Health Care Disparities: The Impact of Benevolent Sexism

Womens Health Issues, 2007

Journal of Primary Care & Community Health

Background and Objectives:Most studies based on self-reported data indicate that female patients more often than males have a same-gender preference for their primary care physician (PCP). Because self-reported preferences may not reflect true preferences, we analyzed objective data to investigate patients’ preferences for PCP gender.Methods:Analyses were performed on 2192 new patients seen within a university-based healthcare system by 13 PCPs (2 male, 11 female) during 2017. New patients were asked about their PCP gender preference when assigned a PCP. We compared the expected prevalence (proportion of males/females in overall patient population) and observed prevalence (gender distribution of patients for each PCP) by PCP gender. A mixed model with PCP as a random effect examined the odds of male and female patients being assigned a same-gender physician.Results:The expected prevalence of new patients was 65% female and 35% male. The observed prevalence (95% confidence interval [...

American Journal of Public Health, 1994

Sociology of Health & Illness, 2008

Article Title: The influence of patient and doctor gender on diagnosing coronary heart disease

2015

Objective. To examine whether physicians attend to gender prevalence data in di-agnostic decision making for coronary heart disease (CHD) and to test the hypothesis that previously reported gender differences in CHD diagnostic certainty are due to discrimination arising from reliance on prevalence data (‘‘statistical discrimination’’). Data Sources. A vignette-based experiment of 256 randomly sampled primary care physicians conducted from 2006 to 2007. Study Design. Factorial experiment. Physicians observed patient presentations of cardinal CHD symptoms, standardized across design factors (gender, race, age, socio-economic status). Data Collection. Structured interview. Principal Findings. Most physicians perceived the U.S. population CHD prevalence as higher in men (48.4 percent) or similar by gender (44.9 percent). For the observed patient, 52 percent did not change their CHD diagnostic certainty based on patient gender. Forty-eight percent of physicians were inconsistent in their...

Journal of Epidemiology & Community Health, 2009

Background: Studies from several countries have documented gender disparities in the management of coronary artery disease. Whether such gender disparities are seen in Italy and, if so, whether they can be explained by factors such as age and severity of illness were investigated. Methods: 77 974 Piedmontese patients, admitted between 1999 and 2002, with a primary diagnosis of myocardial infarction (ICD 410), angina (ICD 413), chronic ischaemia (ICD 414) and chest pain (ICD 786.5) were studied. The number of men and women undergoing surgical treatment was extracted and the male-female odds ratios calculated. Several risk factors and a risk adjustment technique (APR-DRG) were used to control for possible confounders. Backward stepwise multiple logistic regression was used to adjust for significant covariates. Results: Crude analysis demonstrated that gender is a discriminating factor in the probability of surgery (OR 2.11, 95% CI 2.04 to 2.19), with similar findings among those with each main diagnosis. The odds ratios decreased after adjustment for age, co-morbidity and disease severity but remained significant. Conclusions: Men and women admitted to hospitals in a region of northern Italy with a diagnosis of cardiovascular disease are treated differently and this cannot be explained by age or severity of disease.

Mayo Clinic Proceedings, 2001

Annals of Emergency Medicine, 2011

Study objective: Women with potential acute coronary syndromes are less likely to receive cardiac catheterization or revascularization than men. We hypothesize that this may be due to different diagnostic test preferences of female and male patients.

The Annals of Thoracic Surgery, 2019

I n 1972 Congress passed Title IX, a law stating that "no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance." Almost 50 years after Title IX, women make up half of matriculating medical school classes, with 2017 marking the first year that the number of women starting medical school exceeded the number of men despite there being a higher percentage of male applicants. 1 Unfortunately, the surgical workforce is not close to the gender parity that has been achieved within medical schools. Multiple studies have demonstrated influential factors in specialty selection for medical students, namely, exposure to electives, lifestyle, and, most importantly, mentorship. 2 However, in the discipline of surgery, women consist of only 35% and 20% of general and cardiothoracic surgery residents, respectively. 3 More concerning is that only 7% of practicing cardiothoracic surgeons are women, and even fewer are in academic or leadership positions. 4 This limits the number of women mentors or role models for female students interested in surgery and acts as a major impediment to recruitment and retention of women in the field. Pipeline programs designed to increase the representation of women in the surgical and medical workforce have made important gains, but their success is, unfortunately, limited by the entrenched biases at the end of the pipeline.

Women's Health Issues, 2007

Background. Gender disparities in cardiovascular care have been documented in studies of patients, but little is known about whether these disparities persist among managed health care plans. This study examined 1) the feasibility of gender-stratified quality of care reporting by commercial and Medicare health plans; 2) possible gender differences in performance on prevention and treatment of cardiovascular disease in US health plans; and 3) factors that may contribute to disparities as well as potential opportunities for closing the disparity gap.