You can add the doctor’s office to the long list of spaces where gender gaps persist in Canadian society, according to a new awareness campaign that reveals how men and women are treated differently in clinical settings.

Research compiled by the Women’s College Hospital suggests that some women are overlooked and underserved in the health-care system, an issue researchers are calling “the Health Gap.”

The campaign kicked off Tuesday by highlighting factors that led to the creation of the gap in the first place, including the absence of a formal requirement to include women in clinical trials prior to the early 1990s.

Dr. Danielle Martin, a family physician and vice president of the downtown hospital, said the time is right to force this “critically important” systemic flaw into public view.

This “chronic underrepresentation” of women is one of the health-care system’s most devastating inequalities, she added. Despite the striking biological variations between genders, several drugs and treatments are still in use today that have been tested primarily on men and not designed to meet women’s needs.

“It means we can’t give women advice about how to improve their health with the same degree of confidence we give to men,” she said. “And that is a gap that needs to be closed.”

Yet the push to shine a light on women's chromosomal and cultural differences as they apply to diagnosis and treatment isn’t solely for recognition. It’s about saving lives.

The report goes on to identify several gaps.

“One of the things that people don’t realize is that heart disease is the number one killer of Canadian women, but we still have a social misconception that it’s a man’s problem,” she said.

Heart disease is often under-detected in women because doctors may not recognize their unique symptoms. Not every heart attack presents itself as a middle-aged-man-in-angst clutching his chest in pain.

Instead, Martin explained, women are more likely to experience a silent heart attack, meaning they don’t experience symptoms at the time at all.

It’s well-documented that women’s bodies respond differently to drugs and disease.

The menstrual cycle, pregnancy, postpartum and menopause are all processes that add to the complexity of care for women. In Canada, women are twice as likely to develop depression, yet are three times more likely to experience barriers to accessing mental health care.

“We know pregnancy and the postpartum period are very vulnerable times to experience depression, but women tend to be the primary caregiver still for babies and young children,” said Martin. “So making it to an appointment with a mental health worker when you are alone at home with a baby becomes a massive barrier.”

She pointed to how WCH’s free, supervised daycare makes it easier for parents to attend doctor’s appointments as an example of how health-care can be tailored to women’s needs.

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Here are some other ways Martin points out that chromosomes and cultural cues influence how disease is diagnosed and treated.

Chronic conditions

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According to Statistics Canada, women have a life expectancy of 83.3 years, while men average 78.8 years. Yet a longer lifespan isn’t all sunshine and rainbows, Martin said.

WCH’s research shows the gendered health issue gets worse with age.

“We have a growing and emerging group of frail older women, usually outliving their partners but living with multiple and complex illnesses,” she said. They may require a different kind of support, rather than dragging them out of their homes to visit several specialists.”

Addictions and substance abuse

Women tend to progress more quickly from using an addictive substance to dependence, according to the WHC’s research. Often, they also find it harder to quit and are more susceptible to relapse.

“Highly gendered” societal norms governing drinking habits, for example, blur the definition of how much is too much.

“Addiction is devastating, no matter what,” she said. “But how that person copes with it, who they are honest with and where they feel they can get support from … all can be very different depending on the roles of men and women.”

Medical research

Prior to the early 1990s, most research on substance abuse and dependence focused on men. Up until this point, there had also been no formal requirement to include women in clinical trials. Today, women represent just one-third of patients enrolled in cardiovascular studies.

This “chronic underrepresentation” of women, Martin explained, is one of the health-care system’s most devastating inequalities. Despite the striking biological variations between genders, drugs and treatments are still used today that have been tested exclusively on men.

“It means we can’t give women advice about how to improve their health with the same degree of confidence we give to men,” she said. “And that is a gap that needs to be closed.”