5 Ways to Address Gender Bias in Healthcare

Did you know that over 800 women die every day from pregnancy and childbirth complications? It’s the leading cause of death for girls and women between the ages of 15-19 globally.

The discrimination, unequal rights, and mistreatment of women is a global crisis, and it’s not unique to poor or developing countries. In America, gender bias in healthcare impacts the lives of women — particularly minority women — every day. For example, in one survey of healthcare interactions over a two-year period, nearly 30% of women experienced doctors dismissing their concerns.

As a healthcare leader, you can help to change the narrative by getting informed about the issues affecting your community and the diseases, conditions, and interpersonal interactions your patients experience. Learn how your leadership is needed to help address gender inequality and improve outcomes in your organization.

How Does Gender Affect Healthcare?

The World Health Organization (WHO) defines gender as a social construct independent from biological sex which describes the characteristics of women, men, girls, and boys. Social norms around gender include the behaviors, roles, and relationships associated with being a woman or a man. While sex can influence the risk of disease and certain genetic outcomes, the WHO notes that gender norms and socialization contribute to disparate healthcare access, quality, and outcomes, as well as the health risks that women face — and take — compared to men.

In the practice setting, gender bias in healthcare shows up as differences in care between men and women. This creates disparities or biases in access to healthcare services, treatment, research, and outcomes based on a patient’s gender. As a result, women may have higher rates of mortality than men for the same conditions or be undertreated for gender-specific conditions, such as reproductive diseases.

A common manifestation of gender inequality occurs in healthcare decision-making, leading to the mismanagement of women’s health conditions that aren’t well understood. As a historically male-dominated profession, the medical practice was originally developed by studying only the male body.

The inclusion of women and minorities in clinical research and trials wasn’t commonplace in the U.S. until 1989, when the National Institutes of Health updated its policies to that effect. It took a few more years until Congress required this by law in 1993. This was a major step in health equality and in taking a different approach to the way we study women’s health, but it also means that the practice of medicine is still playing catch up.

Examples of Gender Bias in Healthcare

The predominantly male focus of the profession until fairly recently in the modern era has produced some lingering gender bias in healthcare. For example, migraines, osteoporosis, and autoimmune diseases are commonly undertreated and are often mischaracterized as mental health issues in women. The dismissal of women’s health issues as hormonal problems can be traced back to early medical days. The term “hysterical” — often used to describe a woman’s reaction to pain or stress — is derived from the word “hystera,” which means uterus.

Another example of inequity occurs when a woman is treated differently for the same condition that a man experiences. For example, men having a heart attack are more likely to experience “classic” symptoms like chest-clutching pain. For women, the symptoms can be more discrete, such as feelings of generalized pain, indigestion, fatigue, or heartburn. These differences in clinical presentation — and misunderstandings about them — are one reason why women are more likely to die following a heart attack than men.

Gender Bias in Healthcare Statistics

Practice standards in healthcare are constantly changing thanks to the emerging medical research that moves healthcare organizations forward. This allows healthcare providers to deliver best-practice care and continually work toward improving patient outcomes. However, without addressing gender bias in healthcare research and policy, your organization may fail to close the gap in health disparities affecting its patient population. The following statistics about gender inequality should be top of mind when addressing disparities at your healthcare facility:

• Within 1 year of a heart attack, 26% of women will die from complications vs. 19% of men.
• Over 1,200 women died from pregnancy or childbirth complications in the U.S. in 2021, and an estimated 80% of deaths were preventable.
• Women have a 10% greater risk of hospital mortality than men.
• Men are 21% more likely to receive prophylaxis against deep vein thrombosis compared to women.
• Women are twice as likely than men to experience mental illnesses such as depressive disorders.

How Can Your Facility Prevent Gender Inequality in Healthcare?

Gender bias can occur in healthcare facilities at any level — from attitudes within an organizational culture to implicit bias affecting patient-provider interactions. As a healthcare facility leader, you can review the systems in place at your organization that could be contributing to the way patients are viewed and treated.

A helpful first step is to collect and review data that can help uncover hidden biases occurring in everyday healthcare delivery. It’s also essential to understand the demographics within your community to know how you can best serve your patients. This helps identify at-risk populations who may be affected by implicit bias and discrimination. Below are a few ways you can begin to incorporate best-practice care to prevent and limit gender inequality in your healthcare organization.

