Gender Health Gap

What it is

The gap has two parts. One is an outcome: years lived in poor health. The 2024 report models what closing it would mean, an average of seven extra healthy days for every woman each year, more than 500 days over a lifetime, and up to $1 trillion a year added to the global economy by 2040. It also argues that women's health is often simplified to sexual and reproductive health, which it says "meaningfully underrepresents women's health burden".

The other part is a research history. A 1977 US Food and Drug Administration guideline said that women of childbearing potential should not be included in phase 1 and early phase 2 drug trials; the FDA revoked that restriction in 1993, the same year the NIH Revitalization Act required women to be included in NIH-funded clinical research. Animal research lagged further: a 2011 review by Annaliese Beery and Irving Zucker found single-sex studies of male animals outnumbering female ones by 5.5 to 1 in neuroscience.

In effect

The research history shows up in drug safety. In 2001 the US General Accounting Office found that eight of ten prescription drugs withdrawn since 1997 posed greater health risks for women, though four of those may reflect higher prescribing to women. In 2020 Zucker and Brian Prendergast found that of 86 drugs, 76 reached higher blood concentrations or cleared more slowly in women, and that this predicted more adverse reactions in women.

What it does not say

The headline figures are modelled estimates. A gap expressed in healthy days and dollars depends on the disease-burden models behind it, and should be read as an order of magnitude rather than a count. The gap also does not mean that every difference in outcome comes from research neglect; some comes from differences in prescribing, as the 2001 report itself noted. And it says nothing about which products or treatments would close it. That is a question for trials.

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