The Health Crisis

Oct 20

13 min read

Women's health suffers not only from the conditions women live with, but from the symptoms, inequalities and family histories that nobody has thought to put together.

A woman in her thirties visits her GP repeatedly because she is exhausted. She is advised to manage her stress and improve her sleep. A senior executive in her fifties develops heart palpitations, joint pain and difficulty concentrating, leaving her wondering whether the professional confidence she has spent decades building is beginning to disappear.

Her mother, now in her seventies, has lived for years with hypertension, chronic pain and limited mobility, rarely questioning whether her conditions could have been investigated or managed differently.

These three women represent different generations, but their experiences reveal a common weakness in how healthcare can be organised. When symptoms are addressed through separate appointments, family medical histories remain incomplete and women's wider circumstances receive limited attention, who is looking at the whole picture?

Modern medicine has become increasingly sophisticated at treating individual conditions, yet women can still find themselves navigating healthcare systems in which specialists concentrate on separate symptoms, appointments are difficult to coordinate and responsibility for connecting information falls disproportionately on the patient. The deeper issue is whether healthcare systems are designed to recognise the complexity of women's lives or whether women are expected to compensate for the gaps through persistence, personal resources and extraordinary resilience.

For Black women, these challenges can intersect with documented healthcare inequalities, cultural expectations, economic pressures and professional environments where resilience is admired but vulnerability may be misunderstood. This does not mean every Black woman shares the same health experiences or family circumstances. It means that patterns in clinical research and healthcare outcomes deserve investigation rather than explanations that place responsibility entirely on women themselves.

Women Are Living Longer, But Are They Living Healthier?

In 2024, the World Economic Forum and McKinsey Health Institute published Closing the Women's Health Gap: A $1 Trillion Opportunity to Improve Lives and Economies. Their analysis estimated that women spend approximately 25% more time in poor health than men, despite generally living longer. The researchers also projected that addressing gaps in women's healthcare could contribute at least $1 trillion annually to the global economy by 2040 through improved health and economic participation.

Although the economic figure is a modelled projection, its implications are significant. Longer life expectancy does not necessarily translate into more years of good health, particularly when women spend substantial periods managing chronic conditions, persistent symptoms or limitations that affect everyday functioning.

The report also examined weaknesses in medical research, clinical effectiveness and healthcare delivery. Historically, some areas of women's health have received insufficient research attention, while differences in symptoms, disease progression and treatment responses have not always been adequately recognised.

For a woman managing a business, leading an organisation or supporting several generations of her family, the consequences of poor health extend beyond the consulting room. They can influence earning capacity, professional progression, financial independence and the ability to make choices about how she lives and works.

This creates an important distinction between treating women's health as an individual wellbeing concern and recognising it as part of the infrastructure supporting women's economic participation.

What the SWAN Study Reveals About Black Women and Midlife Health

One of the most influential research programmes examining women's midlife health is the Study of Women's Health Across the Nation, commonly known as SWAN. Established in the United States in 1996, the longitudinal study recruited 3,302 women from five racial and ethnic groups to investigate the biological, psychological and social changes associated with ageing and menopause.

A 2015 study led by Nancy Avis and published in JAMA Internal Medicine examined the duration of frequent vasomotor symptoms, including hot flushes and night sweats. The researchers found a median total symptom duration of 7.4 years across the study population, challenging the popular assumption that menopause symptoms necessarily represent a brief transition.

For African American women in the study, the median duration was approximately 10.1 years, the longest reported among the racial and ethnic groups examined. The finding is particularly relevant because prolonged symptoms may coincide with years when women are managing demanding careers, business responsibilities and significant family commitments.

Consider the executive in her fifties from our opening example. She may be leading a team, negotiating contracts or making decisions that affect hundreds of employees while experiencing disrupted sleep and other symptoms that deserve medical attention. Without an appropriate clinical assessment, she may interpret changes in concentration or energy as evidence that she is losing professional capability.

SWAN has also investigated relationships between midlife health, socioeconomic circumstances, stress and discrimination. Its findings reinforce the importance of understanding menopausal experiences within the wider circumstances of women's lives rather than treating ethnicity as a simple biological explanation.

Although SWAN is American research, its findings provide valuable questions for UK healthcare. Evidence from British research and national reviews also demonstrates that ethnic inequalities influence healthcare experiences and outcomes, although the precise findings cannot automatically be transferred between countries.

