Medical research community calls time on health gender bias

SYDNEY, NOV 25 - Australian medical research is in danger of becoming non-competitive on a global stage when it comes to sex and gender analysis, according to a consortium of leading universities and research institutions writing in the Medical Journal of Australia today.

Higher healthcare costs due to unnecessary tests and treatment, and poorer quality of care are other unwelcome consequences of failing to account for differences in the way men and women experience common diseases and respond to therapies.

Dr Cheryl Carcel, Clinical Research Fellow at The George Institute for Global Health, said that while growing numbers of countries have introduced policies and practices which require the integration of sex and gender analyses in competitive research grants and/or publications in journals, few equivalent policies or practices exist here.

“While all Australian Government departments and agencies were required to align their business practices with guidelines on the recognition of sex and gender by 1 July 2016, we found that eight of Australia’s top ten research funding agencies and four of our top ten journals still did not have policies on the collection, analysis and reporting of sex- and gender-specific health data,” she said.

 

“Australian medical research has fallen behind North America and Europe in recognising sex and gender as a key determinant of health, and its importance for health research and improved health outcomes.”

 

“Failure to keep pace with the rest of the world will see Australia become increasingly less competitive when applying for funding from international bodies and reduce international partnership opportunities with overseas organisations,” Dr Carcel added.

Head of Public Health and Medical Director at Bupa Australia Dr Zoe Wainer said that across a broad-range of health areas, data have been collected from men and generalised to women, but a growing body of research shows that this approach was no longer appropriate.

“We know that differences exist between men and women for conditions that cause the greatest health burden in Australia and globally including cancer, cardiometabolic disease, mental illness and substance use, and dementia.”

“While Australian researchers are at the forefront of expanding the global knowledge base on sex and gender differences in health, we clearly need to do better in translating that into practice,” she said.

Amongst the paper’s authors are representatives of leading educational institutions, including UNSW, University of Sydney, University of Melbourne, Monash University, University of Queensland, Macquarie University and La Trobe University as well as the Australian Human Rights Commission and The National Heart Foundation.

Dr Wainer added that it was time for stakeholders across the board to ensure that health research and the medical profession that relies on it reflects current evidence to deliver the best health outcomes and most efficient care for Australians.

“We’re calling on universities and other training institutions, learned academies and professional societies, governments, medical and health research funders, peer-reviewed journals and industry to address this gap in medical research and ensure that Australian science continues to be world leading,” said Dr Wainer.

“This is not simply a women’s or men’s health issue, but an issue for all Australians.”

Calls to action:

Universities and other training institutions

• Commit to developing curricula that acknowledge and explore biological differences between males and females and the role of gender and sociocultural factors in disease presentation and outcomes
• Ensure that implementation of sex and gender analyses in research is managed as an ethical issue

Learned academies and professional societies

• The Australian Academy of Health and Medical Sciences should encourage members to champion the integration of sex and gender analysis in research and create a special interest group to ensure that other committees do so
• Medical colleges include evidenced-based sex and gender integration in clinical guidelines, requirements for funding for research, training and professional development
• Relevant Australian-based professional societies promote the integration of sex and gender analysis in research by developing policies, position papers and guidelines

Governments

• The Therapeutic Goods Administration require all new applications for registration to address sex and gender differences and the Pharmaceutical Benefits Scheme consider incorporating knowledge of sex and gender differences in access to medicines
• Federal and state government health data bodies should develop a standard approach to analysing sex and gender in all health reporting,
• The National Health and Medical Research Council (NHMRC) Australian Health Ethics Committee should treat sex and gender analyses in research as an ethical issue and update their guidelines
• Health funding bodies including the Independent Hospital Pricing Authority and Medicare should consider sex and gender analyses in cost-weighting calculations
• The Australian Commission on Safety and Quality in Health Care should integrate sex and gender data collection and analyses in guidelines for Clinical Quality Registries and ensure adherence to clinical guidelines

Medical and health research funders

• develop policies, practices and guidelines to address the implementation of sex- and gender-specific clinical care and health promotion and prevention

Peer-reviewed journals

• develop and monitor implementation of policies to ensure researchers include sex and gender in reporting of research

Industry

• all new product development should involvement both males and females in clinical trials and the integration of sex and gender analyses

The George Institute for Global Health

The George Institute for Global Health is an independent medical research institute aiming to improve the health of millions of people worldwide by generating effective, evidence-based and affordable solutions to the world’s biggest health challenges. Headquartered in Sydney, with major centres in China, India and the UK, it has projects in more than 50 countries and affiliations with world-class universities. In 2018, The George Institute was ranked the number-one independent research institute in Australia by Times Higher Education.

About Bupa

Bupa is a diverse health and care group which has been committed to a purpose of longer, healthier, happier lives for close to 70 years.

In Australia and New Zealand, Bupa supports more than 6 million customers through a broad range of health and care services including health insurance, aged care, rehabilitation, dental, optical, medical, hearing and medical visa services.

Employing more than 22,000 people, we believe that we can make a real difference to the lives of Australians and New Zealanders through our values, purpose and the way that we deliver personalised care.

As we are not listed, we are able to reinvest our profits into improving the quality of health and care services. Since 2002 we have reinvested approximately $6bn in Australia and New Zealand, while the Bupa Health Foundation has invested over $32 million to support more than 100 health and care projects.

Leads

• Dr Cheryl Carcel

  Head, Brain Health Program