for sexual and reproductive health services has declined particularly in recent years, resulting in reduced access to services, especially for the most vulnerable women. The public health grant was cut by 22% in real terms between 2015/16 and 2020/21 and there has been an 18% decrease in contraceptive spend in real terms since 2015.  A commitment is needed to meaningful increase in the public health budget, and ring-fenced funding for sexual and reproductive health services that rectifies past cuts.

Putting health at the centre of decision making

As President of the BMA, it is my ambition to make health a primary policy focus of the UK Government. For too long, the Government has put the economy ahead of health and overlooked the importance of a healthy population to the economy and national wellbeing. The health of women is a cardinal influence upon the health of subsequent generations. Hence, improving women’s health makes sense from both an economic and a social justice perspective. The Women’s Health Strategy provides an opportunity to put health at the forefront of policy making. Government could create real change that benefits women, and through them, the entire nation, and future generations.

Professor Neena Modi, BMA president