Since the advent of the Affordable Care Act, it’s illegal to charge women more for health insurance than men. But the truth is the average woman still pays $48 more per month. While plan selection, geographic location, and other factors can increase rates, they typically have higher premiums because women’s health care simply costs more.
For starters, women can get pregnant — a basic health care expense men don’t have — with the average delivery running $22,734 to $32,062, according to The Cut. They also live longer, which requires additional aging care. Yet while maternity and life expectancy are biologically-driven, there’s another factor that’s 100 percent man-made: Decades of medical studies completely ignoring women.
That’s right. Before 1994, women were not included in clinical trials. In fact, they were intentionally excluded due to concerns that women would become pregnant during testing. “We thought that the findings from men would be relevant to women and so we were protecting women by not including them,” Dr Janine Clayton, director of the National Institutes of Health (NIH) Office of Research on Women’s Health, explained on Lean In podcast Tilted. Researchers worried experimental drugs could pose risks to fetal health or that hormonal shifts would skew results.
Today, though, the medical community finally understands that men’s and women’s health are different — and not just because women can getting pregnant. “Women’s health is everything that affects a woman from head to toe,” Clayton said, and she’s right: They manifest the signs of heart attack differently, we’re more likely to feel nauseous after taking prescription drugs, and we’re also more likely to have a stroke. In fact, a 2017 study showed that while men are having fewer strokes than ever, women are having more.
When you have a stroke or a heart attack, certain symptoms are undeniable — like severe chest pain. But 42 percent of women who have a heart attack don’t have this so-called common symptom. Instead, they feel tired or our jaw hurts. These symptoms, Clayton said, are “nonspecific”: “Shortness of breath could be asthma [or] a lung infection [or] an allergic reaction. Pain in the jaw or pain with swallowing could be a sore throat.” Nonspecific symptoms are harder to categorize and as a result, when half of female heart attack victims come in the ER, they’re misdiagnosed.
So why don’t doctors just stop associating severe chest pain with heart attacks? Because that is the number one symptom in 70 percent of men. And since women were ignored by decades of research, today’s physicians completed med school and their residencies never learning that women’s heart attacks look different.
Granted, the female body is better researched today, with women making up 49.1 percent of US trial participants in 2016. But that doesn’t mean those test results are presented to doctors in a useful way. Take nicotine replacement therapy, for example. Women’s brains process addiction differently than men, so stop smoking gum and patches don’t work as well for us. Of 42 smoking studies meant to help doctors determine patient treatment, only half involved both men and women. And only five published gender-delineated results.
Clayton said, “Women are in the studies, but the results for the women and for the men are not presented always separately.” Less than one-third of trials break down findings by gender. “If those results are not separated for men and women, we don’t know how well the results apply to both men and to women,” she explained. Say a study claims X medication works well for 50 percent of patients. For all physicians know, that could mean 100 percent of men, zero percent of women.
Looping back to cost, it’s not hard to see how studies that ignore women’s health affect insurance premiums: When women receive the wrong diagnosis or incorrect treatment, they keep coming back to the doctor, striving to get better. And all those return visits and unneeded pills or patches drive up expense, both for the woman and her provider.
Good news is, out of all the current issues facing health care, this is one patients can change: Clayton says it’s as simple as patients asking their doctors “Is it different for men and women?” during exams and treatment. “We need to do a better job of getting the word out about these differences between men and women,” Clayton says, and by demanding answers, women will force their doctors to consider any updated, gender-specific research.