Barriers to women’s health in the United States

Aug 1, 2018
Barriers to women’s health in the United States

Women’s health in the United States needs to be better supported, according to a new position paper from the American College of Physicians (ACP).

It highlights the need for policies to protect reproductive health services, provide family and medical leave, and reduce domestic violence, sexual abuse and harassment.

“Although the greater medical community recognizes that biological and social factors lead to differences in disease expression and treatment between men and women, further consideration of sex and gender is needed in the healthcare system’s broader approach to women’s health,” said the paper, which was published in Annals of Internal Medicine.

Unique health challenges

It went on to say that women faced “unique health challenges across their lifespans in addition to their roles in maintaining healthy families and meeting the healthcare needs of children and seriously ill family members.”

“Ensuring access to nondiscriminatory healthcare coverage, ensuring access to a broad range of evidence-based services for reproductive health care, supporting public policies that positively affect women and their families, and closing knowledge gaps are essential to improving the overall health and well-being of women in the United States.”

It goes on to say that women are more likely to be diagnosed with chronic or autoimmune diseases, and that 38% of women live with a long-term disease compared to 30% of men — women account for 54 million of the 100 million Americans living with at least one chronic condition.

Higher levels of disability are reported among women than men, 24.4% versus 19.8%. They are more likely to die within one year of a heart attack and more likely to delay a visit to the emergency room with cardiac symptoms.

Health insurance barriers

Women are also more likely to have health insurance as a dependent than men, meaning they are at risk of losing that coverage if they become divorced or widowed.

The ACP makes seven recommendations that aim to improve overall well-being throughout all stages of a woman’s life and to address public policy issues that may result in barriers to healthcare access.

Including female-specific and gynecological care elements in the training of all healthcare professionals and providing at least six weeks of paid family or medical leave are among the recommendations.

The ACP said it was “essential” for women to have access to affordable, comprehensive, nondiscriminatory public or private healthcare coverage that includes evidence-based care over the course of their lifespans.

Future of women’s health in the United States

“Health insurers should not be allowed to charge women higher premiums or impose higher cost sharing on women because of their sex or gender,” it said, adding that the ACP respects the principle of patient autonomy.

The organization said it supported efforts to improve the representation of women’s health in clinical research, as well as increasing the availability of screening tools to help healthcare professionals, and treating survivors of domestic or sexual violence.

“As the health care system evolves, stakeholders must consider how to integrate women’s health needs into policy discussion and capitalize on opportunities to improve the health of women, their families, and society,” said the paper.


Daniel H, Erickson SM, Bornstein SS; Health and Public Policy Committee of the American College of Physicians. Women’s Health Policy in the United States: An American College of Physicians Position Paper. Ann Intern Med 2018; 168:874-875.

Barriers to women’s health in the United States

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