User:Sr183155/Gender disparity in American healthcare

In the US, women have worked tirelessly to make huge strides towards gender equality. However, there is still much work that needs to be done. The healthcare system in the US under serves women in a variety of ways. Women face many obstacles in getting proper medical care in the US.

History

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Throughout history, women have received different healthcare based solely on their gender. One startling example is Hysteria, which was a disease thought to only affect women. While the symptoms are muddled, hysteria was a used to characterize some unknown mental and physical condition stemming from the uterus. Plato speculated that hysteria was caused by the uterus wandering through the body. Even when that theory was dismissed, there was no clear reason behind what caused hysteria.[1] After a long and murky history, hysteria is no longer accepted as a medical diagnosis. In the Third Edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders hysteria was finally removed from being a specific clinical disorder in February 1980.[2]

Another striking historical instance of women receiving worse healthcare is the Salem Witch Trials. It has been speculated that the strange behavior of those accused of being witches was due to asthma, encephalitis, Lyme disease, epilepsy, child abuse, delusional psychosis, or convulsive ergotism from a fungus infection in bread. However, the local doctor, William Griggs blamed supernatural causes when he could not provide any medical explanation.[3]

 
Porochista Khakpour, the author of the book "Sick: A Memoir" which received much attention for bringing to light the struggle women go through in the US healthcare system.

Published Works

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In today's society, the gender disparity in healthcare has been receiving more attention. There have been a number of pivotal writings that have shown the struggle that women have gone through in getting proper healthcare. Women have started speaking out about being met with disbelief when explaining their symptoms to their doctors. Porochista Khakpour's book, "Sick: A Memoir" became popular for conveying the struggle that the author went through in an effort to get a diagnosis for her Lyme disease.[4] There have been many more similar works that serve to highlight the struggle some women go through just to get some answers about what is afflicting them. "Through the Shadowlands" by Julie Rehmeyer is a memoir that takes the reader through her struggle to get a proper diagnosis for what is afflicting her. Similarly, Jennifer Brea's documentary "Unrest" follows Brea's struggle to get doctors to believe in her sickness.[4]

Diagnosing

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Women have significant delays in receiving diagnoses for various conditions. A Danish study showed that these delays were significant: two and a half years for cancer diagnoses, and four and a half years for diabetes. These delays were found in over 700 different diseases. While such a study cannot be conducted in the US due to privatized healthcare, there is reason to believe that the US would have similar delays in treatment of women.[5]
The root cause of this issue can be traced to how research is conducted. Most of the time, research about a disease is conducted on male cells. This is due to the common perception that males and females differ only in their reproductive system, thus what is true of one sex can be assumed to be true of the other as well. However, in many diseases this is not the case. Oftentimes women experience different symptoms. If these symptoms are not known or given less importance, women can go without a diagnosis.[5] Women were left out of clinical trials until 1993 when Congress mandated their inclusion after lobbying from the Society for Women's Health Research.[6]

Treatment

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There is a broad range of treatments for a variety of diseases, however in many different cases women receive different treatment for the same diagnosis. Women have been found to be less likely to receive painkillers in emergency rooms.[7] The gender disparity in treatment of pain may stem from doctors considering women to be more emotionally driven. The assumption being made is that women are overstating their pain or making it up due to their emotional nature.[8] It is this same reasoning that leads to women being more likely to be prescribed psychotropic drugs for chronic pain, further enforcing the misconception that the pain is all in their heads.[9] Essentially, women are not being given analgesics when they are necessary because doctors do not believe the pain that they are experiencing.

When women are given analgesics, they have to wait longer. For the same intensity of abdominal pain, men wait less time to receive analgesic treatment. Women are perceived by healthcare providers to be exaggerating the amount of pain they feel. It plays into the stereotype that women are extra dramatic which leads to them overstating how much pain they are really in.[8][10]

 
Women have different symptoms for myocardial infractions that the public is not educated on extensively.

Additionally, women face delays in the treatment of heart attacks. Women were found to be more likely to receive reperfusion therapy outside of the recommended time frame when treating myocardial infractions.[11] Part of this is due to women being more likely to delay getting medical attention for their myocardial infarction symptoms which can be combated with increased education about myocardial infractions in women.[12] Women display different symptoms of heart attack than men do, but many people are only educated about male symptoms.[13]

Outcomes

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The trend for women's health outcomes has been declining.[14] This can be attributed to issues in diagnosing and treating diseases. While women in have a higher life expectancy than men in the US, this can be attributed to women leading generally healthier lives.[15]

References

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  1. ^ "Hysteria". sciencemuseum.org.uk. Retrieved 2020-05-05.
  2. ^ Devereux, Cecily. Hysteria, Feminism, and Gender Revisited: The Case of the Second Wave. ACCUTE: Association of Canadian College and University Teachers of English. OCLC 925414547.
  3. ^ "Britannica Academic". academic.eb.com. Retrieved 2020-02-25.
  4. ^ a b Haas, Lidija. "Memoirs of Disease and Disbelief". The New Yorker. Retrieved 2020-02-25.
  5. ^ a b "Why Women Are Diagnosed with Diseases Later Than Men". Healthline. Retrieved 2020-02-26.
  6. ^ "History". SWHR. Retrieved 2020-02-26.
  7. ^ Chen, Esther H.; Shofer, Frances S.; Dean, Anthony J.; Hollander, Judd E.; Baxt, William G.; Robey, Jennifer L.; Sease, Keara L.; Mills, Angela M. (May 2008). "Gender Disparity in Analgesic Treatment of Emergency Department Patients with Acute Abdominal Pain". Academic Emergency Medicine. 15 (5): 414–418. doi:10.1111/j.1553-2712.2008.00100.x.
  8. ^ a b "How sexist stereotypes mean doctors ignore women's pain". The Independent. 2016-07-27. Retrieved 2020-02-18.
  9. ^ Tunks, E., Bellissimo, A., & Roy, R. (Eds.). (1990). Chronic pain: Psychosocial factors in rehabilitation (2nd ed.). Robert E Krieger Publishing Co.
  10. ^ "Period pain is officially as bad as a heart attack - so why have doctors ignored it?". The Independent. 2016-02-19. Retrieved 2020-02-26.
  11. ^ D’Onofrio, Gail; Safdar, Basmah; Lichtman, Judith H.; Strait, Kelly M.; Dreyer, Rachel P.; Geda, Mary; Spertus, John A.; Krumholz, Harlan M. (2015-04-14). "Sex Differences in Reperfusion in Young Patients With ST-Segment–Elevation Myocardial Infarction". Circulation. 131 (15): 1324–1332. doi:10.1161/circulationaha.114.012293. ISSN 0009-7322.
  12. ^ Rosenfeld, Anne G. (July 2004). "Treatment-Seeking Delay Among Women With Acute Myocardial Infarction: Decision Trajectories and Their Predictors". Nursing Research. 53 (4): 225–236. ISSN 0029-6562.
  13. ^ "Heart Attack Symptoms in Women". www.heart.org. Retrieved 2020-02-26.
  14. ^ Exchange, The. "Rebroadcast: Why Women & People Of Color Face Lower Quality Healthcare & Worse Health Outcomes". www.nhpr.org. Retrieved 2020-02-26.
  15. ^ Asiskovitch, Sharon (2010-03-01). "Gender and health outcomes: The impact of healthcare systems and their financing on life expectancies of women and men". Social Science & Medicine. 70 (6): 886–895. doi:10.1016/j.socscimed.2009.11.018. ISSN 0277-9536.