Gender Disparities in Health Interventions in Primary Care – BIOENGINEER.ORG

Report on Gender Disparities in Primary Care and Alignment with Sustainable Development Goals

A recent study by Holcomb et al. provides a critical analysis of how social determinants of health (SDH) influence health identification and intervention rates, with a specific focus on gender disparities in primary care. The findings directly inform the global effort to achieve several Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities). This report synthesizes the study’s findings and their implications for these goals.

Key Findings on Social Determinants and Health Inequities

The Pervasive Impact of Gender on Health Outcomes (SDG 5)

The research underscores that gender is a critical social determinant that fundamentally shapes healthcare experiences. This disparity is a significant barrier to achieving SDG 5, which calls for gender equality and the empowerment of all women and girls.

• Men and women experience healthcare through different pathways, leading to significant variations in long-term health outcomes.
• Observed higher intervention rates for women in certain contexts necessitate further investigation to distinguish between proactive health-seeking behaviors and systemic responses.
• Addressing these gender-based differences is essential to ensure that healthcare systems promote, rather than hinder, gender equality.

Systemic Bias and its Conflict with Universal Health Coverage (SDG 3)

The study highlights the existence of systemic biases within healthcare, which compromises the goal of providing equitable and universal health coverage as outlined in SDG 3.

• Both explicit and implicit biases influence clinical decision-making, resulting in different diagnostic and treatment approaches for male and female patients.
• Such biases can obscure the actual health needs of individuals, leading to care that is not patient-centered or effective.
• Achieving Target 3.8 of the SDGs (Universal Health Coverage) requires the elimination of these biases to ensure all individuals receive quality essential health-care services without discrimination.

Intersectionality and Compounded Disparities (SDG 10)

The report reveals that the intersection of gender with other social determinants like race, income, and education level exacerbates health inequities, directly challenging the aims of SDG 10 (Reduced Inequalities).

• The combined effects of multiple social factors lead to compounded disadvantages. For example, women from lower socioeconomic backgrounds face dual biases related to their gender and economic status.
• These intersecting inequalities create significant barriers to accessing adequate healthcare resources and receiving impartial treatment.
• To advance SDG 10, healthcare strategies must adopt an intersectional approach, addressing the multifaceted nature of discrimination and inequality.

Strategic Recommendations for Advancing Health Equity and the SDGs

Integrating Social Determinants into Healthcare Frameworks

To align with the principles of the SDGs, healthcare systems must evolve to become more context-aware and patient-centered. This involves a fundamental shift from purely clinical considerations to a holistic view of patient health.

1. Develop and implement care models that actively integrate social determinants of health into patient assessment and treatment planning.
2. Utilize data on social drivers to tailor interventions, ensuring they are appropriate for an individual’s unique life situation, thereby promoting well-being for all as per SDG 3.

Addressing Systemic Challenges to Build Inclusive Institutions (SDG 16)

Transformative change requires building effective and inclusive healthcare institutions, a core component of SDG 16 (Peace, Justice and Strong Institutions). This involves systemic reforms and stakeholder engagement.

1. Implement comprehensive training programs for healthcare providers to recognize and mitigate the implicit biases that affect their clinical interactions.
2. Foster multi-stakeholder collaboration among policymakers, providers, and patients to ensure collective buy-in for creating equitable healthcare systems.
3. Establish platforms for meaningful patient and community engagement, especially for women and marginalized groups, to ensure their voices inform the development of inclusive and responsive healthcare policies.

