A biological divide08/09/17Health
An MEP in the Alliance of Liberals and Democrats for Europe (ALDE) Beatriz Becerra Basterrechea discusses how EU and European public health policies need to adopt a fair, gender-equal perspective.
There is a reality we can no longer ignore. Men and women have different genes, biology and anatomical features, which are related to different health problems. Facts proved by the World Health Organization (WHO) show that while women have higher rates of depression, anxiety, stress, somatisation and eating disorders, men have higher rates of substance abuse and antisocial disorders. Adapting the diagnoses, treatments and medicines to the differences between men and women is crucial for ensuring appropriate medical treatment for everyone.
However, women are still ignored in most clinical tests and research and therefore the possible side effects some treatments may cause on them are often unknown. It’s hard not to call it sexism. This sometimes entails a very high risk to women’s lives.
The same applies for mental health care. Although over the past years some kind of awareness is emerging, there is still a long way to go. Mental healthcare needs to be tackled in an holistic, comprehensive, and gender-sensitive manner. We need inclusive policies that do not leave anyone behind and that take into account all EU citizens, including those who have special healthcare needs like LGBTI citizens.
Health is far more than not becoming ill. According to the WHO, it is “a state of complete physical, mental and social wellbeing and not just the absence of the illnesses or diseases”. Therefore, inequality between men and women is an essential question of health. It is, literally, a matter of life and death.
In general, we are used to relating gender equality discussions to the unbearable pay gap or to the weird lack of women’s public representation or prominence. We also associate it with physical and psychological violence. However, reference is rarely made to health. This is the key issue I dealt with through the European Parliament initiative “Promoting gender equality in mental health and clinical trials” adopted last February 2017, in which I was the rapporteur.
We cannot and must not make do with the present situation. Inequalities are unacceptable; as is inequality in terms of salaries (16% according to the last report from 2015 on equality between men and women in the EU); as it is in terms of pensions (40% according to the aforementioned report). In health terms, we are putting lives at risk. We are putting the lives of half the population at risk – lives of women.
Biology and variance
Biological differences mean that women and men have different health problems. For instance, men cannot suffer from endometriosis, to give one obvious example. But this physical difference does not explain anything in and of itself. What we have to ask ourselves is whether enough attention is paid to endometriosis or if there are appropriate programmes for its prevention and treatment. We have to ask ourselves if enough is invested in researching new treatments.
If we extend these questions to any other illness, the answer is that only gender differences explain why more resources are allocated to male impotence than against illnesses such as endometriosis.
The same can be applied to clinical trials. Gender differences are not taken into account and therefore women’s health is not being protected equally. Women are dramatically underrepresented in biomedical research, despite making up over half of the EU population. Failure to improve women’s representation in clinical trials and biomedical research results in putting women’s health and lives at risk.
However, perhaps where this inequality is most evident is in mental health. It is particularly visible in the rates of common mental disorders like depression or anxiety. Depression and anxiety are three times more present in women than in men.
Mental health and wellbeing are heavily gendered and influenced by many factors such as socioeconomic factors, income disparities and discrimination. The most vulnerable groups of people, such as migrant women, disabled or LGBTI persons, should not be left behind.
This asymmetry is explained by hormonal factors but also by differences in the socio-economic position of men and women in our societies and by other social factors. A woman who is fully in charge of her life will benefit from much stronger mental health.
Balancing the inadequacies of healthcare
The strong support for the principles laid down in my report are an important step towards improving gender equality in mental health and clinical research. The report calls for an holistic approach and stresses that Commission and member states’ policies must take due account of gender differences in research and healthcare, in terms of prevention, diagnosis and treatment.
The primary responsibility for health-related policies in the EU lies with the member states, but the EU nevertheless has a competence in health promotion and disease prevention. The support of the European Parliament for the principles laid down in my report is an important step towards improving gender equality in mental health and clinical research.
The European Union has a lot to contribute with. It is obliged due its founding treaties to guarantee the protection of human health as part of all its policies and to collaborate with member countries to improve public health, to prevent human illnesses and to obviate sources of danger to physical and mental health.
Unfortunately, the current picture shows that, at the moment, we are not properly addressing the issue. Although we are slowly progressing towards achieving equal rights, we still have a long way to go and inequalities between men and women are still a sad reality in many areas. One area that often goes unnoticed is that of gender inequality in areas related to health.
Beatriz Becerra Basterrechea
MEP Group of the Alliance of Liberals and Democrats for Europe (ALDE)
This article will appear in Pan European Networks: Health 3, which will be published in November.