How FemTech is tackling the gender health gap

20 Dec 2022 11min read

What are the fundamental differences in how men and women navigate their healthcare journeys? This question is an important one to consider in order to design successful products and optimise positive patient outcomes. Considering such differences is also influential in achieving health equity, whereby everyone is given the necessary support and opportunities to reach their full health potential.

Health equity holds great opportunity for innovation and product development, providing benefit to patients and the healthcare industry alike. Ensuring health equity in medical devices is reliant on both the recognition and understanding of patient needs and circumstances, which is often established through market segmentation. There have been many studies into the differences in how men and women journey through the healthcare system. This has been linked to an increasing awareness around the gender health gap and the FemTech sector, particularly in the medical and consumer industries that focus on improving the health of women and people with a uterus.

What is the health gap?

The phrase ‘health gap’ is one often used in articles and politics when discussing the healthcare system, but what does it mean? The health gap refers to the disparities in occurrences of disease, health outcomes or access to healthcare across different groups. These healthcare populations can be segmented by any attribute including socio-economic position, ethnicity and sex. Understanding the health gap is a fundamental step for all stakeholders within the healthcare industry who are striving to reach health equity.

multicultural people illustration

The female health gap

The female health gap has had a significant negative impact on the mortality rate of women, including those in the United Kingdom, which has the largest gap of all the G20 countries. Such trends are seen, for example, in cardiac disease statistics, where studies have found that women are 13% less likely to receive life-saving treatments after a heart attack and as a result are twice as likely to die within 30 days of having one [1].

Disparities are also found in patients with Alzheimer’s. An early-stage diagnosis is essential to slow down the progression of the disease, however women are less likely to receive an early-stage diagnosis than their male counterparts [2]. The study found that women have higher verbal memory than that of men and suggested that verbal memory in women may decline at more advanced stages of the disease, making identification of the disease more challenging [2].

The female health gap is a complex, multifaceted problem that requires a holistic view of the healthcare sector’s history, unconscious medical bias and the resulting data gap.

So, what led to this issue?

Some history about the gender health gap

Throughout history, the medical sector has not only been influenced by that of scientific breakthrough, but also by social and cultural attitudes. In certain periods of history, such attitudes have had negative implications on the medical care assigned female at birth (AFAB) people have received. For example, evidence suggests that in ancient Greece, male bodies were considered superior to that of female bodies due to the “wandering womb” theory. This theory suggested that the womb would move around the body, pressing against body parts and causing hysteria, delusion and suffocation. As a result, women were less likely to receive suitable treatment and pain management.

While medicine has seen radical change since this time, the difference in pain management can still be seen today. The study “Gender disparity in analgesic treatment of emergency department patients with acute abdominal pain” found that women in acute pain are less likely to receive certain pain-relieving treatments than men [3]. It has been theorised by some that this is due to women’s pain being more likely to be seen as a result of “having an emotional or a psychological cause”.

Throughout history there have been many successful efforts to reduce the gender health gap. In the 1960’s, the Women’s Health Movement appeared, a health campaign to close the female health gap. The campaign was successful in making medicines safer for women by helping to reduce the gender bias in clinical research and clinical practice. While previous movements and efforts have significantly reduced the gender health gap, it is important to keep working to improve AFAB people’s journey through the medical system and ultimately improve their quality of life.

Unconscious gender bias in medical device development

Unconscious bias is something that is influenced by our life experiences and views and affects the associations that we have with different people. In product design and development, if left unchecked, unconscious bias can lead to significant oversights in the usability and functionality of a product for different groups. This can be as simple as traditional can-openers being difficult for a left-handed person to use. While this example is frustrating for users, unconscious bias is exacerbated in a healthcare setting.

An article by Team Consulting’s Thorbjorg Petursdottir titled “Is AI Sexist?” highlights an example of the challenge of unconscious bias on the development of AI for medical devices. Thorbjorg describes how AI was found to fail to accurately diagnose women with heart disease compared to men. Such gender bias in medical devices can be identified and reduced by having a diverse design development team, conducting human factors studies on a wide cross-section of users and patients and doing regular design checks with a wide selection of stakeholders.

illustration of multicultural people conducting analyses

The data gap in the healthcare sector

A data gap simply refers to the data that you don’t have. Good medical device designs are based on a wealth of data about the design problem, the user and the context of the product. However, if this data is incomplete, it will have a negative impact on the effectiveness of the design. The same goes for decision making among healthcare professionals. If clinicians are not given the information about how to diagnose diseases differently in males and females, how can they be expected to do so?

