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Gender paradox: Women’s health still lags

By December 10, 2018May 26th, 2020Health

While women generally live longer than men, their quality of healthcare is lower and they spend more of their lives in poor health. But this may only be the tip of the iceberg.

Women outlive men around the world by an average of 4.6 years, but overall are less healthy and incur higher healthcare costs.

As a serious social problem, healthcare inequality is an ethical issue. The whole world must become more aware of and be willing to address this fact that, despite a longer average lifespan, women experience more health issues and increased incidence of disease as compared to men.

This “gender paradox” — higher morbidity but lower mortality — in modern health care still exists despite greater health orientation in women, resulting in deficiencies in the access and utilization of women’s care. More specifically:

  • Women use more healthcare services than men with a significantly higher mean number of visits to their primary care clinic, as well as more diagnostic services, specialty care, emergency treatment, diagnostic services, and higher annual total charges.
  • They experience more disability than men, including chronic pain. For example, in all age groups, females experience more low back pain than males.
  • Even when exposed to the same risks or disease, health consequences may be different too. For example, among both sexes who smoke tobacco, women appear to develop pulmonary disease at younger ages than men and with lower cumulative cigarette smoke exposure.
  • Women have more visits to primary care facilities, including diagnostic services than men.
  • Mean charges for primary care, specialty care, emergency treatment, diagnostic services, and annual total charges are significantly higher for women than men.
  • Health insurance costs are higher for women.
  • Women also use more medications than men.

Writing in the Bulletin of the World Health Organization, Mary Manandhar and colleagues state that, “These differences are largely due to the social phenomenon of gender.” Described as the social relationships between males and females in terms of their roles, behaviors, and activities, gender appears to play the primary role in why women have poorer health and receive lower-quality care. A second relationship — the biological difference between genders — appears to play a much lesser role in the gender paradox.

Gender Ads

Not only do women buy more diet books, dietary supplements and other health-related items, women are the primary drivers of overall consumer health spending, also playing a key role in buying for men. This means most marketing is directed at women — marketing that easily sways female consumers of all ages, often towards deceptively unhealthy products and services.

Healthcare Inequality is Common

Gender inequality and its effect on health is not the only healthcare problem we face. Social inequality is common throughout the world, too, and even within wealthy countries; this significantly influences healthcare quality among both genders. Other factors such as education, employment status, and ethnicity are significant primarily due to income level. In low-income areas of the world, life expectancy is 62 years, while in high-income areas it’s 82. But the same inequality range can be found in Western countries within their large inner cities. Moreover, health education directly affects health status. Unfortunately, as noted above, the advertising of unhealthy products and services, which mis-educates consumers, easily sways educational health the wrong way.

Fitness Too

Like health, when it comes to fitness, women lag behind too. However, the reasons are more well-known. Men produce more more testosterone, associated with increased muscle strength. Modern sports is (unfortunately) still a man’s thing, developed by men centuries ago and geared to their abilities. However, there are sports where some women often excel past men, such as gymnastics, equestrian events, swimming, rock-climbing, and ultramarathoning.

What to Do

Individualization is a key to resolving this problem. It’s not just being holistic, but truly looking at each person — every patient — as a unique individual regardless of gender and age. While gender is certainly a component in a complete evaluation of a patient, hundreds of other factors must be considered as well, including the many signs and symptoms used in a complete assessment process. Addressing these inequalities in healthcare can be accomplished through better, more personalized care, regardless of everything and anything else about the individual.

Access to healthcare is an obvious feature of improving global health. The absurdity of reduced or denied access to high-quality care must be addressed — healthcare for everyone is essential. When we consider the business of healthcare, especially the massive waste of resources, including costs of over-assessment and over-treatment, the affordability to provide access to all is a reality.

Part of that reality should include responsibility. This comes on two levels; society as a whole, including governments and business, and individuals.

  • Society should not allow companies to promote and sell dangerous, unhealthy products and services that wreak havoc on people and the world.
  • Individuals who all make personal health choices must also be responsible for their actions — consider a two-pack-a-day smoker’s responsibility for self-inflicted harm.

And, of course, this need not be a political issue, but one associated with a basic human requirement. The world can afford it, and all people should receive the care they need.


  • Global Burden of Disease 2017: a fragile world. Lancet. 2018;392(10159):1683.
  • Manandhar M et al. Gender, health and the 2030 agenda for sustainable development. Bull World Health Organ. 2018; 96(9): 644–653.
  • Merrill RMTelford CT. Pharmaceutical use according to participation in worksite wellness screening and health campaigns. Prev Med Rep. 2018;12:158-163.
  • Bertakis KD, et al. Gender Differences in the Utilization of Health Care Services J Fam Pract. 2000;49(2):147-152.