Canada’s Universal Healthcare system is oftentimes celebrated worldwide, but some experts say it doesn’t treat everyone equally. Experts at Women’s College Hospital in Toronto say a health gap in the system means many women are overlooked and under-served.
“We’re only really starting to recognize the very significant gap that there is in healthcare,” said Dr. Paula Harvey, Physician-in-Chief at the Women’s College Hospital. “We’ve been starting to focus on the gap that occurs in heart disease between men and women, that’s important because heart disease is the number on killer of women in Canada. But this actually can be extrapolated in any of the health conditions that men and women experience.”
The hospital says the health gap is evident throughout the medical field. For instance, though women are more likely to report severe and long-lasting pain, the hospital states they typically get treated less aggressively than men and are more likely to be referred to a therapist instead of a pain clinic.
“There are a lot of differences between men and women, whether it’s physical, social, ethnic issues that all feed into health care,” explains Dr. Harvey.
Women are often overlooked when it comes to conducting health studies, even though they have different risk factors and respond differently to treatments. The hospital also says as women enter different stages of their lives, they become more susceptible to heart disease. Even though that kills more women than men, researchers say many cardiovascular drugs that have been on the market for a long time, have only been tested on men.
“I think a lot of this stems from research,” said Dr. Harvey. “We were researching diseases, diagnostic techniques and treatments in men and not women, in male animals and not in female animals. It’s really only been since the 1990’s that we started to think women are different and they live in a different social environment than men, and may factor into health outcomes.”
The research has been slow to come. Research done on women’s reproductive phases, including during pregnancy, has also been lacking until now.
“It has been considered that studying women is more complicated than studying men, studying female animals has been considered more difficult than studying male animals because we have these hormones that affect the diseases and treatments,” Dr.Harvey said. “But we really have started to address these issues in our research, whether it’s in basic research in animals or it’s whether it’s when we’re doing the research in women, and realizing these are really important factors.”
There’s also been a hesitation to include pre-menopausal women who have the risk of getting pregnant, because Dr. Harvey says there’s concern over clinical trials having an impact on their reproductive system or their children.
“We now have built into our research, mechanisms to make sure that research is done in a safe way but that we’re inclusive of women across that life span, including women in their reproductive years, it’s very important,” she said.
The hospital has a long history of treating and researching women’s health, and has also launched a website specifically dedicated to closing the health gap. The site touches on how socio-economic conditions have an impact on women’s abilities to access health services and programs.
There are clinical programs underway at the hospital that address the gender differences in health conditions, and researchers dedicated to evaluating the health differences and outcomes between men and women.
“Across all of our sub-specialties, this really factors in to the way we manage patients,” said Dr. Harvey. “We’re also very invested in making sure we address equity concerns, and we’re aware of the fact that things like poverty, geographical location and ethnic/cultural differences are all factored in.”
In the late 1800’s, women weren’t able to train as doctors, and that saw the creation of the Women’s College Hospital. The organization became a place where women can practice and train as physicians, and today, the health gap remains a top priority for the hospital.