Sex and gender in health research: Australia lags behind

A consortium of leading research institutions and universities, including UNSW Sydney, have sent a stark warning that Australian medical research is in danger of falling behind its global competitors when it comes to sex and gender analysis in medical research.

In a report published today in the Medical Journal of Australia, researchers point out that higher healthcare costs due to unnecessary tests and treatments, and poorer quality of care are other unwelcome consequences of failing to account for differences in the way men and women experience common diseases and respond to therapy.

Amongst the paper's authors are representatives of leading educational institutions, including UNSW, University of Sydney, University of Melbourne, Monash University, University of Queensland, Macquarie University and La Trobe University as well as the Australian Human Rights Commission and the National Heart Foundation.

Dr. Cheryl Carcel, Clinical Research Fellow at The George Institute for Global Health and Conjoint Senior Lecturer at UNSW, said that while growing numbers of countries have introduced policies and practices which require the integration of sex and gender analyses in competitive research grants and/or publications in journals, few equivalent policies or practices exist here.

Although all Australian Government departments and agencies were required to align their business practices with guidelines on the recognition of sex and gender by 1 July 2016, Dr. Carcel said researchers found that eight of Australia's top ten research funding agencies and four of the nation's top ten journals still did not have policies on the collection, analysis and reporting of sex- and gender-specific health data.

"Australian medical research has fallen behind North America and Europe in recognizing sex and gender as a key determinant of health, and its importance for health research and improved health outcomes," Dr. Carcel said. "Failure to keep pace with the rest of the world will see Australia become increasingly less competitive when applying for funding from international bodies and reduce international partnership opportunities with overseas organizations."

Professor Louise Chappell, Director of the Australian Human Rights Institute at UNSW Sydney, said overlooking gender- and sex-specific analyses is an ethical issue.

Equal rights

"Men and women have an equal right to the highest attainable standard of physical and mental health," Professor Chappell said. "Ensuring we research men and women's medical issues equally will help to achieve this important human right for all."

Head of Public Health and Medical Director at Bupa Australia, Dr. Zoe Wainer, said that across a broad-range of health areas, data have been collected from men and generalized to women, but a growing body of research shows that this approach was no longer appropriate.

Dr. Wainer said it is known that differences exist between men and women for conditions that cause the greatest health burden in Australia and globally, including cancer, cardiometabolic disease, mental illness and substance use, and dementia.

"While Australian researchers are at the forefront of expanding the global knowledge base on sex and gender differences in health, we clearly need to do better in translating that into practice," she said.

Dr. Wainer added that it was time for stakeholders across the board to ensure that health research and the medical profession that relies on it reflects current evidence to deliver the best health outcomes and most efficient care for Australians.

"We're calling on universities and other training institutions, learned academies and professional societies, governments, medical and health research funders, peer-reviewed journals and industry to address this gap in medical research and ensure that Australian science continues to be world leading," said Dr. Wainer.

"This is not simply a women's or men's health issue, but an issue for all Australians."