In 2020, medical technology company Hologic launched a global survey in partnership with Gallup to assess the extent to which women’s health needs were being met. Countries were ranked based on women’s responses to questions in five categories: general health, preventive care, mental health, safety and basic needs such as food and shelter.
No country scored more than 70 points in 2021, with Taiwan, Latvia, Austria and Denmark at the top. Three countries have scored less than 40 points: Afghanistan, Congo and Venezuela. The United States ranked 23rd, with a score of 61 out of 100.
“The economic and psychological burden of the pandemic has been weighing on many households for some time, and we know that it particularly affected women,” said Gertraud Stadler, director of the Institute of Gender Medicine at Berlin’s Charite hospital. did not participate in the survey.
In fact, women were more stressed, worried, sad and angry in 2021 than at any other time in the past decade, according to a Gallup poll included in the Global Women’s Health Index ranking.
Women were also more likely than men to say they did not have enough money to pay for 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, Hologic’s vice president of worldwide medical affairs and former director of breast imaging at the Johns Hopkins School of Medicine.
“Overall, the data is overwhelming. And we understand that women need to be healthy to be fully engaged and empowered. It’s clear that the time has come to work together and find solutions and improve women’s health care.”
“The world is failing women”
According to Hologic and Gallup, the five key areas assessed in the Global Women’s Health Index can explain most of the variation in a woman’s life expectancy at birth.
For example, women who said they had seen a health professional in the past year had an average life expectancy of two years longer than those who had not.
Preventive care is one area where the United States scored better in 2021 than it did in 2020. In the Women’s Health Index, it was the second best in this dimension, after Latvia.
“It was a small improvement, but we have to be happy with it,” Harvey said. “Overall, however, the world is failing women in preventive care.”
About 1.5 billion women had no access to preventive care last year, she said. And worldwide, fewer than 1 in 8 women were screened for cancer in the past year, according to the survey.
While the solution to this shortage may seem simple, experts say it reflects the multiple layers of challenges faced by women.
Women “are always the last to take care of ourselves. We’re the primary doctors for our families,” said Katie Schubert, president and CEO of the Association for Research on Women’s Health, a non-U.S.-based activist group. participated in the new study.
“It comes back to a lot of different burdens that women are taking on, both from the perspective of being a caregiver, but also from the perspective of being part of the community.”
In the US, for example, Schubert says, women are more likely to attend a well-being visit for their children than for themselves. And the proportion of women who do not show up for an important doctor’s visit in the six weeks after giving birth is “quite striking”.
Mother’s health needs attention
Despite some improvement, the U.S. remains an outlier in overall women’s health, in part because of maternal health, an area experts say deserves more attention globally.
U.S. women’s perceptions of their health and safety declined in the 2021 Global Index of Women’s Health, as did measures of individual health, including pain and general health problems.
Wealthy nations generally score better than low-income nations on the Global Index of Women’s Health. In fact, the difference in scores between high- and low-income countries almost doubled from 2020 to 2021, with an average difference of more than 20 points. But life expectancy in the US was below average, even though health care spending was well above average.
To some extent, widening gender disparities in health care 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 inconsistently and are less likely to go to cardiac rehab, Stadler said.
“All of this combines to worse outcomes and higher mortality in women than in men,” he said.
Uplifting women, uplifting society
Experts agree that improving women’s health will lift society as a whole.
“Women often play the role of health managers in their families and communities. And they’re taking on a lot of the caregiving work, so children, partners, parents also benefit from women’s health,” Stadler said.
And the implications are far-reaching.
“Without this basic health and well-being of women, we will not be able to advance the goals related to economic stability or equity in socio-economic development,” said Schubert. “Really, it’s all on the back of a healthy environment, a healthy person and a healthy outcome.”
But gender equality — in health and in other aspects of life — is still far from reality.
Schubert noted that the Covid-19 vaccine trials did not include pregnant women.
“My hope would be that we can better prepare ourselves to be more inclusive and comprehensive in our biomedical research, regardless of whether we’re dealing with a pandemic or another public health emergency,” he said. But the pace of change has been “extremely slow”.
Much of what is measured in the Global Women’s Health Index is aligned with the goals identified by the United Nations in the Sustainable Development Goals.
“It is now critical to look to invest in women and girls to restore and accelerate progress,” UN Women Executive Director Sima Bahous said of the report. “The data show an undeniable decline in their lives made worse by the global crisis: in income, security, education and health. The longer it takes to reverse this trend, the more it will cost us all.”
But there is hope.
“My hope is that we come out of the pandemic stronger,” Stadler said. “The pandemic has brought the importance of preventive behaviors to the attention of more people. People learned a lot about the importance of joint protection action.”