AN Irish based organisation is campaigning to influence European health policy on women. "It's not that we believe women deserve more attention than men," says Peggy Maguire, a director of the European Institute of Women's Health (EIWH), "but that women's health needs are different and that adequate research hasn't been done on women.
EIWH is counteracting what a growing number of commentators see as medicine's unconscious bias against women. Take, for example, drug research. Unless investigating women specific complaints, most drug trials use men and extrapolate the results to women without knowing whether women will derive the same benefits as men or experience the same side effects.
The main reason given by researchers for excluding women is that those of childbearing age may he unwittingly pregnant and a foetus endangered. Another is that the hormonal changes caused by menstruation, pregnancy and menopause introduce variables into the clinical process. This attitude sees women's biology as aberrant male hormonal patterns are the norm from which women deviate. Yet studies show that it is women who take almost 80 per cent of medicines.
The implications of not including women in the research can be clearly seen with a condition like coronary heart disease (CHD). Although CHD is often viewed as a disease primarily affecting men, it is also the single leading cause of death for European women (one in four Irishwomen, for example, die prematurely from CHD compared to one in 10 who die of breast cancer).
Despite this, a growing body of evidence shows that women are less likely to be accurately diagnosed for the disease, less likely to be referred for an angiogram and more likely to have their chest pain put down to stress or psychosomatic illness.
Issues like CHD in women get lost in the complexities of research for a variety of reasons, but mainly because when it comes to women, medicine has focused on reproductive health or "women's problems" at the expense of other health issues. And obviously, the under representation of women in the upper echelons of academe and government where research priorities are decided has also had a profound effect.
As a corrective to these trends one of the primary functions of EIWH is research. "Until you have accurate data and information, you cannot begin to form effective policy," says Peggy Maguire, an administrator with a long time interest in the issue of women's health needs. Fellow directors include Dr Peter Boylan Master of the National Maternity Hospital at Holles St in Dublin.
Since its establishment in 1993, EIWH has been involved in a number of research and educational projects: a survey of Irish women's health needs, an information pack on women specific cancers, the "Cancom Project" Europe Against Cancer. Later this year it will launch one of its biggest programmes to date: a policy paper entitled Women in Europe - Towards Healthy Ageing.
Europe has the highest proportion of older women in the world and by 2010, one in four women will be over 60. While seeing this as a positive trend, EIWH fears that without planning and action, such a marked demographic change will engender serious social, medical and economic consequences.
The problem is that European countries still operate health policies which rely on the bulk of citizens living no longer than their allotted three score years and ten. And, as most countries still put immense obstacles in the way of women who want to combine family and work responsibilities, women's earnings, savings and pension contributions tend to be much lower than men's, right across Europe. In short, those who are living longest have the least means to support themselves in a dependent old age.
"Dependence has physical, economic, psychological and social dimensions that not only tax medical and community services but also have a powerful negative impact on the quality of women's lives," says the report. Many women are also unpaid carers, responsible for spouses and ageing parents. When older women are impaired, their whole family suffers.
THE report focuses on four major health problems - coronary heart disease, cancer, osteoporosis and depression, all issues which "have a particularly strong impact on women in their middle and later years - and recommends programmes of action for dealing with each.
EIWH is anxious to stress that disease and disability, depression and dependency are not inevitable accompaniments to growing old, that good policies can and do make a difference. The buzz word in gerontology circles at the moment is "active" ageing.
"Apart from other considerations, facilitating healthy ageing makes sound financial sense," says Peggy Maguire. Health policies that enable older women maintain quality of life and remain independent benefit not just older women, but society.