Women's Health Week: Improving Health Outcomes, Changing Gender Bias In Healthcare, Tapping Tech

National Women's Health Week is May 8-14 this year. It's a special time to encourage women of all ages to take note of their habits and mindsets and prioritize their health so they may live healthy, full lives. This national health observance is an opportunity to learn about underlying women's health conditions so proactive measures can be taken to improve our wellbeing and establish positive patterns of behavior for future generations of women.

This women's health article features an interview with Linda Dimitropoulos, Vice President of Operations, Innovation, and Strategy for RTI Health Advance. Here we explore biases women often face while pursuing healthcare, how the eruption of Femtech has moved the needle to address women's unique health needs, and more.

An audio version of the interview is available as well:

Gender bias in healthcare women face with providers may lead to poor health outcomes

Linda Dimitropoulos (track one):
I think gender bias is a reality in healthcare, and that women and girls are disproportionately impacted, by it. There are several factors I think play a role in gender bias in healthcare. One factor is basically the historical inequity in medicine and medical research. I mean, prior to the 1990s, women were not, included in many of the research studies that created a real gap in understanding how diseases, drugs, therapies, um, and such differentially affect women. In addition, there has been a reluctance to recognize and discuss health issues specific to women. Menstrual health, pelvic and sexual health, contraception, menopause, and so forth. And if we can't talk about these issues, we really can't address them. I've frequently heard that women aren't listened to, that, their symptoms are attributed to a mental health issue rather than a physical one, or they're just kind of dismissed as, hysteria, if you will.

It was very difficult, when I was a young mother to find, even a gynecologist, an OBGYN who was female, all the female, OBGYNs were booked. It was impossible to get added. I don't have any data at hand, but I think that there has been progress over the last 20, 30 years or so.

Barriers to improving health outcomes - women are expected to be all things to all people

Linda Dimitropoulos (track two):
Women are the major caregivers in this life. I believe the CDC numbers are that more than 75% of women serve as caregivers to others. Many of those spend more than 50% of their time in that role. And so, it's very difficult, I think for women to put themselves first. I think it's one of the more complex issues we're dealing with.

For example, employment is critical, right? It provides a source of income it potentially provides health insurance coverage, social connections, all these things that are involved and are part of social determinants of health. And yet to maintain employment women need access to affordable, reliable childcare employment arrangements that are flexible, that will cover time off to allow them to be able to juggle the multiple roles that we've placed women in. Over the last few decades, what we've done is we've moved more women into the workforce. We haven't taken anything off their plate really. We've added more to their responsibilities, but we haven't done a very good job of taking things off their shoulders. They serve in these key roles in the health of our families in the health of their children. I think it's a real challenge to try and resolve that.

I was astonished by how many women are caregivers and how much time is spent. Adding that to a workload and how to stay employed where every employer is not a flexible one where you can pick off some time or your kid gets sick and you can be late, you can have the flexibility to take care of those things.

Can Femtech change the women’s health narrative & reduce gender bias in healthcare?

Linda Dimitropoulos (track three): 
We don't provide enough support for women across the stages of life. The solution to that is to start by creating awareness of women's health, and that requires specialized knowledge of how these life stages affect health and wellbeing and what those additional responsibilities that come with those life stages leading the thinking in this area is the fem tech industry. By combining a knowledge of women's health issues with technology, we can move to provide a wide range of solutions to improve healthcare for women across a whole range of conditions ranging from early days, menstrual health, pelvic, and sexual health all the way through menopause and including maternal health.

In addition to these very specific stages of life for women, there are other health conditions that affect women disproportionately, such as osteoporosis or cardiovascular disease. The ability to combine this awareness of what women experience with technology is going to help us move forward. So, it's a matter of disrupting the healthcare system with these conversations.

Femtech offers new promise for improving health outcomes for new generations of women

Linda Dimitropoulos (track four):
I believe we're seeing a generation of young women who are more vocal, who are more willing to step forward and have conversations that were traditionally very challenging. And I think technology offers solutions to some of the challenges with simply tracking menstrual cycles. That was a huge challenge, and every time a young woman met with a doctor or a healthcare provider, one of the first things they would ask you were the dates of your last several periods. And so, in years past you had to track that and in the old days tracking in paper calendar but now simple apps make it so easy. When my daughter who's is asked these questions, she pops open her phone and there are all the answers. In addition, she's able to track cycles over years. There's a lot of data to inform her health and care.

