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clinical practice. s going to take time and derable concerted ts to see meaningful ress in addressing imination, r-representation and h disparities, but it’s ble to bring about ge.” e stark gender gap is rated by the perception all heart attacks feature crushing chest pain that radiates down the left arm and into the jaw. But these symptoms are predominantly male.

A heart attack in a woman is more likely to feature dizziness, nausea and back pain which, because of lack of public and medical awareness, results in fewer women seeking help. Those that do are less likely to get the correct treatment in time.

“More men die of heart disease, and at a younger age, but if we only understand it as a man’s disease, it doesn’t help women,” says Dr Babu-narayan, a consultant cardiologist at the Royal Brompton Hospital in London. The BHF Bias and

Biology Report, which examined the heart attack gender gap, estimated that a combination of inequalities led to at least 8,243 preventable female deaths in England and

Wales over a decade.

The inequalities are evident in every major condition, from diabetes and cancer to chronic pain and mental health – even in female-centric areas like pregnancy and childbirth.

Professor Neena Modi, Professor of Neonatal Medicine at Imperial College London and Consultant in Neonatal Medicine at Chelsea and Westminster NHS Foundation Trust, highlights the lack of new medicines for use in pregnancy – only one in the past 30 years – and how pregnant women were excluded from initial Covid vaccine trials.

“It was the most graphic and telling example of the way in which women have been and continue to be disadvantaged,” she says. “There was absolutely no biological or scientific reason to exclude pregnant and breastfeeding women.

“In consequence, these women were put in the absolutely terrible position of having to decide to stop breastfeeding, which is detrimental to the baby, and have the vaccine, or continue breastfeeding and not have the vaccine which is detrimental to their own health.”

Arjun Panesar, CEO of digital health pioneers DDM Health, says: “At the heart of these gender disparities lies a historical imbalance in clinical research – a tilt towards male-centric studies.

“This bias has cast a long shadow, leaving a gap in our understanding of how diabetes uniquely affects women and how treatments should be tailored differently.

“The data deficit extends to gender-specific responses to treatments, interactions of diabetes with women’s health issues like pregnancy and menopause, and the broader social and psychological impacts.” The Message project, funded by the Wellcome Trust, has worked with research funders, regulators, researchers, patient and public groups, academic publishers, and the Department of Health and Social Care to co-design a sex and gender policy framework that will revolutionise the UK medical research sector.

The Government has also launched a Women’s Health Strategy in order to address a range of disparities that taint research and clinical trials, healthcare education and training, and policies and services.

Professor Modi adds: “We are moving in the right direction and it is great that the Government has a strategy but they need to be held to account for implementing it. These disparities have well recognised life or death consequences and there is no excuse not to tackle them.”

Dr Womersley, who is also an NHS doctor in psychiatry, says: “The Message project is a clear indication that change is happening and we now need to see a clinical impact with women receiving better care and outcomes.

“I think there is a problem with trust at the moment and many women feel they are invisible or that their experience is not taken seriously enough by medical professionals.

‘‘ Inequalities are evident in every major condition, from cancer to chronic pain