Gender Bias in Healthcare Research
June 1, 2021
by Daira Wilson, Ph.D., RN, Professor of Nursing
Nursing is rooted in delivering care based on “evidence-based practice.” We follow the science to make sure that everything that we do to provide care for people has been tested to produce the best possible outcomes. But what if some of the things that we are doing are based on results from research that was only done on half of the population? How can we generalize the findings across both genders if the sample only contains one of the genders? My project for this Global Gender and Women’s Studies Faculty Learning Community (FLC) focused on the bias that has occurred in only doing research on men and then using those treatments, outcomes, and policies for women as well, sometimes causing harm or even death due to the bias.
I was inspired to join this FLC through my past experiences with the Global Education FLC and the knowledge that I gained from it which led to a fun and informative project on teaching nursing students how nursing is delivered around the world. For this project, I chose to update a module in my Global and Public Health Policy course in the RN to BSN program since I was now teaching students who were already nurses and had experience in how nursing is delivered.
I curated some articles and a video about various subjects such as the standard signs and symptoms of heart attacks, how pain is perceived and treated, and how seat belts are designed which are all based on male samples but are used as the gold standard for all treatment and policy. I also included research on osteoporosis and breast cancer research which has been done almost exclusively on women, despite the fact that many men get these diseases and the treatment models are inaccurate for them. The results of these studies have been used for years in treatment decisions that have resulted in overdosing, underdosing, or just plain missing signs and symptoms that have caused poor outcomes.
The causes of gender bias in research and healthcare delivery are multifactorial but many times the reasons are based on the fact that women have hormonal fluctuations which can impact how medications are metabolized. Signs of a heart attack for women which include back pain and nausea are labeled “atypical” even though they are very common for women and this has led to more women being misdiagnosed or dying due to a lack of a standard of care that is not based on the female experience with heart attacks. Seat belts are designed for a man who is 5’9 and 170 lbs leading to airbag deployments that are not accurate for the average female.
Since my class includes policy changes and evaluation, I included articles about the need for policy change in research to include both genders so that results could reflect their experiences more accurately. I was curious to see what the students thought about this module so I presented them with a survey asking for their reflections based on the objectives of the module as well as their own personal thoughts on the subject. I was curious to see if this content would help them view research through a new lens and would help them critically think about who the sample is and how the results can be generalized.
Many of them said that they had never even heard of gender bias in research and did not know that it affected their practice. I enjoyed their thoughtful comments such as the need to “believe people (women or minorities) whose symptoms may not align with that model” and for a need to “conduct research that is non-biased and advocate for policy changes that encourage gender equity.” My hope is that by highlighting that gender bias in research is a reality, our next generation of researchers will be more aware and make necessary changes as to who is being included in studies and ultimately, how nurses can deliver better healthcare.
I really enjoyed the FLC, the speakers, and the time when we brainstormed with each other very much and would recommend it to anyone who wants to learn more about global gender and women’s studies and how incorporating this topic into their content can have lasting results.