Removing the Taboo: Talking About Women’s Health Is the First Step to Improving Health Equity

Panelists at the 2023 Asembia Specialty Pharmacy Summit discussed the myriad of challenges that women face when they encounter the health care system and how these issues can be addressed to provide female patients more agency.

The panel was entitled “Women’s Health Inequity–Candid Conversations on Why Women & Health Should be a Strategic Imperative” and featured speakers from various areas of the health care sector to talk about how stakeholders can join forces to improve health equity for women.

Joanne Armstrong, MD, vice president and chief medical officer of women's health and genomics at CVS/Aetna, began with championing digital tools, saying that although women are the dominant users of digital solutions but only 5% are targeted towards them. She also emphasized the role gender biases play in health disparities, especially for women of color, and why topics predominately experienced by women, such as menstruation, should not be considered taboo.

“It's just astonishing to me that the major life events for half of the population are so stigmatized that we cannot even say the word [menstruation]…. If you can't say it, it represents stigma that gets carried into medical settings, educational settings, workplace settings. Clinically, if you can't say it, you don't present to say what your problem is. And there's tons of data that looks at the delay and the medical costs associated with that,” said Armstrong.

Additionally, discussion around women’s health should extend beyond talking about menstruation and pregnancy to include all aspects of health, including mental health and conditions that predominately impact women, such as lupis and multiple sclerosis.

Stephanie Sassman, portfolio leader of women's health at Genentech, noted that researchers have not been required to include women in clinical trials until 1993 and because women may have different gene expressions compared with men across major organs, the science community has a lot of catching up to do to understand how the body functions and the effects of treatments.

“If we're out looking at those effects and we're not really trying to understand that, we're not understanding women's health, but we're also not fully understanding men's health either. And so, there's a business imperative, but there's also health imperative. If we truly want to bring forward personalized health care, we cannot leave 50% of the population aside,” explained Sassman.

Sassman recommended that clinics and government agencies need to establish more partnerships to address major gaps in care for women and normalize discussions around women’s health equity.

Diana Zuskov, assistant vice president of health care strategy, LexisNexis Risk Solutions, referenced that over half of pregnancies in the United States are covered by Medicaid and most women with commercial plans get access through their male partners, which represents a huge differential in access to care for women. She also spoke about the social expectations placed on women to forgo medical care to take on family responsibilities and juggle multiple tasks, placing an extra burden on women to be the spokespeople for their own health.

"Where the solutioning really starts is [health care organizations should be] taking the data and the evidence that's been built to proactively say, 'You know, what, we should be pushing our copay programs to women with these indicators of economic instability, and let's just push that out and make that known to them in a proportionate way so that they we don't have to put the burden on the patient to be accessing these amazing solutions.’"

Regarding women who are a part of the transgender community, the speakers noted that more data is needed to understand how gender health gaps impact transgender individuals and get a better picture about which impacts to health and health disparities are gender-based vs sex-based. They expressed hope that more research is being conducted.

The speakers expressed sympathy for women in states like Texas and Iowa, where strict abortion bans have been signed into law and reproductive specialists are leaving their practices, advocating for people to vote during every election as well as reconsidering whether to engage with business that are either ambivalent to or in favor of restricting access to abortion care.

“When we talk about abortion care aid is health care, it is medical care, that women need to be able to have access to,” said Sassman.