Women’s cardiovascular advocacy aims to address the wide disparities in cardiac care between men and women throughout the United States. By increasing women’s heart health awareness, advocates for healthcare equity aim to bring about systemic change that will ensure that doctors and other healthcare professionals recognize the importance of diagnosing and treating cardiac disease in their female patients at a level of care equal to that received by men. At the community level, advocates also work to increase women’s health awareness across a broad range of topics, so that women are empowered to make informed choices about their own healthcare concerns and treatments. To learn more about how healthcare disparities between men and women may impact your personal heart health journey, consider scheduling a consultation with an experienced women’s health and maternal medicine attorney at Erin Marshall Law. Call 505-218-9949 today to speak with a member of our Albuquerque team.
Heart Health Disparities: The Gender Gap in Cardiac Care
Many women may not be aware of the degree to which they are at risk for heart disease. A 2020 special report from the American Heart Association (AHA) indicates that over the decade (2009-2019) covered in the research, awareness of heart health risks among women actually declined, rather than increasing. According to the report, 65% of survey participants were aware that heart disease was the leading cause of death for women; ten years later, only 44% of women shared the same awareness, even though cardiac problems continued to be the foremost cause of death for women throughout the period.
This under-recognition of heart disease risks in women has the potential to adversely impact not only their day-to-day decision-making and lifestyle choices, but their preparedness to proactively advocate for themselves in healthcare settings. The latter is especially important because physicians and other medical professionals are often similarly inclined to under-appreciate the potential for heart problems in female patients, setting the stage for a sharp gender gap in healthcare for men and women presenting with possible signs of heart disease.
Recognizing Risk Factors for Heart Disease
Part of the problem with heart health awareness for women may arise from confusion about how heart disease happens, and the diversity of risk factors that may come into play. Certainly lifestyle factors, such as diets high in fat and demanding schedules that leave little opportunity for regular exercise, can play a role in increasing the risk of heart attack and stroke, in both men and women, by allowing cholesterol to collect along the inner walls of an individual’s arteries while cardiovascular fitness slowly declines.
Most American adults are probably aware that a high-fat diet and lack of physical activity can contribute to an increased risk of heart disease over time, but these factors are by their nature chronic and cumulative. No single cheeseburger or missed workout is likely to become the reason for an individual’s heart attack or stroke later in life. The acute, time-sensitive risk factors that can affect women during pregnancy and the early postpartum period, however, may be less widely familiar and understood.
Heart Health Awareness at the Doctor’s Office
Although it would be encouraging to think that medical professionals do not share in the general tendency to underrate women’s risk of developing cardiovascular disease (CVD), data suggest that healthcare providers are slower to order diagnostic tests for heart conditions when examining female, as opposed to male, patients. In fact, the National Heart, Lung, and Blood Institute actively encourages women to ask their healthcare providers about diagnostic tests because women are at greater risk than men for delays in even beginning the tests that may be needed to diagnose heart disease. Younger women, the Institute notes, may be particularly at risk in this area, as compared to men they are more likely to be misdiagnosed after cardiac events and sent home without treatment.
There is some uncertainty about the degree to which the hesitancy in ordering tests for women presenting with cardiac symptoms is caused primarily by an under-recognition, among healthcare professionals, of the true prevalence of heart disease in women, or is instead better understood as part of a more general tendency in the healthcare industry to take symptoms of all types less seriously when they are reported by female patients than when the same or closely similar symptoms are reported by men. A further complication is introduced by the fact that women’s symptoms for some cardiac conditions and events – including acute myocardial infarction, otherwise known as a heart attack – can sometimes differ from those commonly experienced and reported by men. While no one wants the burden of pursuing diagnosis and treatment to fall upon the patient, women’s cardiovascular advocacy for their own care can be crucial in securing access to a timely diagnosis and lifesaving medical interventions for heart disease.
Gender Disparities: CVD Risk Factors and Women’s Cardiovascular Health
Among the many challenges facing advocates for women’s heart health awareness is the under-recognition, among both female patients and in many cases among healthcare providers as well, of the differences between men and women with respect to the risk factors that most strongly influence individual risks of cardiovascular disease and personal outcomes from treatment. Type 2 diabetes, for instance, is a risk factor for CVD is a significantly stronger predictor of eventual CVD in women than in men, despite the fact that men tend to be diagnosed with type 2 diabetes earlier and with lower relative body fat than their female counterparts, according to a 2023 study published in the journal Diabetologia and made available to the public through the National Library of Medicine (NLM).
Not only do some risk factors affect male vs. female patients differently, but there are certain key risk factors that women are more likely than men to experience overall. The same 2023 study notes that women are more likely than men to be obese (an important risk factor for the development of cardiovascular disease). In enumerating the most notable disparities between men and women in the incidence of individual risk factors for CVD, the AHA points to the 2012 publication in Vital Health Statistics 10 of results from the 2011 National Health Interview Survey, which found that women were less likely than men to meet the recommended guidelines for weekly physical (cardiovascular) activity – meaning that in addition to carrying a greater average burden of cumulative risk factors than their male peers, women are at the same time less likely to enjoy mitigating factors that might help to reduce overall risk.
Biological Risk Factors
A few risk factors are specific to female biology. Among factors that correlate with an increased risk of heart disease, the AHA points to findings from a 2018 United Kingdom study (also available through the NLM) that identified the following life events as predictive of CVD:
- Early menarche (first menstrual cycle)
- Early menopause
- Miscarriage
All of these factors are directly tied to female reproductive biology, yet questions about age of first period, early symptoms of menopause, and history of pregnancies are routinely left out of screening protocols for heart disease. If you have suffered adverse outcomes because your CVD diagnosis was delayed due to inadequate screening, an attorney at Erin Marshall Law may be able to help you review your options.
