Earlier this year, Yale University researchers made headlines for their study looking at heart attacks in young women, especially the finding that many women ignore their symptoms.
This is just one of several studies to explore how quickly women seek care for heart-related symptoms compared with men — and it was not the first to find that women are slower to get help.
You might think it’s because women are too busy or that they prioritize their families and jobs over their own needs. That may be true in some cases, but health-care-seeking behaviours are actually a lot more complex.
Other factors include the persistent stereotype that heart attacks primarily affect men (they don’t — women are more likely to die from a heart attack), as well as a general lack of public education about heart-disease risks in women (most Canadian women have at least one risk factor for cardiovascular disease). Women are also more likely than men to experience atypical symptoms, such as trouble breathing or pain in the neck or arm, instead of the “classic” symptom of crushing central chest pain.
Still, in my experience, failing to seek care for potentially life-threatening symptoms isn’t just a women’s issue. Our culture has long offered perverse rewards for not taking care of yourself. If men go to the doctor, they’re perceived as weak and whiny, and portrayed as macho if they don’t, while women are commended for not complaining and are seen as martyrs. None of this helps anyone.
There are also more general health-literacy issues we need to overcome. People often don’t understand the significance of the symptoms they’re experiencing. In other instances, they’re not ready to face the possibility of a serious diagnosis, so they avoid seeing a health-care provider even when they know they should.
In my own practice as a family doctor, I’ve found that women come to see me more often than men do, and usually they come on behalf of the whole family. They’ll book an appointment to ask about symptoms their husbands or partners are having, or to ask about their kids, in addition to coming in for questions about their own health. It’s a phenomenon that’s backed up by research: Heart attacks aside, women see health-care providers more often than men do overall, especially in primary care.
That points to a broader caregiver role that women may occupy within their families. And it’s also consistent with the findings in global-development work: If women are educated about how to lower health risks, the health of the whole community improves.
Still, some women may resist taking on the responsibility of family health because they see it as part of the social construct of women as caregivers; other women may view holding the key to family health as a good thing for families and communities, as long as it’s a role that’s supported socially.
It’s no use pretending to be gender blind in health care — the reality is that gender does matter. In a perfect world, we would all access the health care we need when we need it, but as long as we live in this imperfect world, we must learn how gender, among other factors, influences people’s decisions to get the help they need.
Dr. Danielle Martin is a family physician, VP medical affairs and health system solutions at Women’s College Hospital in Toronto, and a senior fellow at WIHV in Toronto.