“OK” is not an acceptable answer for women’s health in America

March is Women’s History Month, a time to reflect on the many achievements and contributions of women to American history and progress. But despite the often heroic efforts of advocates who have fought over the years to ensure women have bright futures, not all women are doing well, especially when it comes to their health. This seems to be especially true for many women in midlife, between the ages of 35 and 64.

This fact is not surprising, especially considering how challenging the past few years have been. And the findings of a recent report show that many of these midlife women — who represent approximately 63 million people in the US — actually don’t feel like they’re doing well.

The report “Ageing Smart. Aging Well: A National Action Plan”, found that 42 percent of the nearly 6,200 women surveyed said their general health was only “OK” or worse, while 39 percent and 38 percent, respectively, said the same about their mental and sexual health. A clear majority, 62 percent of survey respondents, also said they experience at least one of a myriad of barriers — from shame, fear and distrust to cost and access — that prevent them from taking better care of themselves.

These results are a crucial reminder for women of the importance of prioritizing their own health. That means speaking to their healthcare professionals, proactively scheduling checkup appointments, and being their own best healthcare advocates. But it also means we need to see some real changes in the way the American health care system addresses women’s health and supports women. Because just being “OK” is definitely not good enough.

For too many women in midlife, managing their health has taken a back seat to other commitments. Despite the increased risk of certain cancers and other diseases, such as autoimmune diseases, diseases that affect bone and brain health, menopause, cardiovascular disease, and mental and sexual health disorders, midlife women often postpone their doctor appointments and checkups.

According to the survey results, nearly 50 percent of respondents said they were up to date on all recommended screening tests, while another 1 percent said they were up to date on only a few. Although most women in the 2021 survey had some form of health screening, 1 in 5 had none. 17 percent said they had no scheduled screenings in 2022, and only 26 percent said they plan to do so. These are not the numbers we want to see.

This may be partly because this period in a woman’s life, from her childbearing years to menopause, often involves juggling competing personal and professional responsibilities, and in this juggling, unsurprisingly, women often put themselves and their needs aside . However, there are some very real and additional obstacles that women face when it comes to taking care of their own health and going to the doctor. These include logistical ones like the time for appointments, the number of visits needed to get a diagnosis (often many), access to doctors with the appropriate expertise, and the cost of care—regardless of whether the woman is insured or not. The most common structural barrier women reported was the cost of care, with one in ten women reporting that even with insurance coverage, they found it difficult to afford care.

Other barriers include feelings of shame about their condition, distrust of healthcare providers, and feelings that their concerns are not being taken seriously by healthcare providers, as well as friends, family, and partners. Of course, these supply barriers do not affect all women equally. Black and low-income women experience more barriers and poorer health outcomes.

But it doesn’t have to be like that. We must stand up against the forces that make it so difficult for so many women in midlife to truly thrive.

These efforts begin with the understanding that women’s health care involves much more than just reproductive care. Instead, it is a journey of caring through all stages of a woman’s life. It also means that we need to listen to and acknowledge women’s concerns about their health. In reality, however, almost one in five survey participants reported feeling their doctor didn’t believe their symptoms or wasn’t listening to them, which presented a significant obstacle to an accurate diagnosis.

Next we need to normalize aging in women and especially menopause. Talking about this condition, which every woman will experience, should be routine and occur without hesitation or shame—even in the workplace. Despite decades of neglect, we also need to put real money into research into women’s specific health issues and improve the education of healthcare providers. It is no longer acceptable to teach medical and nursing students that a 154-pound young adult white male is the standard patient, even though he has been the basis of research, education and practice for hundreds of years. And we also need to improve the education and resources available to patients.

If we do all of this, we will empower women to take responsibility for their own health. It’s not really difficult to do, especially when policymakers, vendors, and other decision-makers are heeding — and acting on — insights like those outlined here. Because with more support from the medical establishment, midlife women will be able to feel a lot, much better than okay.

Martha Nolan is Senior Policy Advisor at HealthyWomen. HealthyWomen works to educate women ages 35-64 so they can make informed health decisions.

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