1. Promote Workplace Diversity

Establish an organizational culture that places emphasis on diversity, equity, and inclusion for all staff and patients. This starts with evaluating the treatment and pay rates for women in healthcare, who make up 76% of the healthcare workforce. Healthcare leaders can also take a strategic approach to hiring that promotes a more balanced gender representation at the bedside. Consider making efforts to recruit more men into nursing and women into advanced practice roles to work toward equal representation.

Promoting diversity and equality goes beyond representation and pay equity. When gender bias in healthcare is addressed at an organizational level, values of unity and equality can more easily make their way into patient care. Review your company’s stance on diversity and inclusion and strategize ways to promote diversity within the organization.

Provide cultural competence training to understand and respect the cultural and gender-related factors that influence patients’ healthcare experiences. This can help in reducing bias and providing equitable care.

Example: A healthcare organization offers monthly town halls to celebrate staff members’ differences within the company and to highlight gender equality success stories.

2. Uncover Root Causes of Gender Bias in Healthcare

Societal conditioning, company culture, and individual belief systems can all contribute to gender inequality in healthcare. Healthcare leaders can look at the structural dimensions of gender equality to uncover the root of gender inequities that exist within an organization. Action steps may include:

• Acknowledging that women’s rights are closely tied to their economic status, and creating policies that address this. Leaders should examine factors like access to care and ensure vulnerable patients have support during challenging economic times.
• Changing the narrative about gender roles and caregiving. A healthcare culture should aim to reframe attitudes toward caregiving so it becomes a shared responsibility between women and men. In the practice setting, this may mean healthcare providers direct family caregiver teaching to a broader range of family members rather than toward females.
• Expanding female representation in healthcare leadership to be active participants in decision-making processes. Ensure that the leadership and governance structures are diverse and include women in key decision-making roles.

Example: A women’s health clinic conducts a survey for pain management in patients with endometriosis. Providers are also surveyed on their perceptions of pain control. The results are reviewed to identify gaps in patient-provider communications and implicit bias.

3. Focus on Primary Prevention for High-Risk Patient Populations

Healthcare leaders can leverage evidence-based research to address the needs of vulnerable populations within an organization. This starts by collecting data about the community demographics and the health conditions your organization serves. Take extra focus on gender, race, and other demographic factors that contribute to marginalization. This helps identify disparities to target interventions accordingly.

Next, create an action plan to minimize the risk of adverse health outcomes for high-risk populations. Emphasize person-centered care, where patients’ preferences, values, and beliefs are considered in decision-making. Create an open and non-judgmental environment where patients feel comfortable discussing their healthcare concerns, regardless of circumstance.

Example: A healthcare facility serving a large population of indigenous women offers public education to prevent Fetal Alcohol Spectrum Disorder (FASD). Obstetricians within the organization receive cultural competency training to effectively communicate and treat women in this region.

4. Promote the Use of Inclusive Language Organization-Wide

Encourage the use of inclusive language in all organizational communications and patient interactions. This includes using gender-neutral terminology when appropriate in patient care. Healthcare organizations may consider using technology to help with this.

For example, consider integrating a place to share the patient’s preferred pronouns in the patient information banner within an electronic health record (EHR) system. Facilities may also provide staff training about the use of gender-neutral language and sensitivity when addressing patients so that communication is respectful and free from stereotypes.

5. Support Change With Evidence-Based Research

Healthcare organizations can support evidence-based research by applying new concepts related to gender-based healthcare disparities into practice. If your facility is a research center, consider conducting your own research to contribute to advancements in healthcare. This may involve taking steps to include more women in research studies for condition-specific advancements.

Healthy People 2030, established by the Department of Health and Human Services (HHS), also outlines a set of science-backed initiatives striving to improve public health and well-being over the course of ten years. Included in the 2030 goals is an emphasis on improving health equity, eliminating disparities, and improving health for all people — regardless of their gender, race, socioeconomic status, or geographic location.

Your healthcare organization can utilize Healthy People 2030 as an evidence-based framework to address gender inequality at your facility. These are the steps your organization can take to apply the Healthy People initiative to close the gender gap and work toward a better future at your facility:

• Educate health workers on the definitions of health equity and health disparities.
• Use Healthy People objectives that align with national health equity goals.
• Employ data to monitor progress and measure success within your organization.
• Use evidence-based resources to address health disparities.
• Follow the Social Determinants of Health framework to uncover causes of health disparities and implement strategies for change.

Take Additional Steps to Support Equitable Care

Your healthcare organization is committed to treating the dynamic needs within your community. For everyone to receive equal treatment, it’s essential to prevent and reduce gender bias in healthcare. Don’t miss out on the latest healthcare insights and best practices that will help your organization be a valued leader in your community.