The Unseen Crisis: Gaps in Women’s Healthcare

For much of medical history, women were seen as a nuisance or a variable to account for in clinical research and care delivery. Citing feeble excuses like hormone fluctuations or the potential for pregnancy as confounding factors, physicians got away with treating women as an onerous afterthought.

Just over 32 years ago though, on June 10th 1993, an act was passed that pushed American healthcare to take a long overdue step in the right direction. The NIH Revitalization Act required that women be included in clinical trials. Prior to this milestone, the most widespread information on conditions we consider common to this day– heart attacks, autoimmune disorders, and more– was just information on how these conditions presented in a singular demographic. 

This gap of data led to critical blind spots. So, where do these gaps appear?

Through culturally incompetent care

Women are not a monolith. The current state of healthcare fails to incorporate race, body type, cultural beliefs, religion, or socioeconomic status. For instance, Black women are three times more likely to die from pregnancy-related causes in the U.S. than their White counterparts. Conditions in plus-size women are more likely to go undiagnosed due to myopic practices rooted in fatmisia.

Via misinformation

Heart attacks, for example, are described as “chest-clutching events” in medical textbooks. Dangerously omitted is the minuscule but significant detail that those events suggested heart attacks in men. In women, they display fatigue, nausea, and shortness of breath, symptoms that are already frequently dismissed. Autoimmune diseases also manifest differently in women. Despite constructing 80% of those affected with the third most prevalent disease category, an autoimmune disorder, it takes them an average of 5 years to get diagnosed, according to American Autoimmune Association.

In delayed diagnoses

Because the medical system is still catching up on how conditions uniquely affect women, countless patients wait years for accurate diagnoses. A woman with an autoimmune disease might visit multiple specialists before receiving clarity. A girl with ADHD may be labeled as “spacey” or “emotional,” while boys are diagnosed early due to hyperactivity. Over 70% of women worldwide with PCOS may remain undiagnosed in their lifetime... unless the narrative is shifted. 

All this to say that despite digging seemingly bottomless potholes in what could be life-saving information, not much has been done to fill them. Though women make up over half the population, only 1% of healthcare research funding is invested in female-specific conditions beyond oncology. These realizations, put in tandem with each other, point to an unsettling reality: for decades, women were underdiagnosed and left to think the nuances of their health were just inconveniences to all parties involved.

During a health literacy epidemic, where only 12% of U.S. adults test proficient, this disconnect becomes increasingly pervasive. Communities lack accessible resources for understanding mental health, chronic illness, or how to advocate for better care.

Whether or not these oversights are intentional does not change the outcome: care without nuance is care that falls short. And in an industry where the consequence of oversimplified care is the quality of life or life itself, that gamble cannot be afforded.