Women's health gap: 6 conditions that highlight gender inequality in healthcare

This article was originally published in October 2023. It was last updated in October 2024.

Although the world has passed important milestones towards gender parity in recent years, there remains much to be done – especially when it comes to the gender health gap.

Here's why the gap is so important to understand – and six conditions that highlight it.

The health gap relates to the lack of equity concerning healthcare for women and men. This gap can take shape in many ways, from access to care to research.

For instance, the women’s health gap equates to 75 million years of life lost due to poor health or early death each year. Closing the gap would give the 3.9 billion women in the world today an extra seven healthy days a year, or an average of 500 days over a lifetime.

This gap has economic consequences as well. In 2020, for example, only 1% of healthcare research and innovation was invested in female-specific conditions beyond oncology, according to McKinsey. But according to that same research, every $1 invested in women’s health would return around $3 in economic growth.

Bridging the women's health gap could boost the global economy by $1 trillion by 2040, thanks to fewer early deaths and health conditions, and a greater capacity for women to contribute to society and the economy, finds a recent report by McKinsey and the World Economic Forum.

A study in August 2024 revealed that doctors treat men and women differently when it comes to pain. Women are 10% less likely than men to have their pain level assessed when they arrive at hospital, the study found. Women also wait around half an hour longer than men to be seen by a doctor and are less likely to be given pain medication.

The study's co-author, Alex Gileles-Hillel, put the discrepancy down to a longstanding and unchallenged bias: “Women are viewed as exaggerating or hysterical and men are viewed as more stoic when they complain of pain,” he told Nature.

In 2019, a study of almost 7 million people in Denmark found that women were diagnosed when they were four years older than men - for hundreds of different health conditions. Diagnoses for diabetes came four and a half years later, while cancer was diagnosed in women when they were an average two and a half years older.

The researchers surmised that a combination of genetics and environment could be at play but that gender bias might also be partly responsible for the difference.

Lead author Søren Brunak from the University of Copenhagen told NBC News the findings came as a surprise: "Men generally have a tendency to get to the doctor later ... So presumably the difference in onset is even larger."

The same year, British journalist Caroline Criado Perez published her book Invisible Women: Exposing Data Bias in a World Designed for Men, which lifted the lid on the lack of data in women’s health. Men outnumbered women 3:1 in 31 medical trials for congestive heart failure over 15 years, for example.

“For millennia, medicine has functioned on the assumption that male bodies can represent humanity as a whole,” Criado Perez told the UK’s Evening Standard. “As a result, we have a huge historical data gap when it comes to female bodies. Women are dying, and the medical world is complicit. It needs to wake up.”

The following year, the COVID-19 pandemic disrupted access to healthcare globally, and again women were disproportionately affected.

At its Annual Meeting in Davos in January 2024, the World Economic Forum launched the Global Alliance for Women's Health, to change how women’s health is funded and prioritized to close the gender gap.

The research was backed up in May 2024 by a Bill & Melinda Gates Foundation-funded study published in The Lancet, which also found that women live longer than men, but spend more of their lives in poor health.

Like the McKinsey study, it quantified the health gap in terms of disability-adjusted life years (DALYs). It found that women were more likely than men to experience low back pain, depressive disorders and headache disorders, while men had higher DALY rates for mortality-driven conditions: COVID-19, road injuries and ischaemic heart disease.

The report concluded: "The notable health differences between females and males point to an urgent need for policies to be based on sex-specific and age-specific data.

"It is also important to continue promoting gender-sensitive research, and ultimately, implement interventions that not only reduce the burden of disease but also achieve greater health equity."

Closing the women's health gap means increasing the diagnosis of women’s health conditions. Here are just six that have been underdiagnosed:

In October 2024, research from the British Cardiovascular Societies found women are still being underdiagnosed and undertreated for cardiovascular disease (CVD).

Despite CVD being the leading cause of death in women, there is a persistent "misconception that it is a ‘man’s disease’," which has contributed to its under-recognition and undertreatment, the consensus document said.

Writing about the study in The Conversation, Benedicta Quaye, Lecturer in Anatomy at Lancaster University, said: "This is troubling, as cardiovascular diseases can look very different in women than they do in men. Recognizing these differences – and why they exist – is essential to improving diagnoses of cardiovascular disease in women and saving lives."

Women, for example, have smaller hearts than men, on average, and their hearts beat faster.

Women in the UK are also around a third less likely to receive a coronary angiogram (which allows doctors to see narrowing or blockages in blood vessels) after a STEMI heart attack, mainly caused by heart disease.

A study published in The Lancet Regional Health – Europe found that women were more likely to die after being admitted to hospital with a severe heart attack, but they were also less likely to be prescribed medication to prevent future heart attacks, such as statins.

