Where do female patients and healthcare providers fit in when it comes to gender equality?

Today is International Women’s Day and this year’s theme is “Make it Happen.” One thing many people would like to see happen in the healthcare industry is a greater focus on equality.

Whether it’s for patients or providers, the issue of equality is a complex one.

Birth control is widely available, and there are many women in management-level positions at hospitals and in medical schools. But ongoing public debates on women’s health issues show there’s still a long way to go to attain full equality in America.

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In the United States, battles still rage over women’s healthcare. The 1973 Roe vs. Wade Supreme Court decision that made abortion legal remains hotly contested. Abortion opponents are still trying to make the procedure illegal on the state and local level.

Another issue is access to good healthcare. In general, the U.S. healthcare system is modernized and care is available regardless of gender. However, several reports conclude that women who are gay or transgender have unequal access to good quality care in the United States.

The relatively new Affordable Care Act gives women preventive care services that include annual well-woman visits, cancer screenings, and family planning services. However, women may still not be getting the care they need. For example, studies have shown that women are slower to be diagnosed and treated for heart disease than men, even though heart disease kills more women than it does men.

“If a physician envisions a male patient when thinking of the typical patient presenting with a heart attack, they may be less likely to interpret a woman’s symptoms of chest pain as being cardiac in origin,” said Dr. Stacie Daugherty, an assistant professor at the University of Colorado School of Medicine at the Anschutz Medical Campus.

Another issue that affects women in the U.S. is low rates of participation in clinical trials. This can lead to a lack of research on how medications and health conditions affect women.

“Women are historically underrepresented in clinical trials for which our clinical guidelines are based,” said Daugherty.

Phumzile Mlambo-Ngcuka, who leads the United Nations agency promoting equality for women, marked International Women’s Day by proclaiming that no nation has yet attained gender equality.

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Women are often seen in the healthcare arena as assistants and caregivers, although more are rising into other roles, including doctor, medical researcher, and executive.

Women make up more than 75 percent of the healthcare workforce in most countries, although a 2013 report from Rock Health said only 19 percent are hospital chief executive officers and 14 percent sit on healthcare company boards of directors. None were chief executives of Fortune 500 healthcare companies.

According to a report from the Association of American Medical Colleges, 47 percent of medical students are women. That figure has declined from the early 2000s, but it is much higher than in 1970, when about 11 percent of medical school students were female.

“We need to work together to advance women worldwide and hold companies accountable for their leadership practices while helping them to successfully implement the programs and policies that will appropriately advance women,” said Laurie Cooke, chief executive officer of the Healthcare Businesswomen’s Association.

Dr. Jennifer Downs, an assistant professor at Weill Cornell Medical College, cited recent National Institutes of Health data that showed about an equal number of men and women receive research grants. Men still outnumber women more than two to one in terms of who is selected as the principal investigator on research grants.

She mentioned another study in 2012 that showed science faculty members of both sexes viewed a male applicant as more competent, hirable, and deserving of higher salary compared to a woman with the same qualifications.

“These disparities suggest that we still have a long road ahead in the struggle for gender parity,” Downs said.

The dental field is one where equality is improving. According to the American Dental Association (ADA), women make up 19 percent of dentists in the U.S. — a number that is expected to reach 28 percent by 2020. The ADA says that 80 percent of female dentists are under the age of 44, while more than 60 percent of male dentists are 45 or older.

Dr. Nancy Valentine, associate dean of the Institute for Health Care Innovation at the University of Illinois at Chicago College of Nursing, said talented women must “fight mightily” to get into key leadership positions in healthcare.

“It’s clearly a men’s club,” Valentine said. “Men are more likely to be promoted based on very few accomplishments in this industry. Women are so busy knocking themselves out to do the job, they are less able to promote themselves and they lose out.”

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