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Delivering equity in women’s health: How can pharma help turn this into a reality?

A year on from the publication of the first Women’s Health Strategy, Doina Ionescu, General Manager, Merck UK and RoI, examines the progress made and shares how pharma can continue to support.


Women’s health is still poorly understood and often overlooked, creating a health gap across generations. The UK has the largest female health gap in the G20 and the 12th largest globally1. Efforts are being made to address this, with the launch of the 10-year Women’s Health Strategy for England in August 2022.

One year on, there has been some progress with the strategy, especially with the recent announcement of initiatives such as £25 million of funding for integrated care boards to support women’s health needs through local women’s health hubs, further support and transparency around access to IVF services, and a new dedicated section of the NHS website including content on periods, endometriosis and hormone replacement therapy (HRT)1.

This strategy promises a good start to tackling the gender healthcare gap, but to make women’s health a real priority is not just the responsibility of the government. A collective effort from everyone who works in healthcare is vital to make health equity a reality.

There is a lot that we can be doing in our own industry to achieve equitable outcomes for all, many of which can be broken into three key areas. 

Education and awareness: What, where, when, why and how?

Although the newly created hubs and web resources will house and expand specialist knowledge and public awareness, there is still a huge disparity in the understanding of women’s experiences and symptoms; this is the first and ultimate barrier to tackling any health gap.

The Government has acknowledged that there is a lack of education and training for healthcare professionals (HCPs) about women’s health1. In some cases this can lead to misdiagnosis, preventing timely treatment and equitable outcomes for women. For example, the lack of awareness of women’s symptoms in bladder cancer means the condition is often initially misdiagnosed as a urinary tract infection1, which can delay referrals for bladder cancer investigation beyond the 2-week pathway. A UK study in 2013 showed that women were more likely than men to have three or more GP attendances before referral for bladder or renal cancer4.

Younger women and girls are also suffering. We have heard the stories about many missing school due to undiagnosed issues causing painful periods and conditions like endometriosis, which can take up to eight years to diagnose1.

Supporting education is key to helping move the needle in women’s health, and pharma can help.

We, as an industry, can likely access data and insights that provide a deep understanding of the behaviour and attitudes of HCPs, patients and the general public, to create optimised programmes and campaigns. By utilising our resources and ability to collaborate with partners far and wide, we can support the NHS with truly tailored and cutting-edge educational content that helps enact behaviour change. As an industry we can and should endeavour to better understand what women need and why they need it. Taking fertility as an example, Merck has harnessed fertility.com as a website that offers patients and healthcare professionals information and tools to support the fertility journey, from the latest specialist insights to patient guides on the menstrual cycle.

Our ability in the industry to use data to tailor education also serves a vital purpose – tackling disparities for women across different backgrounds and ethnicities. The healthcare gap for underserved communities was exposed during the pandemic and thankfully the Women’s Health Strategy has recognised this. For instance, maternal mortality for black women is four times higher than that of white women1 and a recent study suggested that minority ethnic women with chronic pain were far less likely to be offered the right pain relief than white women1.

To help us understand and tackle the root behaviours, assumptions and systems driving these unacceptable differences, we should consider bringing in views and insights from stakeholders and groups outside of traditional healthcare providers, such as community leaders, patient advocates and key opinion leaders. For example, for some groups we know that if the content doesn’t resonate and show ‘people like me’, we won’t be able to properly educate, raise awareness and ultimately improve outcomes.

Improving research and access through funding and collaboration

Historically women’s health has not been a priority, with a chronic lack of funding for women’s health studies and specialist care services being a key barrier1. Across the board, less than 2.5% of publicly-funded research in the UK has been dedicated to reproductive health1, even though ~16% of the UK population will experience one of these issues2, making this an area of great unmet need.

Funding is starting to improve, with increased investment in research and the development of hubs as part of the Women’s Health Strategy3, but women’s health still lacks consistent and regular funding to improve access to care.

Our industry can play a role in offering resources for research and access improvement or gathering insights to identify unmet needs and priorities.

Supporting employees with workplace policies

Women’s health concerns throughout the various life stages can have huge impact on quality of life and can therefore significantly affect women’s careers. A CIPD poll in 2019 found that 3 in 5 menopausal women were negatively affected at work3, and a BUPA survey conducted in 2020 revealed that almost 1 million women in the UK had left their jobs because of menopausal symptoms4.

Despite this, research has found that surprisingly only around 1 in 4 companies have a menopause or fertility policy4,5.

