The widely held belief that women are inherently healthier than men – living longer and seeking medical care more often – may be a misconception. A latest look at healthcare disparities reveals a more complex reality where medical practices and societal factors often disadvantage women, leading to poorer health outcomes despite a longer lifespan. This is the central argument of Femmes et santé, encore une affaire d’hommes ?, a book co-authored by historian Muriel Salle and neurobiologist Catherine Vidal.
A Medical System Designed for Men
From emergency rooms to pharmaceutical research, medicine has historically overlooked the specific needs of women. Muriel Salle points to a deep-rooted structural bias: “One first thinks of health, the body and diseases in the masculine. And when one proceeds like that, one constructs women as exceptions.” The consequences are well-documented. For example, in identical clinical situations in the emergency room, 62% of healthcare providers consider a man’s case to be serious, compared to only 49% for a woman.
Even medications are affected by this bias. As Dr. Danielle Hassoun notes, “the doses given to women are those that have been tested on men — therefore probably in many ways absolutely not adapted.” Side effects reported by female patients are often dismissed, and symptoms of conditions like heart attack – nausea, shortness of breath, fatigue – can go unrecognized because they don’t align with the traditionally male-defined clinical presentation. This can lead to delayed or incorrect diagnoses and treatment.
Women Live Longer, But Not Necessarily Better
In France, women live an average of a little over 85 years, compared to just over 79 years for men. However, Muriel Salle cautions that “this figure is not as important as one might think.” The real issue isn’t total life expectancy, but rather healthy life expectancy. She explains that “women’s healthy life expectancy stops at a little over 65 years, which means they live 20 years with major health problems.”
These two decades of vulnerability are compounded by economic insecurity. The retirement gap between women and men – around 40% – means women often face illness with limited resources. This is further exacerbated by limited access to healthcare in rural areas, transportation difficulties, and the need to rely on alternative, often uncovered, treatments when conventional medicine fails to address their needs. Salle as well points to a form of healthcare avoidance linked to social factors: “Not being white, not being wealthy, not being sufficiently French-speaking, means you are less likely to go to the doctor willingly.”
Listening to Improve Care
Highlighting the importance of patient-centered care, a recent report by Femme Actuelle ranked the 50 largest French cities based on the quality of healthcare provided to women, considering medical density, specialized services, and municipal commitment to equality. Surprisingly, Bayonne, the smallest city in the ranking, topped the list. The city’s high density of gynecologists and cardiologists, along with specialized endometriosis centers, contributed to its success. However, journalist Sabrina Nadjar emphasized that what truly sets Bayonne apart is the time doctors take to listen to their patients. “What makes the difference in Bayonne compared to others is that doctors take the time to listen to patients. When you spend time with women and listen to them, you arrive at a truly extraordinary care plan.”
This finding resonates with accounts of patients reporting years of pain dismissed as menopause, undiagnosed diabetes, and pericarditis mistaken for anxiety attacks. These experiences underscore the critical need for healthcare providers to fully consider and validate women’s health concerns.
Want to know when screening is most crucial for women? Stay tuned…
Muriel Salle, historian, professor at the Faculty of Medicine of Claude Bernard Lyon 1 University and seminar leader at Sciences Po Lyon. Specialist in the history of women, medical discourse, and women’s health.
Sabrina Nadjar, journalist, editor-in-chief of Femme Actuelle
Dr. Danielle Hassoun, gynecologist-obstetrician in Paris. Responsible for an abortion center and collaboration on research conducted by the INSERM (Unit 108 CSP) on contraceptive failures and representations of menopause.