The data gap covers a range of areas from a lack of ergonomic data regarding the female body, resulting in women being statistically more likely to die in a car accident [4], to clinical studies featuring a majority of male subjects. Acknowledgement of the female data gap in medicine has led to the development of a phenomena called “Yentl Syndrome” which describes instances where women are misdiagnosed or receive inferior treatment because of their symptoms not conforming to that of men [4].

The future of FemTech: growing innovations

First coined by Ida Tin in 2016, “FemTech” has come to signify innovations that are focused on women’s healthcare solutions for female-specific and generic health conditions that disproportionately effect AFAB people, including cardiac care and osteoporosis. Encompassing a wide range of solutions and products, FemTech is often found in the medical and consumer sectors and as a result the last five years have seen significant growth for the industry. Growth is largely considered to be due to increased public awareness, company formation and a surge in FemTech funding. These advancements have allowed some FemTech companies to address markets that big pharma and development companies have yet to make a significant move towards.

Figure 1 shows the range of products and services that start-ups in the FemTech industry are currently working on, highlighting not only the areas that are thriving with innovative developments, but the potential for products in other, less explored areas.

McKinsey adapted graph of FemTech start-ups

There are many FemTech companies whose exciting innovations could cause shifts in the healthcare industry. One such company is Health In Her Hue, whose digital platform allows for interconnectivity between black women and healthcare providers, highlighting the importance of intersectionality within FemTech. Within the connected devices and wearables space, Bloomlife is working on improving prenatal monitoring, with the goal of reducing the risk of still birth. DotEndo is a branch off from DotLab, developing non-invasive blood tests for the diagnosis of endometriosis, helping to relieve patients from a diagnosis journey that can take anywhere up to eleven years.

In addition to the companies that are working on female-specific health problems, there is work to improve generic healthcare for AFAB people. During a myocardial infarction, damaged blood cells release a protein called troponin. Research conducted by the University of Edinburgh found that women have lower levels of troponin after a myocardial infarction compared to men. Since then, the medical industry has worked on developing more sensitive diagnosis equipment that can detect lower troponin levels. The same University of Edinburgh team investigated the possibility that more sensitive tests with sex specific thresholds improves diagnosis of a heart attack. The study found that this allowed for identification in more women, making the number of women suffering a heart attack the same as men. However, women were still less likely to receive treatment and as a result more sensitive tests did not reduce the death rate of women with myocardial injury [5]. This highlights the importance of a holistic approach ensuring that consideration for different segments is highlighted throughout healthcare journeys from diagnosis to treatment and aftercare when tackling medical bias against women.

Outside of sex-specific diagnosis and innovations for female-specific health considerations, the rise of FemTech and advancements in awareness have influenced other areas such as drug delivery. Males and females build subcutaneous tissues in different areas, with women gathering more tissue on their thighs and buttock and men, around their abdomen [6]. Hence, needle length decisions for autoinjectors include male and female physiological data.

What is the future of FemTech in the healthcare industry?

Interest in FemTech is growing, with healthcare companies becoming aware of the potential to shift the current status quo within the healthcare industry. Market analysts predict a significant growth in the sector with the value of FemTech expected to surpass $60 billion in the next 15 years.

To ensure the future of FemTech, the industry must continue to work in multidisciplinary groups with engineers, human factors, designers and scientists to understand end-user needs and experiences to push the boundaries of current practices. The potential for life-saving innovation makes it an exciting time to be in the healthcare industry working in a wide team.

References

[1] A. J. D. C. e. a. Nathalie Conrad, “Diagnostic Tests, Drug Perscrptiopns, and Follow-Up Patterns After Incident Heart Failure: A Cohort Study Of 93,000 UK Patients,” PLos Med, 2019.

[2] A. B. e. Erin E. Sundermann, “Better Verbal Memory in Women Than Men in MCI despite Similar Leels of Hippocamal,” American Academy of Neurology, vol. 86, no. 15, pp. 1368-1376, 2016.

[3] F. S. S. A. J. D. e. Ester H Chen, “Gender disparity in analgesic treatment of emergency department patients with acute adbominal pain,” Acad Emerg Med, vol. 15, no. 5, pp. 414 – 418, 2008.

[4] C. C. Perez, Invisible Women, London: Penguin Random House, 2019.

[5] A. V. f. A. A. e. Kuan Ken Lee, “Sex-Specific Thresholds of High-Sensitivity Troponin in Patients with Acute Coronary Syndrome.,” Journal of the Amerian College of Cardiology, vol. 74, no. 16, pp. 2032-2043, 2019.

[6] S. R. S. e. Kalypso Karastergiou, “Sex Differences in human Adipose Tissue – The Biology of Pear Shape,” biology of Sex Differences, vol. 3, no. 13, 2012.

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