Heart disease is the leading cause of death in the United States amongst both men and women (Corliss, 2016). However, the experience with cardiovascular disease (CVD) between the two sexes is not parallel. CVD is an umbrella term for many heart diseases and among these diseases, the symptoms vary for men and women and throughout time the treatment for CVD has not reflected those disparities. Physicians play a primary role in this as well as politicians, scientists, and the socialization of women’s health being undermined through the media (television, magazines, social media, etc.). It is significant to address the disparities in CVD among men and women because it affects the treatment that women receive or if they receive treatment at all, which can lead to fatal effects including heart failure, blood clots, stroke, and cardiac arrest. Fundamentally, not recognizing these disparities is literally killing women.
The disparity of CVD between men and women is often referred to as “the cardiovascular gender gap” (Corliss, 2016). Such as the well-known wage gap, this disparity is acknowledged by most of society but there is not enough action on the matter. There have been epidemiological, clinical, and experimental data to provide evidence that there are gender-specific variations in cardiovascular risk (CVR) (Perez-Lopez, Larrad-Mur, Kallen, & Chedraui, 2010). Despite this knowledge, policy makers and healthcare providers have not taken the steps to address ways to improve the risk factors and the treatment of CVD for women.
Biologically, there are gender-specific influences that are associated with CVR in women. At the cellular and biochemical level, gender differences in the regulation of physiological mechanisms are directly influenced by genetic polymorphisms (Perez-Lopez, et al., 2010). These genetic differences affect symptoms and the effectiveness of treatments for CVD. With the data that has been collected relating to how gender and sex influences CVR, it would be logical to conclude that because there are different risk factors and symptoms for CVD between men and women, there should also be different diagnosis measures and treatment plans.
It is also important to note that many of the health indications that women are affected by are influenced by social constructs like comorbidities including endocrine disorders such as hypothyroidism and diabetes and psychiatric disorders such as depression. This is just one of the many aspects of women’s health that have been socially constructed. In this case, there have been socially constructed influences that correlate with CVR in women in comparison to men. For example, women are more likely to be diagnosed for depression, which increases the risk for CVD. Psychiatric disorders are often not recognized in women considering that society encompasses the idea that women are “naturally” more emotional—a social construct. Although mental health is generally not recognized on its own, it is important to note the differing socializations of atypical men and atypical women. The lack of recognition in mental health for women runs the possibility of women left untreated for psychiatric disorders, which factors the risk of CVD.
To speak broadly, the disregard to women’s health issues is a social construction. Society has historically placed more importance on issues that relate to men over women, often gone undetectable although it is among daily activities. Specifically, the portrayal of CVD throughout media, which significantly has negative outcomes for women. Women are much more likely to have symptoms that seem insignificant such as indigestion, shortness of breath, and back pain referred to as subtler “atypical” symptoms (Harvard Health Publishing, 2014), whereas men experience more overt and urgent symptoms. It is rare to see subtler “atypical” symptoms being portrayed in television, magazines, and social media; instead more distinguishable symptoms such as angina, swelling, numbness, pain in the arm, etc. are presented to viewers. These distinguishable symptoms are often found in men, and not in women. By ignoring subtler “atypical” symptoms that are generally experienced by women, society continues to re-socialize the inferiority of women in comparison to men.
Such as the lack of recognition in mental health among women, this is an issue because it effects whether or not women reach out for help and if they do, whether they are properly diagnosed and treated by healthcare professionals that also have been re-socialized to place more significance to symptoms and treatments specific for men. This gender disparity is commonly seen among physicians. There is a power dynamic between physicians and patients that frequently goes unrecognized. Physicians hold the power to determine what symptoms are valid and what symptoms are not and this affects whether CVD is correctly recognized in patients, particularly women.
When physicians attempt to diagnose patients, systematic differences in the type of cues considered for either male or female patients may indicate over-sensitivity to some types of information and blindness to others (Adams, et. al., 2008). Inference process for linking cues to diagnostic classes influences clinical decision-making and treatment plans. In the study done by Adams et. al (2008), data shows that in comparison to female physicians, males work with fewer patient cues and appear to be less influenced by patients’ gender when making diagnostic decisions.
