The Women’s Health Strategy for England will set out an ambitious and positive new agenda on women’s health, with women’s voices at the centre. We are launching this call for evidence to inform the priorities, content and actions within the Women’s Health Strategy. This exercise will ensure that the strategy is evidence-based and reflects what women identify as priorities. There is strong evidence of the need for greater focus on women’s health and to recognise and act on the inequalities. In the UK, women have a longer life expectancy than men, with life expectancy at birth being 83.1 for women and 79.4 years for men in 2017 to 2019. However, women in the UK spend a greater proportion of their lives in ill health and disability. Women spend around over a quarter of their lives in ill health or disability, compared with around one fifth for men. Moreover, in recent years, healthy life expectancy has fallen for women but has remained stable for men. There are also differences in life expectancy across socio-economic groups. Taking action on women’s health will support our commitment to extend healthy life expectancy by 5 years by 2035. Work to develop the Women’s Health Strategy will consider women’s health over the life course, from adolescence through to older age. We want to better understand women’s experiences of health, and the health and care system. The strategy will focus on the needs of all women, as we recognise that women are not all the same, and that women will have individual needs and concerns. The government is ambitious about tackling health inequalities and the wider determinants of health, and a better understanding of the specific needs and areas of inequality faced by women will support this important work. We want to understand more about issues that only affect women (for example, gynaecological conditions or menstrual health), and also issues that affect both men and women but may be more prevalent in women, or affect men and women differently. This call for evidence seeks views on 6 core themes that connect different areas of women’s health across the life course.
1. Placing women’s voices at the centre of their health and care In recent years, it has become clear that more could be done in terms of listening to women’s voices. We know that women can face damaging taboos when wanting to start conversations about their health, which can make it more difficult to speak to healthcare professionals, family members, friends and employers. Embarrassment or stigma should not be a barrier to women seeking the help and care they need. We also know that, when women do seek help for health problems, they do not always feel listened to or their concerns taken seriously. We are determined to place women’s voices at the centre of their health and care, both at the level of individual patient–clinician interactions, and at the system level. We want to understand more about women’s experiences of having conversations about their health and where changes can be made to ensure they are heard.
2. Improving the quality and accessibility of information and education on women’s health High-quality information and education is essential for supporting women to stay healthy throughout their life, and to be empowered in making decisions about their health – for example, on treatment options for a health condition. It is also essential that healthcare practitioners can access the necessary information to meet the needs of the women they provide care for. However, there is some evidence that many women struggle to access reliable information about many aspects of women’s health. We know that awareness of symptoms including what is considered ‘normal’ can be low, and that women may not always be aware of the treatment and support available for common health needs such as menstrual health or fertility. These challenges can be a barrier to women seeking care. There is also some evidence that the level of awareness of different conditions varies among medical professionals and wider society. The recent introduction of compulsory relationships, sex and health education in schools is an important milestone in increasing knowledge of female health conditions. Pupils are now taught the facts about several areas of women’s health, including menstruation, contraception, fertility, pregnancy and the menopause. We want to understand more about where and how health information is accessed and its quality, and where improvements can be made.
3. Ensuring the health and care system understands and is responsive to women’s health and care needs across the life course A life course approach focuses on understanding women’s changing health and care needs across their lives, and how specific life events or stages of life can influence future health. For example, we know that women who have high blood pressure or pre-eclampsia during pregnancy are at greater risk of heart attack and stroke in the future. A life course approach also focuses on understanding wider determinants of health, the opportunities for preventative action to support women to improve their health and prevent or reduce the risk of ill health later in life. However, there is some evidence that women can find it difficult to access services that meet their specific health needs – or meet all their needs in one place. We know that there are significant inequalities between different groups of women in terms of access to services, experience of services and health outcomes. The government’s recent integration and innovation white paper sets out proposals for a Health and Care Bill, at the heart of which is delivering integrated person-centred care. Alongside this, the government’s public health reforms will more deeply embed prevention and health improvement expertise, capacity and accountability across national and local government and within the NHS. We want to understand more about women’s experiences of services across their lives, and the key opportunities for targeted action.
4. Maximising women’s health in the workplace Women make up 51% of the population, and 72% of women aged 16 to 64 are in employment. In health and social care, the proportion of women in the workforce is even higher, with 77% of the NHS workforce and 82% of the social care workforce being female. There is some evidence that female-specific health conditions such as heavy menstrual bleeding, endometriosis, pregnancy-related issues and the menopause can affect women’s workforce participation, productivity and outcomes. There is very little evidence on other health conditions, although we do know that common conditions which lead to sickness absence and leaving the workforce are more prevalent in women, for example mental health conditions, and musculoskeletal conditions. We also know that women are more likely to have a long-term sickness absence and leave work following that absence compared with men. Women also continue to take on disproportionate responsibility for childcare and caring for the elderly or disabled, which can further impact both women’s health and women’s workforce participation – for example, women may find it harder to access healthcare while balancing work and caring responsibilities. Women are also more likely to report developing their own health condition, or that an existing condition had worsened, because of their caring responsibilities. We want to understand more about women’s experiences in the workplace, and opportunities for better supporting both women and employers.
5. Ensuring research, evidence and data support improvements in women’s health We have a world-class research and development system in the UK. However, we know that women have been under-represented in research, particularly women of ethnic minorities, older women and women of child-bearing age, those with disabilities and LGBT+ women.[footnote 1] This has implications for the health and care they receive, their options and awareness of treatments, and the support they can access afterwards. Our ambition is to ensure that women’s voices and priorities are at the heart of research, from identification of need to publication and implementation in practice, and that we have the right data and evidence to improve women’s health outcomes and experiences of healthcare services. We want to understand more about how research is used, and identify how areas of health and medical research has overlooked women’s experiences and perspectives.
6. Understanding and responding to the impacts of COVID-19 on women’s health While the situation with COVID-19 is ongoing and in many cases it is too soon to draw conclusions on long-term impacts, we know that COVID-19 has had significant impacts on all elements of people’s lives, including work, leisure, and the way in which people access health and care services. For example, we know that the gender gap in childcare has increased over the pandemic, putting an additional burden on working mothers. We want to understand more about the impacts of COVID-19 on women’s health, and on women’s health services, including both challenges and positive reforms or opportunities for action. Please note, the government has recently held a 3-month consultation seeking views on whether to make permanent the current temporary measure allowing for home use of both pills for early medical abortion up to 10 weeks’ gestation. The scope of this call for evidence therefore does not extend to home use of both pills for early medical abortion up to 10 weeks’ gestation.