In May, a study in the Journal of the American Heart Association reported that women experiencing chest pain wait in hospital emergency rooms nearly 11 minutes longer than men before they are seen by a health care provider. Women with chest pain were also less likely than men to be admitted to the hospital or kept under observation.
This is true even as heart disease remains the most common killer of women, accounting for more than one in five deaths. The JAHA study also found that people of color with chest pain also waited to be seen by a physician longer than White adults with the same symptoms.
The study is among the latest in a string of reports describing what has become known as “medical gaslighting,” a phenomenon in which the health needs of women and people of color are taken less seriously.
Why is this happening? First, it is important to note, this has been happening for a long time.
Only in the 1990s did a new law require the inclusion of women and diverse racial and ethnic participants in clinical research receiving grants from the National Institutes of Health, the world’s single largest funder of biomedical research. Only in 2016 did government guidelines for these grants require that laboratory studies use female subjects. Even today, a great deal of medical school instruction relies on data that do not highlight the many influences of sex and gender on health.
So, while doctors might treat women and men, it can be difficult to break from training and practice that has long focused on the biology and behavior of men. Ongoing knowledge is also affected by these systemic biases. A recently published study analyzed two of the country’s leading medical journals and found that over the last 30 years, fewer than 25% of lead or senior authors were women, with Black researchers accounting for only 2% to 4% of that already small proportion. A recent analysis of sports supplement research found that only 23% of study subjects were women and that only 1% of the 1,800 studies examined possible impacts relating to menstruation.
Beyond the medical community, assumptions about sex, gender, race, and ethnicity can also affect how patients view themselves and reach decisions about their health.
For example, despite major public health campaigns about how heart disease is the leading cause of death for women and men, awareness over the last decade of this fact among women has declined.
People need to know the risks to their health so they can make informed decisions about their lives. This means studying the particular health needs of women and the effects of sex, gender, race, and ethnicity on health.
For nearly 25 years, Women’s Health Research at Yale has led that charge. We are making sure that women’s heart attacks are detected and properly treated. We are addressing the unique stressors that affect the health of women, particularly women of color. We are making sure that medical schools teach the latest data on the health of women and sex-and-gender differences in health.
We must correct this now. We cannot spend any more valuable time sitting in the waiting room.