PERSPECTIVE ON HEALTH : Exposing Medicine’s Sex-Bias Hoax : Breast-cancer research gets nearly twice as much government funding as lung, colon and prostate cancer combined.
We spend twice as much money on the health care of women as on the health care of men. We devote more money and effort into researching diseases of women than diseases of men. For the past quarter of a century, women have outlived men by a wider margin than at any other time in history. Yet a persistent chorus has persuaded the media and much of the public that the health care of women is neglected. How have they pulled off this hoax? By ignoring the overall picture, by making false claims, by disregarding areas where women are favored and by loudly publicizing isolated areas in which men do receive more attention.
Gender-bias claimants accuse doctors of dismissing women as hysterical hypochondriacs, of taking their complaints less seriously than men’s and of giving women less complete diagnostic workups. Studies have shown the exact opposite. Complaints of chest pain, back pain, dizziness, fatigue and headache result in the same amount of diagnostic testing and treatment for men and women most of the time. When there is a difference, women’s complaints generally receive greater attention--more lab tests, blood-pressure checks, prescriptions and return appointments. Isolated studies that show men receiving more care are widely cited by gender-bias claimants; larger, more numerous studies with contrary results are ignored.
A variation of this complaint is to claim that heart disease in women is treated less vigorously than in men. Bias claimants generally neglect to mention that coronary artery disease occurs 15 to 20 years later in women’s lives than in men’s. Older patients are more likely to have other diseases that increase the risks of procedures such as angioplasty and coronary-artery-bypass-graft operations. When risk factors are considered, the treatment of men and women becomes similar.
Women are said to be ignored in medical research. Gender-bias claimants demanded in 1987 that the National Institutes of Health survey all the research it funded, in the belief that this would demonstrate neglect of women. The results showed that diseases specific to women received more than twice as much funding as those specific to men. (Most research funding was for diseases that afflict both sexes.)
Activists for breast-cancer research claim that it is neglected because it’s a women’s disease. Last year, 46,000 women died of breast cancer, while 35,000 men died of prostate cancer. At the same time, government funding for breast-cancer research was $410 million; for prostate cancer, it was $55 million. On a per-fatality basis, breast cancer gets five times as much research money as does prostate cancer. This pattern has been true as far back as we can trace it. Lung, colon and prostate cancer together account for 241,000 deaths per year, more than five times the toll from breast cancer. Yet the combined research funding for these three diseases is $235.2 million, or 57% of the amount spent on breast cancer.
Since most medical research is conducted on diseases that afflict both sexes, bias claimants allege that data are collected just on men and then extrapolated to women. With more than 300,000 medical articles published each year, it’s not too difficult to find some that indeed look at only men. Of course, it’s equally easy to find numerous studies than only look at women. The highly publicized research establishing a link between secondhand smoke and lung cancer had all female subjects.
The studies most often cited as evidence of the neglect of women date from the 1970s and 1980s and dealt with treatments designed to prevent heart disease in middle-aged men. Illnesses are often researched in the populations most at risk and coronary artery disease occurs three times as frequently in men as in women under 65. Diseases more common in women (osteoporosis, rheumatoid arthritis and eating disorders, to name a few) are frequently studied predominantly or exclusively in female subjects.
Life expectancy in the United States has increased 55% for men and 63% for women in this century. Both sexes have benefited greatly from advances in medical care; neither has been ignored. Our goal should be to further improve the health of all. Gender-bias claimants distract us from this goal by sowing divisiveness, needless alarm and anger. It’s time to recognize the falsity of their accusations.
