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Examining Gender Bias in Medical Care

C. Noel Bairey Merz, MD

Sarah J. Kilpatrick, MD, PhD

We’re seeing gender disparities even in a context when those disparities should not exist,"Huang said in an interview. When a man or a woman come to an emergency room after suffering a heart attack, she said, "they should have an equal likelihood of surviving something like a heart attack. But in fact, what we find, is that they don't."

One possible explanation, Huang said, was that "we have medical training that is based on the average patient being a male, 75-kilogram white patient. And so, we're not aware of some of the other possible challenges that providers are facing when they're treating [other types of patients]. We're seeing things like, with hip replacements, those are designed for the male body. We're seeing surgical instruments—those are designed for male physicians' hands."

Page said the failure to understand differences in male and female biology harms everyone, but especially women.

He traced the problem to biomedical research that "over the decades and centuries has sort of assumed that we’re all males. Until about 1990, women were essentially excluded from clinical trials of drugs, for instance. And even today, in many areas of laboratory research that are relevant to medicine, where we study in laboratory animals models of human disease—in many of those arenas, the studies are done exclusively on male laboratory animals and then the results are just extrapolated to, or assumed to be, identical in females. ... So, there's been a kind of an implicit assumption across of much of medical research for decades that studying things in males alone is good enough."

"There still are many areas of fundamental biomedical research where sort of a male-only approach remains the norm," Page said. "We’ve got to go back to the beginning of the enterprise and essentially rebuild it."

After the keynote addresses, the CREWHS symposium showcased research by Cedars-Sinai investigators on gender-related differences affecting women's health. It included such topics as "Pregnancy as a Window to a Woman's Future Cardiovascular Health" and "Sex Differences in Inflammation and Aging."

In introductory remarks, Sarah J. Kilpatrick, MD, PhD, professor and chair of the Department of Obstetrics and Gynecology and a co-founder of CREWHS, said the goal of the new center is to support Cedars-Sinai researchers working in this field "so that they can really discover and implement that knowledge which will change the course of women’s lives." The other co-founder of CREWHS is C. Noel Bairey Merz, MD, professor of Medicine, director of the Barbra Streisand Women's Heart Center and the Linda Joy Pollin Women’s Heart Health Program in the Smidt Heart Institute.

CREWHS also announced its first research award for a Cedars-Sinai investigator. It gave, after considering 22 applications, an award of $30,000 to Nirupama N. Bonthala, MD, the principal investigator on a study on inflammatory bowel disease, or IBD, among pregnant women.

The study's goal is to determine whether there are genetic markers or other indicators that could signal which pregnant women with IBD face a higher risk of suffering pregnancy complications or harm to their own health related to the disease. The award was funded by a donation from the William H. Donner Foundation.