Friday, January 24, 2014

Do Women Deserve More Funding In Health? No. <-- Q&A #1

Last post:                                      My Story:                                         Next One:

Women DON'T deserve more funding in health 

just because they're women.

In terms of funding and treatment in the developed world, women are being looked after just as much, if not, more than men.
But that doesn't mean we ignore the obvious. Men and women are different, and have different bodies, which work differently.
Treating them as separate in terms of treatment and research only makes sense.

But we shouldn't do this just because they're women. 

In this video, Pauline Johnson lays out her "mission" to figure out "why these sex differences occur and use that knowledge to improve the health of women."
We should recognise genders in medicine because it will only lead to better treatments for everyone.



 Pauline Johnson suggests that when looking at health, women should be looked after more.

She frames the whole speech is to make it an issue of women's health and appeals to a feministic agenda that way. She asserts that women should get treated differently to men, and that they deserve a larger chunk of the pot when it comes to medical research and treatments.

Had she framed this argument differently, i.e. scientifically, she would have got her point across to more people, and made her talk more convincing, rather than alienating a large chunk of her audience. 
(The like to dislike ratio at the time I wrote this was about 3:2 - very low for this channel)

Because acknowledging the difference in gender in clinical settings and in drug trials would lead to better treatments for women AND men - it would help more people stay healthy. Period (no pun intended).


It's important to note that the data she presents, as it is with any opinion piece, can be misleading. She's either doing it purposefully to illustrate and convince her audience or she's being blinded by her feministic stand on health.
For example, she uses a statistic that "66% of mice brain studies were on male mice or those whose gender were unspecified" and suggests that this means that women are being neglected in research.
This statement is flawed as we don't know how many studies actually specify gender. All we know is that 34% are specified as female in gender. It's very possible that a lower percentage were specified as male. 

So take some of what she says with a grain of salt. 


However, she makes some vital points on the healthcare for ALL people. There ARE huge differences between men and women. Not so much in the major, non sexual organ tissues/cells like the heart and lungs as she suggests when she says all cells are different, but in the hormones that run around and affect the functioning of the normal and diseased body (which are different in men and women). 


Her idea that we treat and research differently between genders is very valid on heart healthcare. 
Men comprise about 60% of heart patients, but women have a worse prognosis. Is it because they're being neglected? Possibly, but it's not because only men are being studied, as she suggests, but because in clinical trials and hospital situations, GENDER IS NOT ALWAYS ACKNOWLEDGED or taken into account when analysing data.
There is a huge difference in the two.
Over the last few decades, researchers and doctors have begun to see the importance of gender in hospitals.
In a study done on this issue - heart health, linked below - it was found that there is a trend in men of getting higher levels of LDL cholesterol (the bad version of cholesterol) in the third and fourth decades. This suggest there may be some physical or social aspects that aren't considered by doctors or in trials in the case of men, and that these should be addressed more in patients in that category. 
Eventually though, in the 5th decade, women suffer from higher proportions of LDL:HDL due to the post menopause period, as HDL (the good form of cholesterol) levels drop, meaning there is a higher percentage of LDLs left in the body. That same study suggests using HDL levels (or proportion of HDL:LDL) and the amount of fat circulating in the blood as a more accurate form of diagnosis in women [1].

There you can see that acknowledging differences in men and women when doing and analysing medical trials helps the treatment outcomes of BOTH WOMEN AND MEN. 
And noting the differences will only lead to more research being done more efficiently which can help EVERYONE.
Not just women as Pauline Johnson suggests.

You may see that in the case of heart health, this study alone shows the necessity to invest more and do more studies on the diet/drinking/smoking patterns (and other risk factors of heart disease) in  30s - 40 year old men, and more should be done on the effects of menopause on heart health for women.

Thus studying these differences, and noting gender in clinical trials IS a completely sound suggestion that should be taken on board.


In the case of depression, Johnson makes a point that 70% of people diagnosed with depression are female. But on studies of symptoms done on 5600 people (60% of those tested were female by the way), men and women were shown to have near equal rates of depression symptoms [2]. 
This suggests that men don't seek help for cases like this, and are under-diagnosed more than that women are neglected. 
HOWEVER, despite this, Johnson's suggestion that women be studied differently to men, due to their differing brain functioning, is a very good idea as the TREATMENT of this diagnosis can be very different.
Looking forward on how this data can help improve the medical system, it becomes clear that more funding needs to be done on making men more aware or willing to come out and seek help for depression, and more funding needs to be diverted on the effects of the mood centre (and hormones associated with that section) of the brain in women in terms of treatment. 

Again, acknowledging the difference in genders will help improve treatment and health research for men AND women.


I haven't done too much endocrinology yet in med school, so I don't know for sure what the differences between male and women are exactly (other than the obvious that I've discovered on my own =P), but the idea that we acknowledge these differences when we research, trial and treat is VERY GOOD and will only end up saving more lives..


And her suggestion that we can make a change by asking our doctors if there is a difference in treatments for men and women is also excellent. Because guess what, this video made me look up the differences in these diseases alone, and has made me (and hopefully the med students who read my posts), as a future doctor and concerned member of society, aware of this difference which hasn't been considered as much in health to date. 

Had she should have framed it as an issue of science and medicine rather than one of gender inequality, more people would be inclined to do that research too.


By the way - this will be the start of a new series - Q&A.
I got messaged this video on FaceBook and asked for a comment on it, and this (with some reworking and slight editing) was my answer. 
This "series", if you will, is not going to be as well worded and written as carefully as my other more inspiring posts, but I'll try and keep it good. 

Comment or message me anything you find interesting in terms of my treatment, how I view life after cancer after cancer or on interesting things you may have seen on the news or the internet, and I'll try and respond as soon as possible. 


Blogger (here of course)

Sources:



It should be noted that there are huge inequalities in women's health in the developing world for political and social reasons - not for lack of research or investment in treatment as she suggested.
And also - this obviously doesn't concern reproductive health, which is completely different... 
well... for most people that is.

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