Conclusion: A Call to Action for Equitable Healthcare

The research by Holcomb et al. serves as a call to action, illustrating that addressing gender disparities and social determinants of health is fundamental to building a more effective and inclusive healthcare system. The insights provided are not merely clinical observations but are directly linked to the global commitment to the 2030 Agenda for Sustainable Development. Progress in healthcare equity is progress toward achieving SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities), ensuring that every individual has the opportunity to lead a healthy life.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being
   • The article directly addresses health by focusing on “health identification and intervention rates,” “health outcomes,” and the overall functioning of “primary care settings.” It explores how social determinants impact the quality and equity of healthcare, which is central to ensuring healthy lives and promoting well-being for all.
2. SDG 5: Gender Equality
   • The core theme of the article is the “pervasive influence of gender as a social determinant” in healthcare. It analyzes “gender disparities,” “variance in health identification and intervention rates between sexes,” and how “bias exists within the healthcare system that can affect clinical decision-making” based on gender. This directly relates to achieving gender equality and ending discrimination against women in all forms, including within the healthcare system.
3. SDG 10: Reduced Inequalities
   • The article highlights inequalities that go beyond gender, discussing how “intersections with other social determinants, such as race, income, and education level, complicate the landscape even further.” It points to “compounded disparities” faced by individuals, such as “socioeconomically disadvantaged women,” and calls for “equitable healthcare strategies” to reduce these inequalities.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Under SDG 3: Good Health and Well-being
   • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
     
     The article’s emphasis on creating an “inclusive and effective healthcare system” where “every individual receives the care they need based on their specific context” aligns with the goal of universal and equitable access to quality healthcare. It discusses barriers like bias and social determinants that prevent the full realization of this target.
2. Under SDG 5: Gender Equality
   • Target 5.1: End all forms of discrimination against all women and girls everywhere.
     
     The research reveals systemic issues, such as “bias within the healthcare system,” that lead to different “diagnostic and treatment pathways” for men and women. This constitutes a form of discrimination that affects women’s health outcomes, making this target highly relevant.
   • Target 5.c: Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels.
     
     The article’s call for “standardized protocols that account for, rather than exacerbate, disparities related to gender” and the need for “policymakers” to create “transformative change” directly supports the adoption of policies aimed at promoting gender equality within healthcare.
3. Under SDG 10: Reduced Inequalities
   • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
     
     The article advocates for an “inclusive approach to healthcare” by integrating “the voices of patients, especially those from underrepresented groups.” This reflects the goal of promoting the inclusion of all individuals, particularly those facing “compounded disparities” due to the intersection of gender, race, and socioeconomic status.
   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard.
     
     The central focus on reducing “disparities” in “health outcomes” by addressing “healthcare bias” and other discriminatory practices within the healthcare system is a direct reflection of this target. The goal is to move towards “health equity” by dismantling these barriers.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For SDG 3, Target 3.8:
   • Indicator: Health identification and intervention rates.
     
     The article is explicitly centered on the “comparison of social drivers of health identification and intervention rates by sex.” These rates are a direct, measurable indicator of whether people are receiving necessary healthcare services. Progress would be measured by tracking these rates across different population groups to ensure equitable access.
2. For SDG 5, Target 5.1:
   • Indicator: Variance in health intervention rates between sexes.
     
     The article highlights that “women tended to have higher intervention rates in certain contexts,” inviting “scrutiny into the reasons behind such discrepancies.” Measuring the difference in these rates between men and women for various conditions can serve as an indicator of gender-based disparities and potential discrimination in healthcare delivery.
3. For SDG 10, Targets 10.2 and 10.3:
   • Indicator: Health outcomes disaggregated by sex, socioeconomic status, race, and education level.
     
     The article implies the use of this indicator by discussing how “compounded disparities” arise from the “combined effects” of gender, race, income, and education. Analyzing health outcomes (e.g., diagnosis rates, treatment success, mortality) broken down by these demographic factors would be essential to measure progress in reducing health inequalities.
   • Indicator: Prevalence of reported bias in clinical decision-making.
     
     The article discusses how “explicit and implicit biases can lead practitioners to approach male and female patients differently.” While not a simple metric, this could be measured through patient surveys, clinical audits, or studies designed to identify and quantify bias, thereby tracking efforts to eliminate discriminatory practices.

4. Summary Table of SDGs, Targets, and Indicators

Source: bioengineer.org