For employers, the implication is equally important. When women experience persistent health symptoms, the appropriate response should not be to question their professional competence without considering whether clinical assessment, treatment or workplace support could address the difficulty.

When Resilience Becomes An Institutional Expectation

Resilience as a personal capability is not the same as resilience as an institutional expectation, and the difference matters.

Resilience as a capability can help women navigate adversity, build businesses, support families and overcome professional barriers. Resilience as an institutional expectation can become an excuse for overlooking their needs, particularly when women are assumed to be capable of managing difficult circumstances without additional support.

Professor Cheryl L. Woods-Giscombé, a nurse researcher at the University of North Carolina at Chapel Hill, explored these tensions in her 2010 study, Superwoman Schema: African American Women's Views on Stress, Strength, and Health, published in Qualitative Health Research.

Her research identified themes including the obligation to demonstrate strength, resistance to vulnerability, emotional suppression, determination to succeed and responsibility for helping others. These expectations could provide psychological protection while also creating pressures that affect wellbeing and attitudes towards seeking support.

The research helps explain why cultural expectations deserve attention, but it also raises a question about institutional behaviour. What happens when employers interpret a woman's history of coping under pressure as evidence that she requires less support than others?

A founder who continues working through persistent pain may be praised for her dedication. The senior executive who conceals symptoms may be admired for her composure or a woman caring for several relatives may be celebrated for her commitment while her own health needs remain unaddressed. Their resilience can become a convenient substitute for the support they should reasonably expect.

This matters particularly when professional credibility has been hard won. Women who have experienced stereotypes or unequal scrutiny may be concerned that disclosing a health problem will alter how colleagues interpret their judgement, ambition or leadership potential.

Cultural intelligence requires healthcare professionals and employers to recognise these pressures without stereotyping the women experiencing them. More importantly, it requires institutions to examine whether their practices reward women for enduring conditions that should have prompted appropriate support.

What Did Our Mothers And Grandmothers Accept As Normal?

Return to the mother in her seventies.

She may remember a time when menopause was rarely discussed, menstrual pain was treated as an unavoidable part of womanhood and medical decisions were seldom questioned. Her daughter may have entered professional life when employers offered little recognition of women's midlife health, while her granddaughter now has access to digital health information that previous generations could scarcely have imagined.

Each generation has inherited different knowledge, but access to more information does not necessarily mean women are better equipped to interpret it.

Family conversations influence what women consider normal long before they seek medical advice. If several generations have experienced severe menstrual pain without receiving a diagnosis, younger women may assume that similar symptoms are simply something to endure. Yet persistent or debilitating pain may warrant investigation for conditions such as endometriosis, fibroids or other gynaecological problems.

The same principle applies to menopause, cardiovascular disease and chronic conditions. Experiences that were normalised within a family may reflect limited access to information or treatment rather than an accurate understanding of what is medically inevitable.

There is also a clinically important distinction between inherited beliefs and family medical history. Information about conditions such as diabetes, cardiovascular disease and certain cancers among close relatives can help clinicians assess risk when considered alongside other relevant factors.

Yet many women know that a parent or grandparent was seriously ill without knowing the diagnosis, age of onset or whether other relatives experienced similar problems. This missing information may limit opportunities for informed discussions about risk and prevention.

For the younger woman in her thirties, a conversation with her mother and grandmother may reveal health experiences that neither had previously considered relevant. For her mother, the same discussion may provide an opportunity to reconsider symptoms she has accepted for years.

Intergenerational health literacy should therefore involve more than passing down advice. It should create opportunities to compare family experience with contemporary clinical evidence, recognise possible patterns and understand when professional assessment is appropriate.

The question is whether the next generation will inherit only the stories of what previous generations endured or also the knowledge that helps them make more informed decisions about their health.

The Health Inequality That Cannot Be Explained Away

MBRRACE-UK figures published in 2026 provide a stark reminder that access to healthcare does not guarantee equitable outcomes. The National Perinatal Epidemiology Unit at the University of Oxford reported that, during 2022–2024, women from Black ethnic backgrounds in England had 2.72 times the maternal mortality risk of White women. The 95% confidence interval was 1.80–4.00, indicating a substantial and statistically significant disparity.

The same analysis revealed another important inequality. Women living in the 20% most deprived areas of England experienced almost twice the maternal mortality rate of those living in the 20% least deprived areas, with a rate ratio of 1.94. These findings demonstrate why healthcare inequalities cannot be understood through ethnicity, income or geography in isolation. The circumstances influencing health are interconnected, and effective responses must recognise that complexity.

