Uncovering the Historical Roots of Health Disparities: Insights for Women and Men

American medicine has long operated on a narrow view, often focusing on the male body as the standard. This perspective shapes how we understand health and mental illness, impacting women significantly.

Historically, through the 18th and 19th centuries, doctors based their knowledge predominantly on the male body. Laura Hirshbein, from the American Association for the History of Medicine, notes, “The standard was a 70-kilogram white male. Everything else was seen as a deviation.” This disregard for female physiology led to a major gap, especially in how conditions like heart disease are diagnosed in women. Up until the 1990s, many clinical trials for heart medications only involved men. It wasn’t until advocacy for women’s health led the FDA to spotlight this issue that change began.

Hirshbein reflects on her education in the ’90s, highlighting that medical training often misrepresented women’s health. For instance, heart attacks were illustrated with images of male patients, ignoring that women’s symptoms can differ. “We were taught a male-centric approach that didn’t account for how heart disease presents in women,” she explains.

This oversight contributes to persistent myths, such as the belief that women’s reproductive hormones protect them from heart disease—a claim now being challenged by experts. Research shows that women often receive diagnoses later than men, with a recent Danish study indicating a four-year gap for various conditions despite women seeking treatment sooner.

While men’s health diagnoses often focus on traditional symptoms, women’s mental health has sometimes set the bar. Most mental health criteria developed in the 20th century relied heavily on observations from women in state hospitals. Derek Griffith from Global Action on Men’s Health points out that men are diagnosed with depression significantly less than women. Traditional symptoms—such as sadness—may not resonate with men, who are more prone to express depression through irritability or substance use. “When we include those symptoms, the gender gap in diagnosis closes,” Griffith says.

Suicide rates also reveal stark differences. While women are more likely to contemplate suicide, men are four times more likely to die by suicide, often using more lethal means. Griffith notes that changing male roles in society can contribute to confusion and distress, further complicating mental health realities.

This highlights the urgency for a more inclusive approach to health care that considers both genders equally. As society evolves, so too should our understanding of health, pushing us to pay greater attention to how we identify and support men and women in their unique health journeys.



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