digital economy e gender gap: siamo pron4 … economy e gender gap: siamo pron4 all’appuntamento...
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DigitalEconomyegendergap:siamopron4all’appuntamentoconl’Agenda2030?
ValeriaCasoEuropeanStrokeOrganisa4on
Transla'onal Implica'ons
• In1993,theNIHRevitaliza4onActrequiredtheinclusionofwomeninNIH-fundedclinicalresearch.
• Howeverinclusionofwomenisnotrequiredatphases1and2ofNIH-fundedhumansubjecttrialswhencri4calsafetyanddosageissuesareaddressed(Ambien)
• 80%ofthedrugstakenoffthemarketbetween1997and2000“haddispropor4onatelyadverseeffectsonwomen”
• CallforAc4onfor“SexBalancing”inclinicalandnowpre-clinicalstudies
www.gao.gov/new.items/d01286r.pdf
Preclinical studies
• "Theover-relianceonmaleanimalsandcellsinpreclinicalresearchobscureskeysexdifferencesthatcouldguideclinicalstudies"
• "Anditmightbeharmful:womenexperiencehigherratesofadversedrugreac4onsthanmendo."
Collins F, Clayton J. Nature 2014; 509: 282-83
For the 1 and 2 stages, reliable registries and health certification are lacking…women
were unlikely to be admitted to hospital. In the third stage, specifically for Eastern Europe (post-socialist countries), the burden from stroke in women was on the rise
Fourth stage, despite an aging population, decreases in stroke incidence, prevalence and mortality have been observed These trends for women were less pronounced for minorities suggesting a ‘‘gender-gap’’ regarding access to treatment and care.
For the 1 and 2 stages, reliable registries and health certification are lacking…women
were unlikely to be admitted to hospital. In the third stage, specifically for Eastern Europe (post-socialist countries), the burden from stroke in women was on the rise
Fourth stage, despite an aging population, decreases in stroke incidence, prevalence and mortality have been observed These trends for women were less pronounced for minorities suggesting a ‘‘gender-gap’’ regarding access to treatment and care.
Inpress
We compared female-to-male stroke mortality ratio and stroke mortality rates in women and men between countries according to 50 indices of women’s
rights from Women, Business and the Law 2016 and Gender Inequality Index from theHuman Development Report by the Nations Development.
Comparison of stroke outcomes between male and female
Items n mean±SD p
Canamarriedwomangetajobinthesamewayasamarriedman?
No(n=18) 1±0.2 0.003
Yes(n=158) 0.9±0.2
Canamarriedwomanchoosewheretoliveinthesamewayasamarriedman?
No(n=32) 1±0.2 <0.001 Yes(n=144) 0.9±0.2
Canamarriedwomanbeheadofhouseholdorheadoffamilyinthesamewayasamarriedman?
No(n=34) 1±0.2 0.044 Yes(n=12) 0.9±0.1
Doesthelawprohibitdiscrimina4onbycreditorsonthebasisofgenderinaccesstocredit?
No(n=131) 0.93±0.2 0.002
Yes(n=44) 0.85±0.1 Doprotec4onordersfordomes4cviolenceexist?
No(n=51) 1±0.2 <0.001 Yes(n=125) 0.9±0.2
Istheredomes4cviolencelegisla4on?
No(n=46) 1±0.2 0.033 Yes(n=130) 0.9±0.2
Doesdomes4cviolencelegisla4oncoveremo4onalviolence?
No(n=67) 1±0.2 0.018 Yes(n=125) 0.9±0.2
Aretherecivilremediesforsexualharassmentinemployment?
No(n=113) 0.94±0.22 0.033 Yes(n=63) 0.87±0.13
Domarriedmenandmarriedwomenhaveequalownershiprightstoproperty?
No(n=17) 1.1±0.2 0.001
Yes(n=155) 0.9±0.2
Results
Access to Care
• Socialaspectsalsoneedtobeconsidered:womentendtobethecaregiversinfamilies,andinmanysocie4es,decisionsregardingwomen’shealths4lldependonmen.
• Tofostertheinclusionofwomeninclinicaltrials,ageexclusionsshouldbeconsideredonlyinlightofsafetyconsidera4onsandnotasanarbitraryagecut-off.
Inequali'es in women’s access to health care
• In many places, cultural and religious norms are an important barrier to access to health services.
• For example, social and cultural taboos make medical care from male health providers difficult for women to seek; this issue further limits women’s access to care in locations where few female health professionals are available, especially in rural areas.
• For example, in Afghanistan, many women are unable or unwilling
to receive tetanus toxoid vaccinations because to expose their arm to a male vaccinator can be shameful
Unpaid health-care contribu'ons • InEurope,ananalysisoftheHarmonisedEuropeanTimeUseSurveyandtheSta4s4csonIncomeandLivingCondi4onsSurvey(2009)es4matedthevalueofunpaiddomes4ccare:• includingnormalhouseworkchores,personalcare,supportwithmobility,andadministra4vetasks• tobe17–31.6%oftotalEuropeanGDP.
Elderlyhospitalizedpa4entstreatedbyfemaleinternistshavelowermortalityandreadmissionscomparedwiththosecaredforbymaleinternists.Thesefindingssuggestthatthedifferencesinprac4cepanernsbetweenmaleandfemale
physicians,assuggestedinpreviousstudies,mayhaveimportantclinicalimplica4onsforpa4ent
outcomes.
Investment in women and health
• Amother’slevelofschoolingisstronglylinkedwithherchildren’ssurvival.Researchersanributemorethan50%ofchilddeathsavertedbetween1970and2009towomen’sincreasedlevelsofeduca4on
• Newsourcesoforganisedopposi4ontogirls’educa4onareemergingandgainingstrength,includingterroristgroupssuchasBokoHaramandtheTaliban.
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