An economic case for a more women-centric health care system

By Kathryn Haines, principal, and Linda DaSilva, vice president, sales executive, Deloitte Consulting, LLP

Women are leaders, employees, and consumers who make 80% of household health care spending decisions in the United States.¹ As life sciences companies and health care organizations work to make health care more equitable, much of the emphasis is often on race and ethnicity rather than gender. Organizations that prioritize women and their health could help reverse the historic underrepresentation, improve quality of life, and increase the number of productive years women spend in the workforce (see our report, Employers can spark healthy aging).

There is a clear economic benefit to having an equitable emphasis on women’s health (see our report, Understanding the impact of women and health on society). Keeping women healthy and contributing to society can be paramount for promoting economic stability and prosperity. Women make up nearly 60% of the paid workforce in the US and 65% of the unpaid workforce (e.g., caregivers for children and other family members). Women also tend to serve as the chief medical officer for their families and are responsible for most of a family’s medical decisions, according to the report. 

Gender bias is deeply ingrained

While women in the US have a longer life expectancy than men (79.1 years vs. 73.2 years)², they also suffer higher morbidity rates across several conditions.³ Gender bias can keep some women from receiving the right treatment at the right time, which can result in poorer health outcomes. By age 65, women can expect to spend 30% of their remaining years with a disability, compared to 19% for men, according to our research.

Women’s health is largely focused on breast cancer, cervical cancer, and uterine cancer. But cardiovascular disease, not breast cancer, is the number one killer of women.⁴ Symptoms specific to women can be more difficult for clinicians to recognize due to an ingrained gender-agnostic approach to medicine. For example, a man with heart disease might show up at a hospital with chest pain. Women with heart disease, however, might have subtler symptoms, such as indigestion or back pain.⁵ A 2019 study found that one in five women felt that a health care provider had ignored or dismissed their symptoms.⁶ Another study found that women with abdominal pain in the ER waited longer than men on average to receive pain medication (65 minutes vs. 49 minutes for men).⁷ Men are also more likely than women to receive CPR from a bystander in public, and men are 23% more likely to survive a cardiac event.⁸

Some diseases, particularly those related to reproductive organs, are unique to women. Endometriosis, for example, is a complex and incurable disease that affects about 10% of women during their reproductive years. Once diagnosed, treatment is typically aimed at controlling the symptoms. However, it can sometimes take years before the disease is diagnosed. In the meantime, some women could lose their job if they can’t work because they are dealing with symptoms. Last October, the number of International Classification of Diseases (ICD) codes for endometriosis expanded on from nine to more than 100. These new codes will give patients a more accurate diagnosis, help health care providers and patients implement proper treatment plans, and provide more data on endometriosis.⁹ Prior to the addition of the new codes, some women were denied coverage.¹⁰

Positioning women’s health as a growth driver

Men have long been at the center of the US health care system. In 1977, the US Food and Drug Administration (FDA) banned women of childbearing age from participating in drug trials, citing concerns about experimental drugs causing birth defects and monthly fluctuating hormone levels introducing complicating factors in studies.¹¹ Even lab animals used for testing are predominantly male.¹² It was not until 1994 that the US National Institutes of Health (NIH) reversed the policy and mandated that women be included in clinical trials. However, about 75% of clinical trial participants are still men. In 2016, the NIH also mandated that female mice be included in research.¹³

The health care and life sciences sectors, however, have been slow to increase their focus on women’s health. Just 4% of all biopharma research and development spending goes toward female-specific conditions.¹⁴ Of 37 total prescription drugs the FDA approved in 2022, only two were for female-specific health conditions.¹⁵

Health care and life sciences organizations might consider the following steps to position women’s health as a growth driver and social-impact enabler:

• Increase awareness of women’s health: Gaps in awareness and prevalent gender bias can contribute to misconceptions surrounding women’s health. This could be addressed by updating medical education curriculum to be more comprehensive for the full life cycle of women’s health and by incorporating female-specific content to challenge outdated gender biases and stereotypes. Organizations should also try to attract and retain women in leadership roles.
• Increase data-driven insights and actions: Research organizations should provide incentives to drive diversity in clinical trials. They should also try to include female-specific animal models and female cell-lines in medical research. A publicly accessible data repository of disease prevalence could include gender-specific information.
• Improve affordability in health care: Increased use of virtual health, mobile clinics, and drone-delivered medications could help reduce the cost of care in the future. Health care and life sciences organizations should focus on preventing illness rather than treating it (see Deloitte’s perspective on the Future of Health). Interoperability and system-wide electronic health records could help ensure that male and female patients and care teams have access to accurate and timely data.

Conclusion

It is 2023, and women—who make up half of the human population—still do not receive equitable health care. Women’s health has historically been viewed through the narrow lens of reproductive health. As a result, there are large gaps in general health, wellbeing, and health policy that should be addressed to attain true equity in health, access, and care delivery. The concept of women’s holistic health appears to be emerging as a central aspect of health care delivery. By prioritizing and investing in women and health, life sciences and health care leaders have the opportunity to reverse the long-standing under-representation of women and help advance health equity.

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Endnotes:

¹ Women and healthcare decisions, Psychology Today, September 27, 2022

² Life expectancy in the US, US Centers for Disease Control and Prevention, August 31, 2022

³ Paving an equitable path when it comes to women's health, World Economic Forum, March 6, 2023 

⁴ Cardiovascular disease is number 1 killer in women, Forbes, June 13, 2023

⁵ Heart disease: Differences in men and women, Johns Hopkins Medicine

⁶ Recognizing, addressing unintended gender bias in patient care, DukeHealth, January 14, 2020

⁷ Gender bias at the doctor: How women's heart disease, chronic pain is ignored, Today.com, May 13. 2019

⁸ CPR for women, American Heart Association, 2023

⁹ Prominent surgeon leads chance of diagnosis codes for endometriosis, Endometriosis Foundation of America, May 5, 2023

¹⁰ Endometriosis and the barriers to care, The CT Mirror, December 7, 2022

¹¹ Policy of inclusion of women in clinical trials, Office on Women’s Health/US Department of Health and Human Services

¹² Use of male mice skews drug research against women, study finds, The Guardian, May 31, 2019

¹³ History of women’s participation in clinical research, National Institutes of Health

¹⁴ New drug therapy approvals 2022, FDA, January 2023;  Women's health care comes out of the shadows, Forbes, April 12, 2018

¹⁵ The drive for women’s health equity, Harvard T.H. Chan School of Public Health, March 22, 2023; The drive for women’s health equity, Harvard T.H. Chan School of Public Health, March 22, 2023

This publication contains general information only and Deloitte is not, by means of this publication, rendering accounting, business, financial, investment, legal, tax, or other professional advice or services. This publication is not a substitute for such professional advice or services, nor should it be used as a basis for any decision or action that may affect your business. Before making any decision or taking any action that may affect your business, you should consult a qualified professional advisor.

Deloitte shall not be responsible for any loss sustained by any person who relies on this publication.

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