Included Health Co-Founder and CEO Owen Tripp

Population Health

Closing the Women’s Health Gap

Despite living longer than men, women spend a quarter of their lives in worse health, prompting the World Economic Forum and the McKinsey Health Institute to publish an in-depth report to unpack the underlying factors driving the disparity.

The report explores the root causes of the women’s health gap, which span far beyond sexual and reproductive health even though the area is a go-to oversimplification for many gender differences. (Chart: Contributing Factors to Women’s Health Burden)

• Just 5% of women’s health burden is related to gender-specific conditions (maternal and gynecological)
• 47% stems from conditions that affect women either disproportionately (depression, auto-immune disease) or differently (AFib, colon cancer)
• 43% comes from conditions that don’t affect women disproportionately or differently (ischemic heart disease, tuberculosis, etc.)

The large disparity resulting from conditions that impact everyone more-or-less equally can be attributed to several systemic issues, which the report does a great job outlining alongside possible solutions.

• Better clinical trial design is needed to ensure equitable representation for conditions that affect women differently, such as incorporating male vs. female disease prevalence mix and using sex-specific thresholds for biomarkers.

• Accurately assessing the prevalence of conditions such as endometriosis and menopause is needed to improve the notoriously underestimated metrics, which leads to underinvestment due to misunderstood market potential. 

• Enhancing access to gender-specific care is critical to improving outcomes, which might include health systems implementing new guidelines (e.g, sex-specific cutoffs for biomarkers, discharge checklists) to guide decision making and minimize biases.

In typical McKinsey fashion, the report devotes significant real estate to the economic burden of the women’s health gap, which if closed could boost global GDP by $1T due to improved workforce participation. It’s also worth noting that 10 conditions contribute over half of the economic burden. (Chart: Economic Burden by Condition)

The Takeaway

Tackling the women’s health gap is essential for far better reasons than boosting GDP, but regardless of the justification, progress depends on addressing the issues outlined in this report. Glaring research gaps, disparities in care delivery, and underinvestment have led to massive disparities in women’s health, but they’ve also created a huge opportunity for those that can help to solve them.

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The Wire

• Cancer Center Accused of Fraud: A blogger’s investigation into the prestigious Dana-Farber Cancer Institute is leading to the retraction of six scientific studies and the correction of 31 others – all published by the institute’s top researchers (including its CEO). The Harvard-affiliated cancer institute is accused of falsifying research by Photoshopping many of the supporting graphics. The investigation used AI to identify 57 studies that appeared manipulated (the institute acknowledged 37), causing speculation that a new AI-fueled crackdown could be coming to academia.

• CMS Launches New Behavioral Health Model: CMS is launching a new model to advance the integration of behavioral health in primary care, which will align Medicare and Medicaid reimbursements through state-based programs. The Innovation in Behavioral Health Model encourages creating care plans that incorporate both physical and mental healthcare for patients facing mental health or substance use disorders, and will help community-based practices coordinate those plans with social care services.

• Amazon Pharmacy Virtual Consult Pilot: Amazon is full-speed-ahead with the integration of two of its most successful healthcare ventures, and it looks like One Medical providers will soon be able to request drug consultations from Amazon Pharmacy staff for complex senior patients. Forbes reports that a new pilot program allows One Medical providers to request pharmacist consults for tasks ranging from simple medication reviews to comprehensive drug interaction reviews, with the goal of making these types of consultations as common in the outpatient setting as they are in hospitals.

• CardioSignal Lands $10M: CardioSignal raised $10M to expand access to heart disease detection using one of the most accessible devices in the world – the smartphone. CardioSignal’s algorithm analyzes gyroscope and accelerometer data produced by smartphones when placed on patients’ chests, allowing it to create digital biomarkers for AFib and heart failure. That might sound like a far out approach, but CardioSignal’s biomarkers are backed by clinical studies like this one that show high sensitivity and specificity for AFib detection (95% & 96%).

• Is Physician Burnout Easing? That’s the suggestion of Medscape’s 2024 Physician Burnout and Depression Report, which indicated that while physician burnout levels remain high, they ticked down in this year’s survey. Fewer physicians reported burnout (49% vs. 53%) and depression (20% vs. 23%) compared to last year, but the pandemic’s impact is still apparent given 2020’s burnout rate was “just” 41%. Unsurprisingly, physicians working in the ED remain the most burnt out (63%).

• Eroding Attitudes About US Healthcare: Jarrard’s latest survey of 1,670 US adults found that attitudes toward the healthcare system continue to erode. Only 21% of respondents agreed that the US healthcare system delivers good value for the cost (vs. 58% disagreed), while 22% agreed that the system provides equitable care for all (vs. 57% disagreed). When asked what parties are most to blame for rising healthcare costs, payors ranked first with 47% of the vote, while hospitals came in fifth at 13%. Just 35% felt that payors “are meeting the needs of most Americans,” compared to 43% in 2022.

• Walgreens Explores Offloading Shields: Walgreens is looking to shed its Shields Health Solutions specialty pharmacy business to help buoy its sinking financial outlook. According to Bloomberg, Shields could attract interest from PE firms at a valuation of over $4B, which would certainly help the prospects of a turnaround plan that also involves closing 60 VillageMD clinics. The drug-store chain is shifting its attention toward delivering services to payor, provider and pharma clients, but the US Healthcare division (including Shields) is struggling to reach positive margins.

• Too Much Sitting Could Be Lethal: A massive occupational study of about 482k people in Taiwan found that people who mostly sit at work have a 34% higher risk for cardiovascular disease and a 16% higher all-cause mortality risk than those who mostly don’t sit while working. That’s after adjusting for many factors including age and BMI. The good news is, ‘mostly sitters’ could counteract these hazards by adding 15 to 30 minutes of physical activity daily and alternating between sitting and “non-sitting.” 

• Dexcom Nears Debut of Consumer CGM: Dexcom is gearing up to launch a consumer-grade continuous glucose monitor for people who don’t take insulin. The Stelo CGM device was submitted to the FDA late last year, setting it up for a mass market debut this summer. Dexcom’s CEO says that the health enthusiast-focused Stelo will start as a direct-to-consumer product with the end goal of “eventually seeking reimbursement.”

• Survey on AI Sentiment: A Sermo survey of healthcare leaders found that most are taking the long view on AI’s impact on their operations. Of over 100 decision-makers, only 25% said they had implemented AI, and 21% said “significant opportunities” are being missed for deploying AI. That said, 91% said AI will be a major part of their growth and success five years out, and medical AI integration is expected to triple over the same period (21% vs. 62%).

• Optum Perks Rolls Out Telehealth: Optum Perks, part of the RVO Health joint venture between Optum and Red Ventures, is rolling out a telehealth solution to provide accessible care and prescriptions for hundreds of conditions such as acne, congestion, and high blood pressure. The new service starts at $25 and uses symptom questionnaires instead of virtual visits to keep costs down and streamline treatments after physicians review each case.

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