The deadly consequences of a gender-blind approach to heart disease
Cardiovascular disease (CVD) is the leading cause of premature death for Australian women, largely due to a lack of a gender lens in both education and medical response. Today’s policy analysis provides the evidence for a gendered approach to CVD.
Scorecard on Women and Policy provided by Amy Webster, Women’s Health Victoria
Topic: Health policy
Sub-topic: Cardiovascular disease
A gender-neutral approach to CVD leads to increased mortality rates for women
Cardiovascular health (CVD) tends to be viewed as a gender-neutral health issue. This has masked and perpetuated a subtle focus on men’s experience of CVD, to the detriment of women’s health.
A gender-neutral approach to the detection and treatment of diseases, such as CVD, can have devastating consequences. CVD is the leading cause of premature death in Australian women. While men suffer twice as many heart attacks as women, women are more likely to die from them. Women are also more likely to die of stroke than men.
Australian and international studies have found that, because women’s symptoms are less likely to be recognised by women themselves and by health professionals, women are less likely to be told they are at risk and less likely to be given appropriate medical treatment, which may contribute to women’s high mortality rates.
Women are less likely to experience chest pain and more likely to experience less recognised symptoms of coronary heart disease such as fatigue, shortness of breath, nausea, pain between the shoulder blades and jaw pain. However, these symptoms are often mistaken for flu, stress or being ‘run down’ (p. 3, 12). Women also experience additional risk factors and treatment complexities for CVD as a result of pregnancy and menopause, and the later presentation of CVD in women contributes to the likelihood of co-morbidities, including depression, which influences their treatment and outcomes.
CVD and intersectional disadvantage
Risk factors for women are also compounded by intersectional disadvantage:
· Women from the most disadvantaged areas of Australia have CVD death rates 29% higher than those women from the least disadvantaged areas;
· Aboriginal and Torres Strait Islander women commonly have more risk factors for CVD than non- Aboriginal and Torres Strait Islander women, including higher rates of smoking, diabetes and obesity;
A lack of trained health professionals, particularly in rural and remote areas, and entrenched beliefs about CVD in medical training and education, can be barriers for addressing CVD in women (p. Under-representation of women in cardiovascular trials and research has also resulted in a gender-neutral approach to treatment which can lead to ineffective or harmful treatment regimens.
Adopting a gender-aware approach to CVD
The differential experience of CVD for women has significant implications for the delivery of health care services. A gendered approach to CVD should include:
· Increased representation of women in cardiovascular trials and research to ensure treatments are effective for women; and
· Education about the differential risk factors for, and symptoms of, CVD in women, for both health professionals and women, particularly targeting higher risk population groups (p. 8).
National Heart Foundation of Australia (2014). Heart attack survivors survey: gender comparison
National Heart Foundation of Australia (2011). Women and heart disease: forum report
AIHW (2006). Socioeconomic inequalities in heart disease in Australia: current picture and trends since 1992.
Penm (2008). Cardiovascular disease and its associated risk factors in Aboriginal and Torres Strait Islander peoples 2004 – 05.
Kim and Menon (2009). Status of women in cardiovascular clinical trials. Arteriosclerosis, Thrombosis, and Vascular Biology. 29:279-83.
This analysis is a contribution to the Scorecard on Women and Policy project, initiated by the Women's Policy Action Tank. We invite policy specialists in all areas to provide analysis of public policy using a gender lens: firstname.lastname@example.org Follow us on Twitter: @PolicyforWomen
 For example, the Multicultural Centre for Women’s Health has been working collaboratively with other stakeholders, such as the Heart Foundation and Diabetes Victoria, to ensure its Health Education Program is updated and its Bilingual Health Educators are receiving ongoing training so they are competent in providing education to women from different cultural backgrounds.