Previous research has found women were 50% more likely than men to be given an incorrect diagnosis following a heart attack.

Dr Sonya Babu-Narayan, associate medical director at the BHF and a consultant cardiologist told The Times: “Deep-rooted inequalities mean women are underdiagnosed, undertreated and underserved.”

Endometriosis is referred to as “the missed disease” because so little is still known about it and it’s underdiagnosed.

Globally, it affects 10% of women and girls of reproductive age, but in the US, for example, only two out 10 cases are diagnosed, with diagnosis taking more than seven years – and even longer for Black women.

American filmmaker, lawyer and activist Shannon Cohn recently directed the documentary Below the Belt to shine a light on the condition – and spoke to the Forum’s Radio Davos podcast about her own experience.

Cohn had her first painful symptoms of the condition when she was just 16, but then there was a “yawning 13-year gap of not being believed actually by healthcare providers, being told my symptoms were in my head or part of being a woman, or I was exaggerating”.

Around three times as many boys are diagnosed with autism as girls, and girls are often diagnosed later than boys, or not diagnosed at all, which can lead to mental health problems in adulthood, according to research.

Medical gender bias contributes to this underdiagnosis in women, because girls often don’t present with the same behaviours and symptoms as boys – and they learn to disguise or “mask” those that don’t fit with social norms.

“Because females often mask and defy stereotypically autistic presentations, individuals and families must endlessly educate others and advocate for themselves or their children to receive the treatments, supports and accommodations they deserve,” says clinical psychologist, Karen Saporito.

Amira Ghouaibi, Project Lead of the Women’s Health Initiative at the World Economic Forum, believes still more research is needed into why women’s medical needs are not being met before we can achieve gender equality in health.

“Every woman should be able to receive quality care when and where she needs it. We will only be able to achieve this once we examine the state of the women’s health gap, and then identify the biggest disparities to inform strategies and policies towards better women’s health outcomes.”

Another neurodevelopmental condition that frequently co-occurs with autism, and is similarly mis- or under-diagnosed in females, is attention deficit hyperactivity disorder (ADHD). In the US, less than 1% of women have a diagnosis of ADHD, but the number is growing rapidly, according to research.

In 2023, analysis of a data set found the rate of diagnosis among women aged 23 to 49 almost doubled between 2020 and 2022, which the study said supports findings that women tend to be diagnosed later in life than men.

As with autism, ADHD symptoms present differently in women, while historically, research focused on boys with the condition.

The study said the gap between women and men in terms of diagnosis is closing: "While males remain more likely to be diagnosed with ADHD than females, the disparity has decreased over the past 12 years.

"The ratio of males to females diagnosed with ADHD decreased nearly five-fold during that time, from males being 133% more likely to be diagnosed with ADHD than females in 2010 to 28% more likely to be diagnosed with ADHD in 2022."

Autoimmune diseases are those that stimulate the body's immune defences to attack itself and include lupus, psoriasis, multiple sclerosis, rheumatoid arthritis and thyroid diseases.

After cancer and heart disease, they are the third most prevalent disease category.

Women account for the majority of people (80%) with autoimmune diseases, but it takes an average of five years for them to get a diagnosis, according to the American Autoimmune Association.

Recent research in the US highlights why more funding needs to go into research for conditions that tend to affect women more than men.

Scientists at Stanford University have discovered evidence for a molecule – Xist – that exists only in women. It triggers a chemical response that is a hallmark of autoimmune disease and could explain why these conditions are more prevalent in women.

Although potential treatments could be a long way off, Jeffrey Sparks, an associate physician and director of immuno-oncology and autoimmunity at Brigham and Women’s Hospital, who was not involved in the study, told the Washington Post: “The sky’s the limit here ... Once you understand the fundamental mechanisms, you could think about developing therapies, early detection and preventions.”

It's estimated that antimicrobial resistance (AMR) – when parasites, bacteria and viruses evolve to be drug-resistant – could be responsible for around 10 million deaths a year by 2050. The World Bank puts the increased cost of healthcare at $1 trillion.

Now new research from the World Health Organization (WHO) suggests women are more exposed to these so-called superbugs than men, the Financial Times reports.

The reasons for this vary from the fact women are more likely to take antibiotics in their lifetime and are more likely to be healthcare workers – coming into contact with pathogens – to the risk of exposure to pathogens during childbirth in non-sterile settings, lack of adequate sanitation for women in low and middle-income countries or exposure to bacteria in water when they are undertaking household chores.

The WHO urged countries to gather and share information on sex and gender in their monitoring of drug-resistant infections.