Addressing Gender Bias in Healthcare
In the first quarter of this month, we worked with Reckitt on their latest campaign ‘The Gender Pain Gap’.
As part of the campaign, Reckitt hosted a talk at the Best Practice Show. Titled ‘Gender bias in the management of women’s pain’, three healthcare professionals raised a series of pertinent points on how women’s pain is viewed and the impact this has on their treatment.
Women’s pain IS different
Far from suggesting pain is experienced by both sexes in the same way, Professor Katy Vincent, Senior Fellow in Pain in Women and Associate Professor, the University of Oxford , proposed that women’s pain is, in fact, different
Common causes of pain for women can involve:
- Period pain (dysmenorrhoea)
- Painful during or after sex (dyspareunia)
- Chronic pelvic pain
Women’s pain is often more intimate than a males and, as shown by the above, it’s experienced around and due to female reproductive organs. The prevalence of several common chronic pain conditions is also greater for some women than men including; fibromyalgia, migraine and chronic tension-type headache, irritable bowel syndrome, temporomandibular disorders, and interstitial cystitis.
The extent to which the lives of women are affected by the pain varies widely and studies of general practice records showed that despite affecting millions, annually only 4% actually consult a GP for their symptoms.
For many of us (myself included!) we silently accept the taboo or avoid discussing symptoms mainly because, as women, we think this is a normal part of life and ‘get on with it’.
But what the talk made clear is that just because pain is common, it doesn’t mean it should be considered normal and by extension, acceptable.
Take period pain as an example. It’s experienced by 80-90% of women and a leading cause of absenteeism with 30-40% of women regularly missing school or work as a result. If the pain is ‘normal’, why should it have such a detrimental effect on our lives?
Interestingly I also found out that due to longer life expectancies and less time spent pregnant and/or breastfeeding, women in developed countries have four times more periods than women 200 years ago – on average 450 in a lifetime.
However, women in developing countries, who may breastfeed for longer and have multiple pregnancies with a lower life expectancy could have an estimated 100 periods over the course of their lives.
What then is ‘normal’ if there are so many different lived experiences? What is the baseline for ‘normal’ pain?
Gender bias in action
Consider this.
- Women are given IUDs without pain medication but the new male implant contraception ‘ADAM’ is available under local or general anaesthetic.
- Women are often given sedatives rather than painkillers because our pain is seen as hysteria.
- Women are 25% less likely to receive pain medication than men
- Women wait, on average, 26 minutes longer to be prescribed pain relief in A&E.
Gender biases have serious and sometimes fatal repercussions. One study found that women are up to seven times more likely than men to be misdiagnosed and discharged in the middle of having a heart attack.
Why? Because medical concepts of most diseases are based on the understanding of male physiology as historically women have been excluded from clinical trials. Men were treated as the “medical norm” and women ‘…in essence, considered small men.’
Mad fact for you. It took until 2014 for the National Institute of Health to begin to acknowledge a problem with male bias in preclinical trials, and until 2016 for it to mandate that any research money it granted must include females. 2016!!!
The way we talk about pain matters
Led by Professor Rebeccah Slater, Professor of Paediatric Neuroscience, University of Oxford , the conversation moved onto the effect our words have.
One GP pointed out that drugs used to treat pain are overstated. ‘I say things like pain killer and then the patient is led to believe what I am giving them will get rid of the pain completely when it doesn’t. I don’t use words like cholesterol combuster or low mood miracle’.
Concerns were raised that using certain terms and words that suggest pain medication will rid one of pain completely were detrimental to the patient. They place too much focus on pain, when focus should be looking at quality of life instead.
If GPs are making this mistake then, as copywriters or creatives, we also have to think about the weight our words can have when devising material for patients.
What can be done?
Some of my key takeaways from the talk were as follows:
- Use words wisely – whether you’re a marketeer or a clinician talking to a patient, think about the weight of your words. Don’t use phrases like ‘pain killer’. Over promising the effects of pain medication leaves patients frustrated and disappointed when the pain returns. Ideas offered by the audience for more realistic phrases were ‘pain relief’ or ‘pain management’
- Provide additional support tools – many HCPs in the audience spoke about the need to educate patients on new technologies. However, for HCPs to do this, they must be aware of what ‘new technologies’ there are. That’s why reaching out to them with education packs could create powerful brand advocates for your brand or service.
- Consider language barriers – whilst gender is one consideration, within this single characteristic are many variants and assuming all women speak (and read) English in the UK is a mistake. Translating assets into different languages ensures that those often most vulnerable can advocate for themselves.**
*Brands like Daye are making waves in this area as well investing in innovation to bridge the gender gap in medical research and innovation.
**I was delighted to see another client of ours, Breast Cancer Now , had their leaflets translated into numerous languages including Arabic, Urdu and Spanish.
I was encouraged by how many HCPs attended but it’s concerning we’re still having this conversation. For anyone who wants to find out more about gender bias and femhealth issues, below is a list of resources I’ve personally found pretty useful lately.
Oh, and you can find out more about the campaign by visiting the Nurofen case study on our website.
Additional resources
Brilliant people to follow
Valentina Milanova is the founder of Daye, the gynae health research and development company on a mission to close the gender pain gap and overcome historical gender biases in medical research and product innovation.
If you want to learn more about health inequalities in general, Jane is your person. Her feed is full of useful insights and she set up Intent Health, a healthcare communications agency focussed on reaching forgotten, ignored, or misunderstood communities.
An old school friend set up a sex education and vulva acceptance campaign, This Is A Vulva, to stem the rise in labiaplasty. She also runs make your own vulva workshops/pub quiz which are a must.
Great books
Invisible Women: Data Bias in a World Designed for Men
Interesting research
- https://link.springer.com/article/10.1186/s12939-020-01283-4
- A whole heap of papers from the British Medical Journal – https://www.bmj.com/gender
- https://www.gov.uk/government/publications/womens-health-strategy-for-england/womens-health-strategy-for-england
