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Closing Gender-Based Gaps in Medicine: The Power of Data, Provider Education, and Patient Advocacy


Womens Health POV-BUTTONWomen are less likely than men to receive optimal healthcare. This problem is global and most often represented in the stark statistics on maternal mortality and other reproductive health outcomes that are at odds with the knowledge and tools available today. But gender-based gaps in healthcare extend beyond reproductive health into many other therapeutic areas. Closing the gaps will require an approach as multifaceted as the issue itself.

Tabby Khan, MD, MPH, Komodo Health’s medical director, recently discussed these disparities on the "EmpowHER" podcast with host Shreya Parekh. Dr. Khan has a background in both surgery and public health. Outside of her busy role working with Komodo Health clients and supporting the development of clinically informed software, she plays an integral role in producing much of Komodo’s data-driven stories.  

Here are some key takeaways from Dr. Khan’s insights:

Women in the U.S. face gaps in care for many reasons.
At the research level, a lack of female representation in clinical trials creates bias down the line, including in unrepresentative clinical guidelines that contribute to treatment delays and a greater disease burden. Implicit gender bias can also play a role: Women's pain is less likely to be taken seriously by providers, for example. Socially rooted health behaviors are also contributive: Women have never had more responsibilities at work than they do today, but they still tend to carry a majority of the burden of at-home responsibilities as well. For some women, their own healthcare can take a backseat.

Data is crucial for shrinking the gap, especially for women of color and other underrepresented minorities.
Health conditions can present very differently across genders. For example, a recent Komodo Health analysis found that women were twice as likely as men to present with nausea ahead of a myocardial infarction and were 32% more likely to present with malaise and fatigue. These differences, and the clinical guidelines that exclude them, contribute to huge gender-based disparities in treatment and outcomes. Real-world insights available today are helping elucidate these differences to update and inform clinical guidelines. This data is also important in addressing the additional layers of burden faced by women of color in areas of medicine compounded by gender-based disparities.

Dr. Khan summarized a recent Komodo analysis, which found that, among patients with HER2+ breast cancer, 67% of the providers seeing Black patients did not have a history of participating in clinical trials and 63% of physicians were not using the most novel therapy. These differences are likely two of many contributors to the vast disparities in outcomes in this disease, with Black women facing higher mortality. Komodo’s Healthcare Map™, with a high volume of closed claims and broad minority representation, is especially powerful for quantifying healthcare trends in historically underrepresented populations. Komodo’s new MapLab™ solution delivers the deep, high-impact clinical insights needed to drive systemic change in trends such as gender disparity.

Immediate change is possible but requires both patient self-advocacy and provider education.
As we continue to expose and improve gender healthcare disparities, unnecessary risks for women will lessen. But change will not happen overnight. Women must learn to be advocates for themselves in healthcare. That means speaking up for their needs, empowering themselves with information about their own bodies and patient journeys, pursuing provider attention when they feel like something is wrong, and seeking a second opinion when they are unsure about the care they’re receiving. It can also help for women to choose a physician that is a good fit for them, especially one who makes them feel listened to and heard. It’s also important for patients to recognize that a well-chosen physician is an expert who has likely seen a health condition in a variety of manifestations and will use evidence-based medicine and data to support their patients.

Providers, on the other hand, must take steps to educate themselves about emerging research into gender differences in clinical presentation. Medical students often hear, “When you hear hoofbeats, think horses, not zebras.” While this aphorism is helpful for population-level health, it’s not always the best approach for personalized, individual medicine, especially in many female-specific diseases where diving deeper is important. Certain autoimmune conditions and reproductive cancers that are diagnosed more often in women, for example, present with vague symptoms that are easily written off as something benign. And in conditions without routine screenings to catch early signs of disease, sufficient provider education becomes even more important. Physicians should also remember that nobody has more data on a patient's lived experience with a disease than the patient, and it is key that physicians develop the skills and intention to hear and reflect what a patient is sharing. Knowing what you don’t and when to refer a patient to another provider are also key.

To hear more about gender disparities in care and the steps Komodo Health is taking to solve them — listen to Dr. Khan’s full interview or read one of our recent publications on women’s health:

  • Iron Deficiency Anemia: High Burden, Low Priority? Iron Deficiency Anemia in U.S Women and the Challenges of Data Gaps With Over-the-Counter Treatments
  • Uterine Fibroids: A Silent Fight: Delays in Uterine Fibroid Treatment Among Women of Color
  • Myocardial Infarctions: Panic Attack or Heart Attack? Women With Myocardial Infarctions Are More Likely To Be Misdiagnosed and Undertreated 
  • Metastatic Breast Cancer: Stark Disparities Between Black & White Patients in Cook County, IL
  • HER2+ & Breast Cancer: Using Demographic Data to Illuminate Clinical Trial Access Gaps
  • Uterine Cancer: As Rates of Diagnosis Rise, So Do Racial Disparities in Care & Outcomes

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