This study was unsuccessful in finding evidence of differences due to variations in the knowledge structures used by male and female physicians, indicating that doctors’ diagnoses were not influenced by gender-stereotypical thinking. However, the study found differences in the way male and female doctors respond to patient information, particularly in their perceptions of cue relevance. Compared with their male colleagues, female physicians recall more patient cues and pay more attention to the way in which patients present their verbal histories, especially in the case of female patients. These findings confirm differences in male and female doctors’ consulting styles, with female doctors being particularly interested in patient narratives (Adams, Buckingham, Lindenmeyer, & McKinlay, 2008).
If female physicians are found to have better consulting styles, then it is no surprise that women choose to see female physicians and that women do not receive the best treatment for CVD nor preventive care unless they are seen by a physician that is a woman (Adams et al., 2008). Women should not have to seek specific treatment from a physician that is a woman, considering that both men and women undergo the same medical education and career preparedness as physicians. It is important to note that this constrains the choices that women are able to make for their health. Many women may not have the agency to seek help from a physician that is a woman because there are limitations to availability within their environment and social status.
The treatment and care provided to men and women varies even among hospitals. Within these hospitals, women may not have the agency to seek help from a physician that is a woman. Furthermore, the social position of men provides them with better treatment and care than women for CVD. This is because healthcare systems often cater to men considering the fact that medical research overwhelmingly accommodates men. Physicians that hold a position of power in hospitals are also likely to be men, which influences what symptoms are prioritized and which symptoms are overlooked. Therefore, there are more available choices regarding treatment for CVD for men to make in comparison to women. Men have choices that women often do not regarding their treatment and have control over making better decisions for their health because of this further access of resources.
Li et al. (2016), in their nationwide study, found that of Americans hospitalized with ischemic cardiac conditions, women were less likely to receive optimal care at discharge compared with men. The substantial sex disparity in mortality could potentially be reduced by providing equitable and optimal care. In fact, approximately 69% of the association between sex and all-cause mortality could potentially be reduced by providing optimal quality of care to women patients hospitalized for cardiac conditions. Unfortunately, this study did not discuss why women were receiving suboptimal care in hospitals compared to men. However, it could be asserted that inferior quality of care among women is related to the lack of choices that they have for treatment compared to men and the social constructs that have re-socialized healthcare professionals and researchers to undermine the symptoms of CVD in women and not accommodate to their specified needs for optimal care and treatment.
To raise awareness of the disparity that exists between men and women regarding CVD, it is crucial that physicians, scientists, and politicians recognize the “cardiovascular gender gap”. The rate of awareness of heart disease as the leading cause of death in women almost doubled between 1997, when the American Heart Association (AHA) launched its first campaign for women, and 2009 (Mosca, Barrett-Connor, & Wenger, 2011). During that same period, the death rate resulting from CVD decreased by nearly half (Mosca, et al., 2011). This determines that awareness is affective in eliminating the disparities in treatment and care for CVD among men and women.
Awareness leads to more research involving women participants, which provides distinct data and knowledge to lower the risks of CVD among women and to curate treatments specific to women. With more research involving women participants, healthcare providers will not have to rely on the research involving men participants to develop treatment plans for women. This would deconstruct the power imbalance between men and women because women would have access to further resources as men do.
There is limited systematic evaluation of provider performance in CVD preventive care, which makes it difficult to document gender differences in the delivery of care (Mosca, 2011). However, there is enough knowledge to determine that this disparity exits and that it is an issue that needs to be recognized and amended. When issues are recognized, policies are made and social change is imminent. Women make up half of the population of the nation, and yet the symptoms of CVD among women are considered unusual. These subtle “atypical” symptoms need be taken more seriously by those in society with influence because they have the power to control the behavior of those in the health field and develop better treatment plans that are specific to women with CVD that will ultimately aid in women receiving optimal care in hospitals.