The 2026 MBRRACE-UK report, Saving Lives, Improving Mothers' Care, also reinforces the article's central argument. Its recommendations emphasise coordinated working across healthcare services, better communication and the importance of recognising clinical deterioration promptly. The message is significant because the need for joined-up care is not simply an observation drawn from women's personal experiences; it is supported by findings from a national confidential enquiry into maternal deaths.

Maternal mortality represents a specific clinical outcome and should not be treated as evidence that identical disparities exist across every area of women's healthcare. Nevertheless, these findings raise questions about how healthcare systems recognise risk, coordinate treatment and respond to women whose circumstances involve multiple clinical and socioeconomic pressures.

The NHS Race and Health Observatory's 2022 review, Ethnic Inequalities in Healthcare, identified inequalities across maternity services, mental healthcare and other areas of NHS provision. Taken together, these findings reinforce the importance of examining not only whether women can access services, but whether the care they receive is timely, appropriate and sufficiently coordinated.

For Black women, culturally informed healthcare should mean that symptoms receive appropriate investigation, communication reflects individual circumstances and clinical decisions are not influenced by stereotypes. It should also mean that responsibility does not end once a woman has successfully obtained an appointment. The quality, continuity and effectiveness of the care she receives matter just as much.

When Several Conditions Collide, Who Is Connecting The Evidence?

Think again about the mother in her seventies. Her blood pressure is reviewed by her GP, her chronic pain is addressed through another service and her mobility difficulties are assessed by a physiotherapist. Each professional may be providing appropriate care, but has anyone examined how her conditions and medications interact, whether treatments are creating additional difficulties or which outcomes matter most to her?

This is the challenge of multimorbidity, the coexistence of two or more long-term health conditions. NICE guideline NG56, Multimorbidity: Clinical Assessment and Management, recommends an individualised approach that considers treatment burden, quality of life, medication and the patient's priorities.

For women living with several conditions, fragmented care can create a substantial administrative burden. Appointments must be arranged, prescriptions understood, information communicated between services and transport organised. These responsibilities become particularly demanding when someone is also working, caring for relatives or managing financial constraints.

The woman in her seventies may be receiving clinically appropriate treatment for each condition while still lacking a coordinated plan that reflects her overall health and independence. Her daughter may be helping to organise appointments while simultaneously managing her own menopausal symptoms and professional responsibilities. The younger woman may eventually become responsible for navigating the same systems without having received a clear account of her family's medical history.

Connected care does not require every symptom to have a common cause. It requires healthcare professionals to recognise possible interactions, review treatments appropriately and ensure that the patient understands who is responsible for coordinating her care.

Who Pays When Women's Health Is Not Properly Supported?

Consider the executive in her fifties. She has spent decades building professional credibility, developing expertise and taking responsibility for important organisational decisions. Yet persistent symptoms are affecting her sleep and concentration, and she is beginning to question whether she can continue operating at the same level.

Her organisation may have invested considerably in her leadership development while offering limited practical support for the health-related circumstances affecting her working life.

The Fawcett Society's 2022 Menopause and the Workplace research reported that one in ten women surveyed who had worked during menopause had left a job because of their symptoms. This finding illustrates how health-related difficulties can influence employment decisions, particularly where appropriate workplace support is unavailable.

For founders, the consequences can be more immediate. A woman whose business depends heavily on her personal availability may experience interrupted revenue, missed opportunities or additional costs when health problems prevent her from working. For senior professionals, reduced hours or interrupted careers may affect lifetime earnings, progression and pension contributions.

The economic consequences become more complicated when women are simultaneously supporting ageing parents, adult children or relatives living with long-term conditions. A daughter who reduces her working hours to care for her mother may experience financial pressures of her own, while the mother may require additional assistance because her conditions have not been sufficiently coordinated.

This is particularly relevant to women in their forties, fifties and sixties who are navigating demanding careers alongside substantial family responsibilities. Their health decisions may be influenced by whether they can arrange replacement care, afford time away from work or access appointments without sacrificing essential income.

These pressures demonstrate why advice about prioritising personal wellbeing cannot be separated from the resources available to act on that advice. Two women with similar symptoms may face very different practical choices because their employment arrangements, financial circumstances and caring responsibilities differ.

