Does Healthcare Discriminate Against Women? | Big Think

Does Healthcare Discriminate Against Women?

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Women’s health expert Paula Johnson is worried that there are systemic issues restricting women and minorities from access to proper to medical care, both in the United States and internationally.

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Dr. Paula Johnson:

Dr. Paula Johnson is a women's health specialist and a pioneer in the treatment and prevention of cardiovascular disease. She conceived of and developed one of the first facilities in the country to focus on heart disease in women. At Boston's Brigham and Women's Hospital (BWH), Dr. Johnson was made chief medical resident in 1990--the first woman to hold that position in the history of the hospital. Dr. Johnson is serves as head of the Mary Horrigan Connors Center for Women's Health and Gender Biology and is chief of the Division of Women's Health at Brigham and Women's Hospital in Boston. She also directs the Center for Cardiovascular Disease in Women.

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TRANSCRIPT:

Question: How is access to medical care affected by sex and race?

Paula Johnson: Access to care is complicated: there’s a part of access that has to do with being insured, there’s a part of access that has to do with being able to find the care that you need, and part of access has to do with, when you find the care or when you go to your Physician, or you’re in a emergency room, actually being given the care that is indicated, the most appropriate care. With all three points, we really have to think about the impact of one’s sex and also how that intersects with one’s race.

If we were to think about women, many women are at higher risk, for example, of loosing their insurance—especially since more women are dependent, for example, on their spouse’s insurance, so if a job is lost it’s a difficult situation. Many more women are employed on a part-time situation [in] which health insurance is not offered or may not be offered—once again an access issue. But then there are times when we actually are insured that women may not actually be able to find the types of care that they need. For example, we know that there are access issues with regards to primary care that [are] pretty general not only for women but also for men. But we also know that women are more likely to seek medical care, so that lack of access will experienced more acutely.

There are some categories of health issues for which there are relative shortages of healthcare providers; for example, in the mental health area it may be difficult to access the appropriate mental health provider and if we know that, for example, women had higher rate of depression this may impact access more significantly for women. Another area where there is an emerging shortage, for example, is mammographers. We all know that, especially over the age of 40, you need to get your yearly mammogram, and for a set of complex reasons, the number of radiologists going to Mammography is actually decreasing. So I think women’s health can shed a real light unto health areas and providers that can really help up us to think about our system.

There is also very good data that suggests that minority women, especially African-American women, are not offered the same types of advanced care that white males may be offered. And this [has] been shown now in a number of studies and that is something that we do need to take in to account as we work within our health systems, to make sure that care is appropriate but that people who do have significant medical problems are getting the types of care that they need.

Question: What policy changes would you like to see address those issues?

Paula Johnson: So for women’s health in particular, access with regards to insurance coverage is critical as we expand coverage. We’ve done that in the state of Massachusetts. Hopefully we will see that happening throughout the United States, but as we improve coverage for the whole segment of population that is uncovered, [it] will absolutely assist women. We also want to make sure that we don’t pull back on some of the government and state sponsored programs such as Medicaid that are also particularly helpful to women. So I think that it one area that is very important.

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