International women’s day, women and health equity

Equity is not achieved by treating everyone equally. “It is achieved by treating everyone justly according to their circumstances.” — Paula Dressel

Women’s quest for equality is more than one hundred years old. But women cannot reach equality without equity. Especially health equity. 

Equality and equity

Equality and equity are not synonyms. Equality assumes that every segment of society is the same and therefore needs the same things. Whereas equity accepts that each segment is different and therefore needs different things. That people who started with less need more. 

Equality gives every segment the same opportunities and resources. Whereas equity allocates to a segment the exact opportunities and resources that it needs to thrive as much as the better endued segments. “Equality is giving everyone the same pair of shoes. Equity is giving everyone a pair of shoes that fits.”

Equity is fairness and equality in outcomes, not equality in supports and opportunities. Equity is a long-term and sustainable solution. It is both a goal and a process. Equality is a consequence of equity.

Women and equity

Women suffer inequity because they have been marginalised historically. They need support in all spheres of life from education to the workplace to health. Only then can they achieve civil, social, legal, economic, and political equality.

But equity and fair and just are subjective concepts. People disagree on what these stand for. Laws and policies that seek equity are therefore often challenged in law courts and in people’s court, that is in political campaigns. 

Financial independence is essential for women to achieve equality. Education and health are the sine qua non for such independence. But health is most important. Because an unhealthy person cannot be productive and therefore cannot be financially independent. So, health equity is crucial for women.

Health equity

Because of differences in men’s and women’s health issues, and because women’s health issues have historically received inadequate attention, health equity is a core issue for women. 

Differences in men’s and women’s health issues

A few of the several differences between men and women’s health issues are:

• Reproductive System. Ovarian cancer, uterine cancer, and cervical cancer are specific to women. Prostate cancer and testicular cancer are specific to men.
• Cardiovascular Disease. Cardiovascular disease (CVD) is the leading cause of death for both men and women. CVD develops later in life for women, but they are more likely not die from it than men. Symptoms of CVD in men and women are also different. Men tend to have more chest pain and sweating. Women tend to have more palpitations, nausea or vomiting, and fatigue than men. Because these differences, CVD may be harder to diagnose in women.
• Mental Health. Women tend to experience depression and anxiety. Men tend to experience substance abuse.
• Aging. As they age, women experience more bone loss and are at a higher risk of osteoporosis. Men experience more hair loss and a higher risk of prostate cancer.
• Hormonal Differences. Because of hormonal changes during menstrual cycle, pregnancy, and menopause, women are at a higher risk of certain conditions such as breast cancer and osteoporosis. Men have higher levels of testosterone, which puts them at higher risk of conditions such as prostate cancer.

Why women’s health receives less attention

Main factors that affect women’s health equity are:

• Economic factors. Often women are not financially independent, and this restricts their access healthcare. 
• Lack of representation. Historically women have been underrepresented in medical research and clinical trials. Thus, their health needs and issues are less understood. And that causes misdiagnosis and inadequate treatment.
• Gender bias. Historically women have been seen as less important than men.  This bias, conscious or unconscious, has led to inadequate attention to their health issues, and to medical research and treatment of these issues.
• Cultural. In some cultures, women’s reproductive health, mental health, and sexual health issues carry a stigma or are taboo. This results in lack of attention and resources to these issues.

These factors must be addressed to ensure gender equity and to improve health outcomes for women.

Centers of Excellence

One effective way to address women’s health issue is to setup 

Centers of Excellence in Women’s Health (CEWH). CEWH will be a healthcare facility that will offer high-quality medical care to women of all ages. It will focus on health needs unique to women such as reproductive health, breast health, menopause, osteoporosis, cardiovascular health, and mental health.

CEWH will offer tests, diagnosis, treatment, preventive care, and counselling services to women. They may also provide support programs, community outreach programs, and educational resources to help women better manage their health and wellbeing. They will promote advocacy and research related to women’s health by working closely with other health care facilities, NGOs and CSOs, advocacy groups, and other organisations to ensure women get best possible health care.  

CEWH in the world

Many countries of the world have already setup CEWH. But these may be known by different names. Not possible therefore to estimate the total number of CEWH the world has.

The United States has more than twenty National Centers of Excellence in Women’s Health. India has five such centers. But many other health centers and program in the US and in India offer specialized health care to women. 

Conclusion

Women have remained marginalized for hundreds of years. Equity demands that they be treated fairly, justly. That their different circumstances be recognized. That they be given additional resources and opportunities so that they can have the same outcome as men.

Women have shown themselves to be as good as men in diverse fields. But such sporadic showing does not indicate that the gender gap is narrowing.

For example, India was the second country in the world, after Sri Lanka, to have a women head of government, prime minister Indira Gandhi. And the fifth country in the world to have a woman head of state, President Pratibha Patil. But we have yet to give women the equity that they need to reach gender equality.

World Economic Forum says that the gender gap will not close entirely until 2133. That is, even with our best efforts, gender equality will not be reached for at least another one hundred years. 

Setting up of centers of excellence focussed on women’s health all around the world is a recognition of the fact that women’s health equity is essential to reach gender equality. 

“No country can ever truly flourish if it stifles the potential of its women and deprives itself of the contribution of half its citizens.”

― Michelle Obama

Making women financially independent will be a big step towards equity. This requires that women be healthy. Because unhealthy women cannot be productive. 

This International Women’s Day, let us resolve to make India’s women healthier.

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