Women Are Different In Their Health Needs
January 15, 2015 - Women are different from men in so many ways! That’s a good thing, but should be addressed as we deliver health care. In the past, too many medical studies, medical devices, and medically-related diagnoses, therapies, prognoses, devices, instruments, and all sorts of other health-related subjects have been focused on adult males. This mono-vision was not good for anyone—particularly those who have been inadvertently discriminated against.
Three examples from a recent Health Leaders Journal show that: women need smaller medical devices because their frames are smaller; the symptoms of a heart attack in women are different than those typically experienced by a man; and interestingly, even the cells of a women differ than those of a man as the basic genetic composition is different by one chromosome right from conception.
These numerous differences create opportunities to institute programs for better health for women, as we try to stop making “one size fit all.” And, to be sure, it is not just the reproductive capability that differentiates women from men; it is a host of nuances down to the basic cellular level.
Educating women about the symptoms of a heart attack is one major goal, due to the fact that heart disease is the number one cause of death in women. Women may experience symptoms similar to a man, such as chest pain, shortness of breath, light headedness, but in addition, may also experience mild back pain, body aches, and sudden fatigue. As we have shown at NCH, stopping a heart attack with the Code Save-A-Heart is very effective. Patients, however, have to identify when they are having these symptoms. If the heart attack is not recognized intervention is late and is much less effective.
Thus, the American Heart Association’s campaign, “Go Red for Women,” aimed at increasing heart disease awareness for women, was started in 2004 and has been a very effective educational program. Over 51% of all heart attacks occur in women. Women also have a more difficult time recovering, spend more time in the hospital, suffer from higher rates of complications and have a higher mortality rate than men. Are women just not getting into care as quickly due to not recognizing the symptoms early? This has been the question. Younger women in the past appear not to be getting the message.
Women with heart attacks, heart failure, and atrial fibrillation receive fewer guideline-based therapies than men. Further, women start dialysis later than men and are also referred later for treatment of rheumatoid arthritis. Osteoporosis and depression are considered female disorders. Both are probably under-diagnosed in men, according to an article entitled, Sex and gender differences in health.
Obtaining an accurate family history, noting risk factors, reviewing diet and exercise plans are all very important for either gender, and particularly important for women who have a tendency towards denial. Keeping awareness front and center for physicians, nurse practitioners, and physician assistants who have large practices composed of women makes perfect sense. Obviously, offices of obstetricians and gynecologists fit this criteria. Would it be better to have a one stop shop for care? Having the Ob/Gyns engaged in prevention of heart disease is an idea whose time has come.
In this digital age using social media to educate and communicate with women also makes perfect sense. Patients can fill out personal questionnaires at home or while waiting in the office. They might benefit from the process as a reminder to do the right things for their own health. Wellness questions could be a subtle reminder to bring the subject forward later in the face-to-face encounter.
There is an anticipated 85% growth in the population of women aged 40-45 over the next decade. One in three women will need assistance with heart disease, breast cancer, depression, or menopausal symptoms. About 40% of women do not get mammograms and there are other areas of poor self-care. Screening procedures work in “at risk” populations.
Interestingly, there is no difference in expenditures for care when reproductive biology is removed from the calculations, according to an older New England Journal of Medicine article.
This modern world is becoming even more complex for both genders. Sex and gender differences should be considered to improve health and health care for women and men. We need to assist in as many ways as possible to bring the maximum assistance so we can all live better, longer, happier, and healthier lives.
Past Health Advice Articles
Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.