Women are not small men. That may sound obvious, but too often that idea has informed health care, with male physiology the default for research and treatment. From the earliest phases of testing and clinical trials on animals, models have historically been based on male specimens. Questions about sex-based differences were rarely investigated or recorded, with the assumption that other than reproduction, there were few important differences in how organs and biological systems functioned.
This is not true–and the differences matter. In some cases, the same condition can have different symptoms or sets of causes; in others, a disease is more prevalent among women. Drugs and medical devices can work differently, too. For example, many drugs to treat rheumatoid arthritis are much less effective on women; ditto for asthma inhalers. Women report adverse events from approved medicines 52% more often than men–and serious ones, including fatalities, 36% more often, according to the U.S. Food and Drug Administration. In addition, conditions that disproportionately affect women are systematically underestimated, under-studied, and underinvested in. Only 4% of all healthcare research and development in the U.S. is specifically targeted at women’s health issues.
All this contributes to a sizeable global health gap. Although women generally live longer, they spend 25% more of their lives in poor health. About 60% of the healthy years that women lose come between ages 20 to 60 when they are most likely to be working.
Finally, the level of care can be unequal. In the treatment of arrhythmia, men are three times more likely to receive cardiac resynchronization therapy. Knowledge of such inequities has not been a secret, but it has yet to reach the mainstream.
The health gap is bad for women, damaging their ability to enjoy life to the fullest. It also carries significant economic costs. In a new report, the World Economic Forum (WEF) and the McKinsey Health Institute (MHI) estimate that closing the male-f