Even absent a miscarriage, pregnancy and childbirth also pose significant risks of acute cardiac events. In fact, the AHA’s resources for women’s cardiovascular advocacy include a fact sheet on Cardiovascular Health and Maternal Health that notes CVD is the leading cause of maternal death, with an estimated 10% of pregnant women experiencing heart-related complications such as preeclampsia (a pregnancy-related condition characterized by often severe increases in blood pressure, among other issues, according to the Cleveland Clinic). The statistics are both daunting and well-documented, and yet many women – especially younger women just starting their families – are not adequately educated about the risks of preeclampsia, gestational diabetes, or the diagnosis and management of other pregnancy-related conditions that can elevate CVD risk later in life.
Social Risk Factors
There are important biological differences between male and female bodies, so some portion of women’s cardiovascular advocacy will always consist in raising awareness of those sex-specific factors, and educating doctors and patients about the tools and strategies available for mitigating the risks they pose. Unfortunately, however, there are also a number of factors, associated with both increased incidence of CVD and worse outcomes post-diagnosis, that evidence strongly suggests are essentially social in nature. Research compiled by the National Heart, Lung, and Blood Institute shows that women are, disturbingly, less likely than male peers to be seen by a cardiac specialist when they are hospitalized for heart-related issues, and less likely to receive some medications and treatments, including the statins that are often considered standard for lowering high cholesterol in men. Younger women, especially, are at increased risk of being misdiagnosed, or simply undiagnosed, and sent home without treatment after a cardiac event.
Impacts of Inadequate Medical Care
These lapses and oversights in medical care have direct, and in some cases devastating, impacts on women and their families. The AHA points to a set of publications that, together, provide evidence that women are more likely than men to die within five years of a cardiac event, are also more likely to be diagnosed with heart failure within that same five-year period, and are – perhaps not coincidentally – less likely to be referred to any form of cardiac rehabilitation.
Causes of Inadequate Medical Care
All of these findings point to social and systemic factors that tend toward deprioritizing women’s heart health, and that weigh against prompt diagnosis and aggressive treatment for cardiovascular disease in women. The statistics become even more grim when race and ethnicity are taken into consideration: In virtually every category of heart health measured, African American women face greater delays in CVD diagnosis and worse long-term outcomes than their White counterparts – a tragic reality that is starkly reflected in the national maternal mortality rate for African American women, which during the period 2019-2024 was often more than double that of non-Hispanic white women, as reported by the Centers for Disease Control and Prevention (CDC). Statistics for maternal mortality among Native American women may be even higher; troublingly, the CDC only reports data for Native American women for July 2021-August 2022, but during that period the maternal mortality rate for this category reached 118 maternal deaths per 100,000 live births. These factors contribute to the United States’ unenviable distinction of being host to the highest overall maternal mortality rate among all wealthy nations, as described in a 2024 report from the Department of Health and Human Services (HHS).
Women’s Cardiovascular Advocacy: Leading the Fight for Systemic Change
One of the most persistent and troubling problems in women’s healthcare advocacy is the tendency to reduce conversations about women’s health awareness to conversations about breast cancer or maternity care. PubMed, in conjunction with the NLM, offers the text of a 2017 study in which researchers found that women consistently perceived their risk of breast cancer to be greater than their risk of heart disease – even though, as the American Heart Association reports, breast cancer accounted for roughly one in 32 deaths among American women, compared to one in three attributable to CVD. The 2017 study further suggested that women’s misperception of personal risk was attributable, at least in part, to emphases in media coverage and other forms of public messaging.
In other words, when narratives about women’s health awareness are dominated by information about breast tissue, maternity care, and female reproduction, women’s cardiovascular advocacy is put at a disadvantage relative to both men’s heart health awareness and women’s awareness of the relative risks they face for, and from, distinct health conditions. The prevalence of a reproduction-dominant framing of women’s health, in both medical and non-medical settings also comes at the expense of a certain logic: With so many of the risks women experience during pregnancy, childbirth, and beyond stemming from cardiac complications, there is little justification for leaving women’s heart health out of the story. Women’s healthcare advocates and adversely affected patients and families agree: Systemic change is needed – in exam rooms, in media coverage and public health bulletins, and in societal norms that continue to diagnose and treat women more slowly and less effectively than male patients presenting with similar symptoms relating to the same conditions.
Contact an Experienced New Mexico Attorney
The risks to women’s cardiovascular health caused by complacency arising out of imbalances in health education can hardly be overstated. As residents of a majority-minority state with expansive rural areas that present limited options for care compared to major urban centers, New Mexican women may be at especially elevated risk compared to the already-daunting national statistics. The systemic change that is needed in order to close the gender gap in cardiac care starts with women’s cardiovascular advocacy, shifting the emphasis in women’s health awareness campaigns to more directly highlight the leading killer of women across all age groups. At Erin Marshall Law, we are committed to fighting for that systemic change – but we are also here to support the women and families who have been let down by the medical professionals who should have had the knowledge of women’s heart health to promptly diagnose CVD, and treat female patients with a standard of care comparable to that applied to men who received the same diagnosis. Contact our Albuquerque office today at 505-218-9949 to learn more.
