Women are disadvantaged in the Swiss healthcare system

(© Image: Depositphotos)
(© Image: Depositphotos)

A research report by the Interdisciplinary Center for Gender Studies (IZFG) at the University of Bern reveals unequal treatment of women and men in healthcare in Switzerland. The report was compiled as a scientific basis for the Federal Council’s report published today in response to a postulate. This calls for better consideration to be given to the specific characteristics of women in the healthcare sector.

The research report by the Interdisciplinary Center for Gender Studies (IZFG) at the University of Bern was compiled as a scientific basis for the Federal Council’s postulate report ’Women’s health. Better consideration of their characteristics’, which was drawn up in response to a postulate by National Councillor Laurence Fehlmann Rielle. In it, Fehlmann Rielle calls for better consideration to be given to the specific characteristics of women in the health sector. The research report was compiled by the ICFTU in collaboration with the Department of Health at Bern University of Applied Sciences (BFH) on behalf of the Federal Office of Public Health (FOPH) in 2023 and published today.

’We found disadvantages for women in all the areas examined,’ says co-author Christine Bigler from IZFG. This applies to research, drug development and treatment, detection and diagnostics, prevention, rehabilitation and long-term care, education and the healthcare sector.

Deficits in research, treatment and prevention

Based on an extensive literature review and interviews with 15 experts, the six main problem areas mentioned above with regard to women’s healthcare in Switzerland were identified for the research report. In a second step, proposals for the most urgent measures were developed for each of these areas in a workshop with a total of over 60 relevant stakeholders. The research team was supported throughout the entire process by a federal advisory group and internal experts from the field of gender/health.

’Women are still systematically underrepresented in medical research,’ notes co-author Michèle Amacker from IZFG. In practice, this leads, for example, to unsuitable dosages and thus to more side effects for women during chemotherapy. Women also receive quantitatively fewer, less suitable and less invasive treatments than men, which, among other things, leads to poorer prognoses than for men. The study also shows that there are often limited treatment options for diseases specific to women and that there are also deficits in aftercare: Women are referred to rehabilitation less frequently, take advantage of it less often or abandon it more often.

Diagnostic procedures are also geared more towards men, as the report shows. This is the case, for example, with dementia-related illnesses, although women are significantly more frequently affected by them than men. ’Together with the underdeveloped diagnostics for certain female-specific diseases such as endometriosis, this often leads to delayed or non-existent diagnoses in women,’ explains Christine Bigler.

Action also needed in training and the advancement of women in the healthcare sector

According to the authors of the research report, measures in training and structural measures in the healthcare sector are also key to improving the situation. Findings from gender medicine have so far only been selectively incorporated into the relevant professional and further training courses. The overrepresentation of men in many specialist areas and at higher hierarchical levels also demonstrably contributes to the fact that female patients are disadvantaged in healthcare.

The report recommends establishing gender as an integral part of all areas of health, especially in the area of current developments towards personalized medicine. This also requires more specialized knowledge from the field of gender medicine. According to Michèle Amacker, the continuing education courses on gender-specific medicine offered jointly by the University of Bern and the University of Zurich since 2020, the recently established Gender Medicine Professorship at the University of Zurich, the establishment of the Unité Santé et Genre at the University of Lausanne and the National Research Program 83 on ’Gender Medicine and Health’ recently launched by the SNSF are important steps in this direction.

Christine Bigler also emphasizes the great relevance of social gender for women’s health. This includes social roles and gender stereotypes, which, among other things, cause female patients and doctors to behave differently from their male counterparts. Too little attention has so far been paid to this social gender as a factor influencing health. ’Without systematic consideration of these differences, equality between men and women in the Swiss healthcare system remains unattainable,’ summarizes co-author Tina Büchler. This is why an interdisciplinary approach, taking into account social science and psychological approaches, is essential for gender equality in the Swiss healthcare system. ’It is also important that measures - for example in prevention - are aimed at overcoming obstructive stereotypes,’ says Tina Büchler.

’Gender-equitable healthcare benefits all genders,’ emphasizes Michèle Amacker, including men and people of other genders and gender identities, such as trans people. This requires a fundamental rethink in the entire healthcare sector, which is still strongly rooted in a binary and hetero-centric concept of gender.