Women's health gap

Women might live longer than men, on average, but they also suffer from poor health for longer. In the European Union, for example, women’s life expectancy is five years higher than men’s, but the gap shrinks to just one year if you consider how much of that time is spent in good health.¹

Reasons for this disparity include lack of research, testing, and investment focused specifically on women’s health. Closing the women’s health gap would present at least USD1 trillion of economic opportunities, according to research by the McKinsey Health Institute and the World Economic Forum.

Or, to put it another way, every USD1 invested in women’s health unlocks USD3 in economic growth.²

There is already some positive momentum, especially on the philanthropy side: the Bill Gates Foundation has committed USD2.5 billion over the next five years to accelerate R&D into women’s health.³

Such money is needed to help find better diagnoses and treatments for diseases like endometriosis, which affects as many as one in ten women. It is a very painful condition, in which the tissue that normally lines the uterus also grows outside of it, breaking down and bleeding with each menstrual cycle. This leads to heavy periods, the build-up of scar tissue, extreme tiredness, and potential fertility issues.

In 2022, the National Institutes of Health (NIH) allocated just USD16 million to endometriosis research, compared to, for example, over USD1.2 billion to diabetes.⁴

Part of the problem is that endometriosis is difficult to diagnose and involve an invasive approach – the only definitive way is through keyhole surgery (laparoscopy). And then there is no definitive cure, lowering the incentive to diagnose.

Investment can help a growing number of start-ups to develop innovative non-surgical diagnostic tests as well as new therapies.

But women-specific issues, such as endometriosis, are just the tip of the iceberg.

Diagnosis and treatment

Disability-adjusted life years (DALYs) show that only 5% of women’s health burden is related to gender-specific conditions, like endometriosis, menopause, polycystic ovary syndrome (PCOS), or ovarian cancer. Some 51% of the burden is linked to conditions which affect women uniquely, disproportionately, or differently.

Much medical testing and measurement is conducted on men, which can lead to gaps in understanding, affecting the speed of diagnosis and the efficacy of treatment. Men, for example, tend to be diagnosed with type 2 diabetes at a younger age and at a lower body fat mass than women.⁵

Indeed, across hundreds of diseases, women tend to be diagnosed four years later, on average, than men, according to a study of 6.9 million Danish people.⁶ This, in turn, delays treatment, prolongs suffering and increases the probability of a poor outcome.

Then there is treatment. There are many examples of treatments which do not work for women because they have not been optimised for them. PD-1 centric  cancer treatments have been shown to be less effective in women than in men.⁷ Similarly, while asthma is more prevalent in women, the commonly used ICS/LABA inhaler is more effective at treating men. Achieving sex parity in asthma treatment could benefit 16 million more women.⁸ There are reverse examples, too. Novartis discovered that its heart failure drug ENTRESTO, launched in 2015, was particularly effective for women, who are twice as likely as men to develop heart failure with preserved ejection fraction (HFpEF).

Better tailoring of treatment and diagnosis for women – including through increasing their participation in clinical trials – could reduce the number of early deaths, improve the quality of life and the years lived with a health burden and expand women’s participation in the workforce. According to McKinsey and WEF, closing the health gap would give women seven more healthy days every year. Targeted investment could help make that happen, boosting the economy and improving wellbeing.