In 2020, medical technology company Hologic launched a global survey in partnership with Gallup to assess how well women’s health needs are being met. Countries were ranked based on women’s answers to questions in five categories: public health, preventive care, mental health, safety and basic needs such as food and shelter.
No country scored above 70 in 2021, with Taiwan, Latvia, Austria and Denmark in the lead. Three countries scored less than 40 points: Afghanistan, Congo and Venezuela. The United States came in 23rd place with 61 points out of 100.
“The economic and psychological burden of the epidemic will weigh on many families for a while, and we know that it particularly affects women,” said Gertrude Stadler, director of the Institute for Gender in Medicine at Berlin’s Charité. He did not participate in the survey.
In fact, women were more stressed, anxious, sad and angry in 2021 than at any other time in the past decade, according to a Gallup survey that is included in the World Health Index rankings for women.
Women were also more likely than men to say they didn’t have enough money to buy food in 2021, a share that rose from 34% of women in 2020 to 37% in 2021.
“We understand that you can only influence and improve what you measure,” said Dr. Susan Harvey, vice president of global medical affairs at Hologic and former director of breast imaging at Johns Hopkins School of Medicine.
“Overall, the data is realistic. And we understand that we need healthy women to be fully engaged and empowered. It is clearly time to work together and start finding solutions and improving women’s health care.”
‘The world fails women’
According to Hologic and Gallup, the five major domains assessed in the Global Women’s Health Index can explain most of the variance in women’s life expectancy at birth.
For example, they found that women who said they had seen a healthcare professional in the past year had a two-year life expectancy longer than those who did not.
Preventive care is one area where the US scores better in 2021 than it did in 2020. It ranked second in this dimension in the Global Women’s Health Index, behind only Latvia.
“It was a slight improvement, but we have to be happy with that,” Harvey said. “In general, though, the world is failing women in preventive care.”
She said about 1.5 billion women did not get preventive care last year. Globally, fewer than 1 in 8 women have been screened for cancer at any time in the past year, according to the survey.
Although the remedy for this deficiency may seem more straightforward, experts say it actually reflects the multiple layers of challenges women face.
Katie Schubert, president and CEO of the Society for Women’s Health Research, a US-based advocacy group, said it was not involved in the new study.
“It goes back to a lot of those different burdens that women carry, both from the perspective of being caregivers but also from the perspective of being part of their community.”
Schubert says that in the United States, for example, women are more likely to go to a good visit with their children than they are for themselves. And the proportion of women who don’t show up to see a major doctor six weeks after giving birth is “absolutely staggering”.
Maternal health needs attention
Despite some improvement, the United States remains poor outside of women’s overall health — in part due to maternal health, an area experts agree deserves more attention worldwide.
Opinions about health and safety among US women declined in the 2021 Global Women’s Health Index, as did individual measures of health, including pain and general health problems.
Rich countries generally score better than low-income countries on the Global Women’s Health Index. In fact, the gap in scores between high and low-income countries nearly doubled from 2020 to 2021, with an average difference of more than 20 points. But life expectancy in the United States was below average, despite spending on health care that was well above average.
In some ways, the widest gender disparities in healthcare are already well known around the world.
For example, in many countries women who seek medical help for a heart attack take longer to get a correct diagnosis, are treated less consistently and are less likely to attend cardiac rehabilitation, Stadler says.
“All of this leads to worse outcomes and a higher mortality rate in women than in men,” she said.
Raising women and raising society
Experts agree that improving women’s health will lift society as a whole.
“Women often take on the role of health director in their families and communities. They do a large share of the caring work, so children, partners and fathers also benefit from women’s health,” Stadler said.
The effects are extensive.
“Without this foundational health and well-being of women, we will not be able to achieve any of the goals of economic stability or equity in social and economic development,” Schubert said. “This really stands on the shoulders of a healthy environment, a healthy person, and healthy outcomes.”
But gender equality – in health and other aspects of life – is still far from reality.
Schubert noted that the Covid-19 vaccine trials did not include pregnant women.
“I hope we can better prepare to be more comprehensive and expansive in our biomedical research moving forward, regardless of whether we are dealing with a pandemic or some other public health emergency,” she said. But the pace of change was “too slow”.
Much of what is measured in the Global Women’s Health Index aligns with the goals set by the United Nations in its Sustainable Development Goals.
“It is critical that we mobilize our efforts now to invest in women and girls to restore and accelerate progress,” Sima Bhus, Executive Director of UN Women, said of that report. “The data shows undeniable declines in their lives that have been exacerbated by global crises – in income, safety, education and health. The longer we take to reverse this trend, the more it will cost us all.”
But there is some hope.
“I hope we come out stronger from the pandemic,” Stadler said. “The pandemic has increased people’s interest in the importance of preventive behaviors. People have learned a lot about the importance of working together to protect each other.”
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