Because women live longer than men, Caroline de Pauw has long believed that they live better. Also the doctor in sociology was she “skeptical” when a publishing house asked him to look into their health. “I tended to think that the priority public in terms of health was rather men, if only because women are in the majority during prevention operations, in particular screening”, she explains. Released in the summer of 2022, his guide to Women’s Health (Ed. Mango) proves that they are not better off. Quite the contrary.
“While women are more concerned about their health, surveys show that they are the first to give up care, often for the benefit of their family or their work”, reports the sociologist, also director of the URPS (Regional Union of Health Professionals) liberal doctors of Hauts-de-France. And when they consult, it is not uncommon for their symptoms to be disregarded. “They are still told that such and such a pain is in the head », summarizes Caroline de Pauw, regretting that women are often still perceived as “a fragile little thing”.
The woman, an “exception to the rule”
For Muriel Salle, professor of history at the Institute of Political Studies in Lyon (1), these stereotypes are the legacy of a medicine “androcentric”made by men for men. “Since the birth of the clinic, that is to say roughly the 19the century, medicine takes the human body as its standard. This does not mean that the woman is ignored, but she is thought of as an exception to the rule. However, in medicine as in grammar, we retain exceptions less well. raises the historian.
And “perception bias” which scientific writings still abounded not so long ago. “Until the 2000s, for example, we read that the embryo, by default, was male. The female embryo was seen as a developmental variation. illustrates Muriel Salle, for whom this relegation to the background directly harms the health of women, whose specificities have long been ignored.
“France claims a beautiful model, that of equal access to health for all, but this universalism tends to deny certain differences, particularly biological ones”, points out Caroline de Pauw. Because men and women are not equal in the face of certain risks, such as addiction. « C’est particularly marked for tobacco and alcohol, to which women are predisposed to become addicted more quickly and at lower doses than men, says the sociologist. Manufacturers have also understood this and are increasingly taking the female public as their marketing target. »
Biological and above all social differences
Prevention messages are not always appropriate. “Most women smoke and drink to manage their stress and daily life, making them feel guilty is useless”, believes the sociologist, for whom we should first tackle the causes of this overconsumption: their living conditions. “Women represent 85% of single-parent families living below the poverty line. How do you want to take care of yourself and your health when you spend your time wondering what your children will be able to eat? »
For Catherine Vidal, neurobiologist and author in 2020 of a report for the High Council for Equality, which is authoritative on the subject (2), this social dimension is decisive in access to care and support for women. “Certainly, there are differences between the sexes – at the genetic, cellular, hormonal level… – but the influence of gender is mainly reflected in the inequality of access to care, and this inequality stems primarily from factors social, economic and cultural, insists the researcher, also a member of the Inserm ethics committee, where she co-directs the “Gender and health research” group.
Precariousness and depression
According to her, depression, which affects twice as many women, is the best proof of this. “For too long, we have been content to caricature the woman, weakened by her hormones and her mood swings. Now, many studies show that this difference in prevalence is directly related to the socio-economic level. But women are the first victims of precariousness. underlines the specialist, who also cites the weight of violence on their physical and mental health.
“These realities are documented, based on recent scientific work and carried out in France as well as in the United States, Canada, Germany or England”, continues Catherine Vidal. Clear, “It’s not activism”. “And it’s not a zero-sum game: working more on women’s health does not mean that we are going to neglect men’s health”, would like to clarify Muriel Salle.
According to these specialists, certain signs show that the subject is gaining visibility in France. Thus the national strategy to combat endometriosis, launched in January 2022. « It’s not a women’s problem, it’s a society problem.” had then launched Emmanuel Macron. “Obviously, there is a political opportunity for the president, but on the ground, support channels are really being put in place, rejoices Caroline de Pauw. And above all, the word of women, who had understood that suffering during menstruation or sexual intercourse was normal, is freed. »
A step forward that Muriel Salle also welcomes, while regretting a late realization. “The first description of endometriosis dates back to the 19e century “recalls the historian. Today, it is estimated that the disease affects one in ten women.
———
Some numbers
In France, the life expectancy of women at birth is 85.4 years in 2021, compared to 79.3 years for men, according to DREES.
The gap should gradually narrow according to INSEEwhich calculates that girls born in 2022 will live to be 93 on average compared to 90 for boys, or three years longer.
Cardiovascular diseases (heart attack and stroke) are the leading cause of death in women, ahead of cancer.
Cancers of the cervix and breast are the most common, but that of the lung is the deadliest.
12% of women suffer from depressive syndrome, estimates INSEE, against 9% of men.