Paula Johnson: His and hers ... healthcare

Summary

The speaker recounts her grandmother's struggle with depression, highlighting the importance of recognizing sex differences in health. She emphasizes the need for further research and clinical application to address these disparities, particularly in diseases like heart disease and lung cancer. The talk calls for a collective effort to improve women's health, suggesting that it's an equal rights issue and a matter of scientific integrity.

Takeaways

• 👵 The speaker's grandmother's experience with depression sparked a lifelong quest to understand sex differences in health.
• 🌍 The grandmother's love for travel and life contrasted with her later struggle with severe, undiagnosed depression.
• 🏥 The medical community's lack of understanding of depression, especially in women, was highlighted by the difficulty in diagnosing the grandmother's condition.
• 🔍 Women are 70% more likely to experience depression in their lifetimes compared to men, yet are often misdiagnosed.
• 👩‍⚕️ The speaker leads a center focused on discovering why sex differences in health occur and using that knowledge to improve women's health.
• 🧬 The concept that 'every cell has a sex' implies that biological sex influences health at the cellular and molecular levels.
• 📊 The inclusion of women in clinical trials has improved our understanding of sex differences in disease, but more research is needed.
• ❤️ Heart disease, a leading cause of death in women, is often misdiagnosed due to sex differences in symptoms and disease presentation.
• 💊 A landmark study on heart disease treatment effectiveness was hindered by the lack of sex-specific analysis in clinical trials.
• 🚫 Nonsmoking women are three times more likely to be diagnosed with lung cancer than nonsmoking men, indicating sex differences in disease susceptibility.
• 🧠 Research into sex differences in brain function related to mood disorders like depression is crucial for developing effective treatments.

Q & A

What was the speaker's childhood relationship with her grandmother like?

The speaker cherished her childhood memories of spending time with her grandmother, Mamar, in Brooklyn, New York. Her grandmother's apartment was an oasis where she could enjoy warm milk with a touch of caffeine, which she called 'coffee.' They would look at pictures from her grandmother's travels, dance to her favorite music, and share special moments.

What significant change occurred in the speaker's grandmother's life when she was 60?

At the age of 60, the speaker's grandmother stopped working, traveling, and dancing. She no longer engaged in their usual activities like having 'coffee times' together. This change was a result of her developing depression, which went undiagnosed for a long time.

Why did the speaker's family struggle with her grandmother's health?

The speaker's family struggled because her grandmother's depression was not diagnosed for a long time, and even when it was, it was a condition that was not well understood at the time. The care for her grandmother became all-consuming, affecting the family's daily life and work.

What is the current understanding of sex differences in depression?

Today, it is known that women are 70 percent more likely to experience depression over their lifetimes compared to men. However, women are also misdiagnosed between 30 and 50 percent of the time. The symptoms of depression in women, such as fatigue, sleep disturbance, pain, and anxiety, are often overlooked.

How has the inclusion of women in clinical trials impacted medical research?

The inclusion of women in clinical trials, mandated by the NIH Revitalization Act of 1993, has led to the discovery of major differences in how women and men experience disease. This has improved the understanding of sex differences in health but also revealed that these differences are often overlooked in clinical care.

What is the significance of the term 'every cell has a sex'?

The term 'every cell has a sex,' coined by the Institute of Medicine, signifies that there are biological differences between men and women at the cellular and molecular levels. These differences are present across all organs, from the brain to the heart, lungs, and joints.

Why is it important to consider sex differences in heart disease?

Sex differences in heart disease are important because the typical presentation of the disease can look different in women compared to men. Women may have more diffuse plaque along the artery, which can be harder to detect with standard tests like cardiac catheterization. This can lead to misdiagnosis and inadequate treatment.

What was the outcome of the study that aimed to find the most effective treatments for heart disease in women?

The study found that 65 percent of the papers written over a 10-year period had to be discarded because they did not differentiate between women and men in their analysis, even though women were included in the studies. This highlighted a significant lost opportunity in understanding effective treatments for women.

How do sex differences in lung cancer present in nonsmoking women?

Nonsmoking women are three times more likely to be diagnosed with lung cancer than nonsmoking men. Interestingly, when women are diagnosed, their survival rates tend to be better than those of men, possibly due to certain genes in lung tumor cells that are activated mainly by estrogen.

What is the potential impact of considering sex differences in medical research and treatment?

Considering sex differences in medical research and treatment can lead to more personalized and effective care. For example, a new lung cancer drug was found to be more effective in women because it targeted genetic mutations that were more common in them. This approach can improve health outcomes for both women and men.

What steps can individuals take to promote awareness and improve women's health?

Individuals can promote awareness and improve women's health by thinking about women's health with the same importance as other causes they care about and by asking doctors if there are differences in disease or treatment between women and men. This encourages doctors to consider sex differences and seek out relevant information.