What's exciting about the Femtech kind of movement is that they're breaking new ground for women into traditionally male dominated areas, medicine, and technology. The fem tech companies are disrupting healthcare in multiple spaces already including virtual clinics that focus on women's health issues specifically. I mentioned tracking menstrual health, tracking fertility, sexual health, pelvic care, the experiences of one going through menopause. We’re seeing solutions tailored for subpopulations such as black women, LGBTQ populations.

It’s somewhat of a revolution in healthcare. I think as these organizations gain a foothold, we're seeing them expand their offerings. For example, Maven started out in maternity care, and it's expanded across the entire reproductive life cycle. So many of these businesses started direct to consumer models and over time have gained some experience. They collected some real-world data to improve their offerings and solutions. And now we're seeing them move into looking for regulatory and reimbursement pathways to expand into broader markets. It's really very exciting space that offers opportunities and solutions to many of these traditional challenges that we've seen in women's health.

Change starts somewhere: Improving health quality and outcomes and lowering total cost of care

Linda Dimitropoulos (track five):
I've been tracking some of the work that policymakers are finally starting to pay some long overdue attention to reducing high rates of deaths and severe health complications among black women. I think to comprehensively address the challenge requires making change in how we cover healthcare. We need to make a range of high-quality healthcare coverage, access to care, and other services accessible before, during and after pregnancy.

We might look at starting with Medicaid. Medicaid pays for more than 40% of US births and 65% of birth to black mothers. Expanding and enhancing Medicaid coverage needs to be part of the strategy.  I believe that states that have expanded Medicaid under the Affordable Care Act have seen a significant rise in health coverage among women of reproductive age, which has improved their access to preconception and prenatal services that make pregnancy and birth safer for parent and baby.

Research also shows that Medicaid expansion is associated with reduced rates of maternal death, particularly for black women. Expanding Medicaid is not the only answer, but we know that expanding access to healthcare coverage improves overall access to care. And that leads to significant reduction in maternal death rates. I said, it's not the only answer, but I think that it's probably a major component of any strategy.

The future of Femtech: are payers and providers ready to assimilate Femtech or expand care delivery models?

Linda Dimitropoulos (track six):
I do think health plans payers, providers are all very interest in what digital health and technology solutions can offer to improve care, to reduce costs.  There is some caution out there that is probably warranted. Everything is not going to meet every claim. Every solution isn't going to be able to meet all its goals. Developers are very passionate and yet at the same time, they don't always understand the complexities of healthcare and healthcare payment. And they're not always positioned to get their product into the market. Providers and payers are also not necessarily well positioned to evaluate the claims of each of the products at the pace they're coming out. There is a real need to be able to provide the right levels of evidence to be able to move solutions that are truly helpful into the market and make sure that there is appropriate payment for those solutions.

What I see happening in the Femtech market is many products are starting direct to consumer. They're collecting more data. They're getting more feedback about what can be useful. So, in the sense, developing their product in concert with their consumers, and then they're able to build an evidence base that may be more compelling to payers and providers who will then be determining whether they want to adopt the use of the solution and pay for, for it. We're seeing progress but I think what what's happening right now is that there's so much development that it's kind of overwhelming the current and existing processes for evaluating the impact of those tools, but I do feel very positive about what they will bring.

Now is the time to prioritize women’s health and work to end gender bias in healthcare

Linda Dimitropoulos (track six):
Women's health is increasingly being recognized as a priority, not just in the United States, but globally. It really is essential to address not only sexual and reproductive health and health issues that occur for women throughout their life cycle but given their role as a caregiver ensuring that they have access to quality care also can lead to improved health for their children and families. Women experience unique healthcare challenges and are more likely to be diagnosed with certain diseases than men are, chronic diseases and conditions such as heart disease, cancer, diabetes are leading causes of death for women. 38% of women suffer from one or more diseases compared to only 30% of men. Women are bearing the responsibilities for caring for families, both children and elder care and that is showing up in their health.

Improving access to insurance coverage, preventing, and reducing chronic health conditions, promoting wellness, which is an area that we have not invested enough in, preventive care and wellness, and these things can significantly affect the lives of women of all ages because women represent the backbone of our family’s overall health, ensuring that they have access to quality care also can lead to improve health for children and families. And I think there's many innovative opportunities available to policymakers and others address the unique health challenges women face, and therefore to improve the overall health of women, um, and families broadly speaking.

I do think the next generation, my daughter, your daughter is going to really change things.

Listen to the interview with Linda Dimitropoulos

We're pleased to offer an audio recording of this interview via the RTI Health Advance account on Soundcloud. Explore the playlist here, and learn more about Linda on her biography page on our website.

RTI Health Advance is committed to a more equitable future in healthcare with improved health outcomes for women and all genders. Learn more about our health equity and quality improvement capabilities.