According to Merck’s first DE&I report, women make up 43% of our global workforce and 38% of our leadership at Merck4. Also, over a quarter of our staff in the UK are in the age groups for menopause and its preceding phase of transition (perimenopause). We know that it is important to provide equal opportunities for all employees, which is why we have a menopause policy and support programme in place, alongside flexible working options. We also have a fertility policy.

We encourage others in the industry to develop more robust policies that will promote equality and provide better support for women across their life stages and career paths. Supporting women is not only important for society, but a sound investment in the future of the industry and overall economy, especially given the high numbers of experienced women leaving the workplace due to menopausal symptoms4.

What now?

There isn’t a one-size-fits-all approach to help solve the challenges we have with women’s health, but I know that our industry can really help close the health equity gap.

While this isn’t going to happen quickly, I know that the Women’s Health Strategy is a positive step and will hold us all accountable.

The next 12 months will be vital to see how the hubs and other potential collaborations will improve outcomes, and I for one am excited to see what happens.

References

1 UK Parliament. Women’s health outcomes: Is there a gender gap? Available from: https://lordslibrary.parliament.uk/womens-health-outcomes-is-there-a-gender-gap/. [Accessed August 2023]

2 UK Gov. £25 million for women’s health hub expansion. Available from: https://www.gov.uk/government/news/25-million-for-womens-health-hub-expansion. [Accessed August 2023]

3 Department of Health and Social Care. Women’s Health Strategy for England. Available from: https://www.gov.uk/government/publications/womens-health-strategy-for-england/womens-health-strategy-for-england. [Accessed August 2023]

4 Lyratzopoulos G, Abel GA, McPhail S, Neal RD, Rubin GP: Gender inequalities in the promptness of diagnosis of bladder and renal cancer after symptomatic presentation: evidence from secondary analysis of an English primary care audit survey. BMJ Open, 13 May 2013; 3:e002861

5 Endometriosis UK. Endometriosis facts and figures. Available from: https://www.endometriosis-uk.org/endometriosis-facts-and-figures. [Accessed August 2023]

6 Women’s and Equalities Committee, Black Maternal Health Report 2023. Available from https://publications.parliament.uk/pa/cm5803/cmselect/cmwomeq/94/report.html . [Accessed August 2023]

7 Chaudhury R. et al, Ethnic Disparities in Treatment of Chronic Pain in Individuals with Parkinson’s Disease Living in the United Kingdom (2022). Available from https://kclpure.kcl.ac.uk/portal/en/publications/ethnic-disparities-in-treatment-of-chronic-pain-in-individuals-wi [Accessed August 2023].

8 UK Clinical Research Collaboration. UK Health Research Analysis 2018. Available from: https://hrcsonline.net/wp-content/uploads/2020/01/UK-Health-Research-Analysis-2018-for-web-v1-28Jan2020.pdf. [Accessed August 2023]

9 UK Gov. Survey reveals women experience severe reproductive health issues. Available from: https://www.gov.uk/government/news/survey-reveals-women-experience-severe-reproductive-health-issues. [Accessed August 2023]

10 NIHR. Improving women’s health and care through research. Available from: https://www.nihr.ac.uk/blog/improving-womens-health-and-care-through-research/32872. [Accessed August 2023]

11 CIPD. Majority of working women experiencing the menopause say it has a negative impact on them at work. Available from: https://www.cipd.org/uk/about/press-releases/menopause-at-work/. [Accessed August 2023]

12 UK Parliament. Written evidence from Bupa [MEW0046]. Available from: https://committees.parliament.uk/writtenevidence/39244/html/. [Accessed August 2023]

13 Fertility Network UK. Fertility Network launches Fertility in the Workplace initiative to support employers and employees. Available from: https://fertilitynetworkuk.org/fertility-network-launches-fertility-in-the-workplace-initiative-to-support-employers-and-employees/. [Accessed August 2023]

14 CIPD. The Menopause Workplace Pledge: The growing movement to support women through the menopause at work. Available from: https://www.cipd.org/uk/views-and-insights/thought-leadership/cipd-voice/menopause-workplace-pledge-growing-movement-support-women-through-menopause-work/. [Accessed August 2023]

15 Merck. Premier Diversity, Equity & Inclusion Report. Available from: https://www.merckgroup.com/company/diversity-inclusion/DEI-Report-EN.pdf. [Accessed August 2023]

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Doina Ionescu
Doina Ionescu
Doina Ionescu is General Manager at Merck UK and RoI.

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