For employers, the commercial question is whether workplace policies support the retention and advancement of experienced women or create avoidable barriers when health needs arise. For founders, it is whether operational resilience, delegation and contingency planning are sufficient to protect both personal wellbeing and business continuity.

Women's health belongs within conversations about leadership sustainability because organisations cannot fully benefit from women's expertise while overlooking the circumstances that influence their ability to remain economically active.

Will Artificial Intelligence Close the Health Gap or Reproduce It?

Artificial intelligence, digital symptom tracking and remote monitoring are creating new possibilities for women's healthcare. These technologies may help identify patterns, improve communication with clinicians and support chronic disease management, but their effectiveness depends on the quality and representativeness of the data used to develop them.

In 2019, research by Ziad Obermeyer and colleagues, published in Science, demonstrated how a healthcare risk algorithm used in the United States produced racial bias because healthcare expenditure had been used as a proxy for medical need. The algorithm underestimated the needs of Black patients because historical spending did not accurately reflect their underlying health requirements.

Although the study did not investigate a women's health diagnostic tool, it illustrates how technological systems can reproduce existing inequalities when the assumptions informing their design are flawed.

For Black women, older women and those managing multiple conditions, the development of digital healthcare raises questions about research representation, clinical validation and accessibility. The woman in her thirties may be comfortable recording symptoms through an application, while her grandmother may require assistance accessing online appointments or interpreting digital correspondence. Neither experience should determine the quality of care available to them.

Innovation should therefore be judged by whether it improves clinical outcomes and access across different populations, not simply by its technological sophistication.

What Women Can Do When Healthcare Feels Disconnected

While responsibility for clinical quality and coordinated care rests with healthcare institutions, women can benefit from having practical information available when discussing their health.

Before a GP appointment, recording when symptoms began, how frequently they occur, what makes them better or worse and how they affect daily life can help communicate concerns clearly. Bringing an up-to-date list of prescribed medicines, over-the-counter treatments and supplements can also support safer clinical decisions, particularly when several conditions are being managed.

For women receiving care from different services, it may be useful to ask whether a medication review or coordinated care plan is appropriate, who is responsible for following up test results and whether one treatment could be affecting another condition.

Family conversations can provide additional information. Understanding whether close relatives experienced cardiovascular disease, diabetes, certain cancers or other significant conditions, together with their approximate ages at diagnosis, may help clinicians assess relevant risks.

These steps do not replace medical assessment, nor should women be expected to diagnose themselves. Their purpose is to support informed conversations while ensuring that clinical responsibility remains with qualified healthcare professionals.

The larger objective is a system in which women do not need exceptional organisational skills, financial resources or persistence simply to receive appropriately coordinated care.

What Should The Next Generation No Longer Have To Endure?

Women's health deserves the same intellectual seriousness, cultural intelligence and strategic attention that we bring to leadership, entrepreneurship and economic empowerment.

The experiences of women across generations offer an opportunity to examine how medical knowledge, cultural expectations and healthcare systems have changed. Older women may hold valuable information about family histories and previous experiences of treatment, while younger women may bring greater access to contemporary research and digital resources. Healthcare professionals can help distinguish clinical evidence from inherited assumptions, creating a more informed conversation about prevention, diagnosis and appropriate care.

The exhausted woman in her thirties, the executive in her fifties and her mother in her seventies should not each have to discover alone what the others already know. Their experiences may be different, but the knowledge gained from one generation should help inform the decisions available to the next.

As we open this discussion, consider what the women in your family taught you about managing illness, pain, menopause or asking for medical help. Were there symptoms that previous generations accepted as normal but which you now believe deserved greater medical attention? What information would have changed their experiences, and what should younger women understand differently today?

We welcome perspectives from women across generations, healthcare professionals, carers, founders and senior leaders. You don't need to share personal medical details to take part. The value lies in examining the beliefs, barriers and systems that influence women's experiences of healthcare.

The measure of progress will not be how much more we know about women's health, but how effectively that knowledge changes the care women receive and what the next generation no longer has to endure.

How many women in your family have experienced symptoms that were treated separately, only for another generation to encounter similar health concerns years later? What might change if healthcare professionals connected those experiences rather than examining each one in isolation?

We want to hear your perspective.

Like this post, if you believe women's health deserves more joined-up thinking, comment on the changes you believe healthcare professionals and policymakers need to make and share this article with women, colleagues and decision-makers who should be part of this conversation. Your experience, professional insight or family history could raise a question that others have never considered.