Why women’s health is so far behind the curve

In what is believed to be a first-of-its-kind study, researchers found small but “measurable” amounts of metals such as lead and arsenic in both organic and non-organic tampons found on the market. And the news is creating a fire storm online.

While the authors of the report say more research is needed to understand what these findings could mean for people who use tampons, the news has a lot of people frustrated with how women’s health, in general, is treated.

Women’s health across the world is under-researched and underfunded. On average, a woman will spend nine years in poor health, affecting her ability to work and perform in the economy, as well as her overall quality of life.

For more on women’s health and the women’s health gap, Marketplace’s Nancy Marshall-Genzer turned to Lucy Pérez, a former cancer researcher and senior partner at McKinsey & Co. Pérez is also coleader of the McKinsey Health Institute, whose report explored the health and economic impacts of closing the women’s health gap.

The following is an edited transcript of their conversation.

Nancy Marshall-Genzer: So Lucy, let’s start with a definition. What exactly is the women’s health gap, and how does it affect a person’s quality of life?

Lucy Pérez: So the women’s health gap refers to the amount of time that — all other things being equal — women spend in poor health relative to men. And what this refers to is the fact that women actually end up spending more time in poor health than men do. On average, that’s about 25% more time in poor health. And because the majority of this poor health is happening during women’s prime working years — that is, between ages 20 to 60 — it has huge implications on the economy and economic productivity.

Marshall-Genzer: What are some of those implications?

Pérez: The implications that arise from women being in poor health more often than men manifest in multiple ways. They first manifest in being absent from work, perhaps more often, right — what we call “absenteeism,” because of being in poor health. It also translates, in some instances, in less years of productive life. And the fourth way they manifest is that we know women tend to do more of the unpaid caregiving. That means when they step out of work to take care of a loved one, be it a child, another family member or a friend, and this unpaid caregiving responsibilities tend to fall on women and, again, take them out of the workforce. So these things altogether really impact productivity.

Marshall-Genzer: Oh they sure do. And you mentioned that the health care gap occurs during women’s working years, in many cases. So how does that affect her role in the economy or even her ability to hold down a full-time job?

Pérez: So the women’s health gap involves much more than sexual and reproductive health, which is what for a long time people thought of as women’s health. And what we now know and how we’re increasingly defining women’s health is to understand what are those conditions that impact women, not just uniquely but also differently and disproportionately. And what we’re seeing is that the majority of this health gap happens in conditions that impact both men and women, but impact men and women differently, right? And as a result of that, women are having worse health outcomes. And because they have these worse health outcomes, they’re spending more time in poor health and less able to be as productive as they could be if they were in good health. This productivity challenge that is the result of poor health then means less productive days at work, fewer work days, and as a result, sometimes women making choices to exit the workforce sooner than they would otherwise want to.

Marshall-Genzer: So Lucy, you estimate around $300 billion could be added to U.S. economic output if this gap were closed. So it seems like there’s an economic incentive here. So why aren’t more companies and organizations investing in women’s health?

Pérez: It’s a great question, Nancy. Indeed, there’s a huge economic opportunity. In the U.S. alone, we’re talking about an incremental $300 billion contribution to the GDP annually, and that’s just the economic productivity part of the equation. But there’s also new market opportunities from developing products and services to help improve those health outcomes for women. One of the reasons why we believe there has been less investment in this space is that, until recently, there was very limited appreciation for this opportunity. For too long, we’ve been operating in a world that really didn’t even appreciate the scale of impact that sex-based differences are having.

If you think about it, when we did the research, one of the facts that surprised me the most was taking a look at how often are researchers asking the questions, “Are there sex based differences?” right? Are there differences in the outcomes between men and women? We took a look at the literature covering 64 conditions that together account for 85% of women’s disease burden, and what we found across this publication — which by the way, there were more than 650 academic papers that we looked at — is that half the time, the question of whether there were sex-based differences was not even asked. And when the question was asked, women had worse outcomes two-thirds of the time, men had worse outcomes 10% of the time. So only a quarter of the time where there are no sex-based differences.

But yet, we operate in a world where we assume there’s no sex-based differences. And so what we’re seeing now is an increased understanding and appreciation for the need to study this sex-based differences, because only by investing in understanding those will we develop the solutions that help mitigate and drive better outcomes for both men and women. And that will, in turn, result in realizing that huge economic opportunity — the $300 billion in annual contributions to the GDP that we’re talking about.

Marshall-Genzer: And you’ve also mentioned that everyone has a role to play in closing this gap, including employers. So what’s the employer role here?

Pérez: Women are a big part of the workforce, and so employers can be doing more to support women’s health and making sure that the workplace environment and the benefits and policies that are in place are indeed conducive to supporting the needs of women. For example, when women approach menopause, there are different policies and benefits that can be available to support them through this period that would help ensure that they can continue to play an important role in their workplaces in full health. The same is true when we look at other conditions that impact women differently or disproportionately and ensuring that there’s the support so that they can continue to be fully productive and have more days in full health.

Marshall-Genzer: You know, Lucy, it seems like we really have a long way to go toward closing the women’s health gap. Despite that, are you optimistic we’ll eventually get there?

Pérez: It is a lot of work that needs to be done to close the women’s health gap, but yes, I am optimistic, because I look at the emerging signals that we are seeing, right. There’s a need to take actions on multiple fronts, and it all begins with awareness, and we’re seeing increased awareness and understanding of what this health gap is and how we can close it. We are also similarly knowing there’s a need for more investment, and we’re seeing more announcements — both from the public sector and the private sector — about channeling more dollars towards a better understanding of how conditions impact women differently, disproportionately or uniquely. So that is promising as well, and with this greater understanding and appreciation we’re seeing from providers and caregivers, a recognition that we need to have more sex-appropriate care protocols for how we take care of men and women.

And so all of these are signs that we’re headed in the right direction, but we need an acceleration — both in terms of the pace at which change is happening, the level of investment that is being put forward, and making sure that the choices that are being made really help us have the information in hand to close this gap as quickly as possible. The sooner we close, the greater economic opportunity, the better health outcomes for everyone and, as such, a stronger society.

Marshall-Genzer: OK, so a few good signs on a very long road, is that it?

Pérez: That’s absolutely right. We all need to keep leaning in.