2024世界经济论坛-缩小女性健康差距：1万亿美元改善生活和经济的机会（英）.docx

WOR1.DECONOMICFQRUMIncollaborationwiththeMcKinseyHealthInstituteClosingtheWome5sHealthGap:A$1TrillionOpportunitytoImprove1.ivesandEconomiesINSIGHTREPORTJANUARY2024Images:GettyImagesContentsForeword3Executivesummary4Introduction51. Theroleofscienceinaddressinghealthdisparities92. Datagapsunderestimatewomen'shealthburden,limitinginnovationandinvestment133. Creatingsex-andgender-responsivecaredeliverysystems164. Directinginvestmentstowardswomen,shealth205. Closingthewomen'shealthgapcouldbsttheglobaleconomy246. Calltoaction:Howtoclosethewomen'shealthgap30Conclusion34Contributors35Endnotes36DisclaimerThisdocumentispublishedbytheWorldEnomicForumasacontributiontoaproject,insightareaorinteraction.Thefindings,interpretationsandconclusionsexpressedhereinarearesultofacollaborativeprocessfacilitatedandendorsedbytheWorldEconomicForumbutwhoseresultsdonotnecessarilyrepresenttheviewsoftheWorldEconomicForum,northeentiretyofitsMembers,Partnersorotherstakeholders.©2024WorldEomicForum.Allrightsreserved.Nopartofthispublicationmaybereproducedortransmittedinanyformorbyanymeans,includingphotopyigandrecording,orbyanyinformationstorageandretrievalsystem.January2024ClosingtheWomen'sHealthGap:A$1TrillionOpportunitytoImprove1.ivesandEconomiesForeword1.ucyP6rezSeniorPartner.McKinsey&Company;Affiliated1.eader,McKinseyHealthInstitute,USAShyamHeadCentreHealthM(Hiit)C-Ioflh(?，eCji-IHWurldForum，Foralltheeffortstoimprovegenderequityoverthepastcentury,thegapbetweenmen'shealthandwomen'shealthremainswide,whetherit'sinresearch,data,careorinvestment.Andeverypersonontheplanetisaffectedbythewomen'shealthgap,whethertheyknowitornot.Whenweconsidertheimpactofclosingthegap,wearenotjusttalkingaboutwomen'slives,butthoseofpeoplewelove,ourcommunitiesandtheworldatlarge.Weknowit,spossibletoreachequityinhealthformenandwomen.Inthisreport,ClosingtheWomen'sHealthGap:A$1TrillionOpportunitytoImprove1.ivesandEconomies,we'repleasedtoshowcasehowthenarrowingofthewomen'shealthgapwouldallow3.9billionwomentolivehealthier,higher-qualitylives.Itcouldalsoallowatleast$1trilliontobepumpedintoenomicproductivityannually,whichreflectshownarrowingthegapwouldleadtofewerearlydeaths,fewerhealthnditions,extendedeconomicandsocietalcapacitytocontribute,andincreasedproductivity.Ofthat,thelargestimpactwouldbecreatedfromwomenhavingfewerhealthconditions,lettingthemavoid24millionlifeyearslostduetodisabilityandboostingeconomicproductivitybyupto$400billion.Women'shealthencompassesmorethanwomen-Specificconditions,andachievinghealthequityispossiblewithintentional,coordinatedefforts.Whiletherearemanyways,largeandsmall,forawiderangeoforganizationstoimprovewomen'shealth,specificactionscouldcreatemeaningfulimpact.Amongtheseareinvestinginwomen-centricresearch;collectingandanalysingsex-,ethnicity-andgender-specificdata;enhancingaccesstogenderspecificcare;creatingincentivesfornewfinancingmodels;andestablishingbusinesspoliciesthatsupportwomen'shealthandstrengthenwomen'srepresentationindecision-making.Weinviteleadersfromthepublic,socialandprivatesectorstoreviewthisreportandfindwaystobringtheirowncontributionstofillingthegapinwomen'shealthoutlinedhere.Weareexcitedtoseerecentmomentuminaddressingthisgap,suchasthedebutoftheWomen'sHealthInnovationOpportunityMap;,therecentcreationoftheWhiteHouseInitiativeonWomen'sHealthResearch;thelaunchoftheWomen,sHealthInterestGroupfromtheEuropeanInstituteofWomen'sHealth;andnewsthatAustraliaisontracktobecomeoneofthefirstcountriestoeliminatecervicalcancer.Inthismulti-yearresearcheffort,theanalysisbacksuponeofthecorebeliefsofeveryoneinvolved:thatweallhavearoletoplayinimprovingwomen'slives.AsNobelPrizewinnerMalalaYousafzaioncesaid,Wecannotsucceedwhenhalfofusareheldback."ExecutivesummaryInvestmentsaddressingthewome,shealthgapcouldaddyearstolifeandlifetoyears-andpotentiallyboosttheglobaleconomyby$1trillionannuallyby2040.Whendiscussingthechallengesinwomen'shealth,acommonrejoinderisthatwomen,2onaverage,livelongerthanmen.Butthisneglectsthefactthatwomenspend25%moreoftheirlivesindebilitatinghealth.Addressingthegapsandshortcomingsinwomen'shealthcouldreducethetimewomenspendinpoorhealthbyalmosttwo-thirds.Thishasthepotentialtohelp3.9billionwomenlivehealthier,higher-qualitylivesbyaddinganaverageofsevendaysofhealthylivingforeachwomanannually,addinguptopotentiallymorethan500daysoverawoman'slifetime.Beyondthesocietalimpactsofhealthierwomen,includingmoreprogressionineducationandIntergenerationalbenefits,3improvingwomen'shealthcouldalsoenablewomentoparticipateintheworkforcemoreactively.Thiswouldpotentiallyboosttheeconomybyatleast$1trillionannuallyby2040.Theseestimates-whilesignificant-arelikelyanunderestimationgivendatalimitations.Inthisreport,women'shealthisdefinedasbiologicalconditionsandgeneralhealthconditionsthatoftenaffectwomenuniquely,differentlyordisproportionately.Therearemanyeffortstoimprovewomen'shealthglobally;however,thisreportfocusesontheeconomicimplicationsofthewomen'shealthgapandthebusinesscaseforclosingit.TherootcausesofthegapTherearefourprimaryareasthatneedtobeaddressedtoclosethehealthgap:1. Science:Thestudyofhumanbiologydefaultstothemalebody,whichhindersunderstandingofsex-basedbiologicaldifferencesandresultsinfeweravailableandlesseffectivetreatmentsforwomen.2. Data:Healthburdensforwomenaresystematicallyunderestimated,withdatasetsthatexcludeorundervalueimportantnditions.3. Caredelivery:Womenaremorelikelytofacebarrierstocare,andexperiencediagnosticdelaysand/orSuboptimaltreatment.4. Investment:Therehasbeenlowerinvestmentinwomen'shealthconditionsrelativetotheirprevalence.Thisdrivesareinforcingcycleofweakerscientificunderstandingaboutwomen'sbodiesandlimiteddatatode-risknewinvestment.Thesefactorsplayoutinmanydifferentwaysandtovaryingextentsacrossregionsandincomelevels.However,theevidencesuggeststhatnogeographicregionoragegroupisunaffected.ChartingthewayforwardMovingforwardrequiresunderstandingthebroadereffectsofthewomen'shealthgap,anddrivingactiononfivefronts:-Investinwomen-centricresearchacrosstheresearchanddevelopment(R&D)continuumtofillthegapsinunder-researched,oftenundiagnosedwomen-specificconditions(forexample,endometriosis,andpregnancyandmaternalhealthcomplications),aswellasdiseasesaffectingwomendifferentlyand/ordisproportionately(forexample,cardiovasculardisease).-Strengthenthesystematiccollection,analysisandreportingofsex-andgender-specificdatatoestablishamoreaccuraterepresentationofwomen'shealthburdenandevaluatetheimpactofdifferentinterventions.- Increaseaccesstowomen-specificcareinallareas,frompreventiontotreatment.- Createincentivesforinvestmentinareasofwomen'shealthinnovationanddevelopnewfinancingmodels.- Implementpoliciessupportingwomen'shealth,suchasacademicinstitutionsadaptingmedicalschoolcurriculaandemployerscreatingpregnancy-andmenopause-friendlyworkspaces.Anecosystemapproach,involvingmulti-sectoralstakeholders,isneededtoaccomplishthesegoals.Itispossibletocreatebetterhealthforwomen,allowinggreaterworkforceparticipationand,mostimportantly,theabilitytolivehealthierlives.IntroductionWomenspend25%moretimeinupoorhealthnthanmen.Overthepasttwocenturies,theriseinlifeexpectancy-forbothmenandwomen-hasbeenatremendoussuccessstory.Globallifeexpectancyincreasedfrom30yearsto73yearsbetween1800and2018.4Butthisisnotthefullpicture.Womenspendmoreoftheirlivesinpoorhealthandwithdegreesofdisability(the"healthspan"ratherthantheuIifespan").Awomanwillspendanaverageofnineyearsinpoorhealth,affectingherabilitytobepresentand/orproductiveathome,intheworkforceandinthecommunity,andreducingherearningpotential.BOX1:TerminologyThisreportreflectswomen'shealthasamarketsegment.Theauthorsacknowledgetheimportanceofhealthcaretothetransgender,non-binaryandgender-fluidcommunities,andthatnotallpeoplewhoidentifyaswomenarebornbiologicallyfemale.Theauthorshaveoftenusedtheterm"sexandgender"toreflectinclusivelanguageandrecognizetheneedforfutureresearchintohealthissuesthatisinclusiveofthetransgender,non-binaryandgender-fluidcommunities.Theyalsoacknowledgetheprofounddifferencesforwomenbasedonfactorssuchasrace,ethnicity,socioeconomicstatus,disability,ageandsexualorientation.Additionalworkandresearchshouldreflecthowtotacklethesebarriersalongsidetheoverallwomen,shealthgap.Inthisreport,theterm"woman"includesthoseunderage18.BuildingonpreviousworkfromtheMcKinseyHealthInstituteandtheMcKinseyGlobalInstituteanalystsquantifiedthishealthgapintermsofdisability-adjustedlifeyears(DA1.Ys),andtheextenttowhichthisdifferenceisduetotheStructuraIZsystematicbarrierswomenface(Box2,"Researchmethodology").Addressingthe25%moretimespentinapoorhealth"bywomenversusmenwouldnotonlyimprovethehealthandlivesofmillionsofwomen,butitcouldalsoboosttheglobaleconomybyatleast$1trillionannuallyby2040.Thisestimateisprobablyconservative,giventhehistoricalunder-reportinganddatagapsonwomen'shealthconditions,whichbothundercounttheprevalenceandundervaluethehealthburdenofmanyconditionsforwomen.Critically,betterhealthiscorrelatedwitheconomicprosperity.Thewomen'shealthgapequatesto75millionyearsoflifelostduetopoorhealthorearlydeathperyear(Figure1),theequivalentofsevendaysperwomanperyear.Addressingthegapcouldgeneratetheequivalentimpactof137millionwomenaccessingfull-timepositionsby2040.7Thishasthepotentialtoliftwomenoutofpovertyandallowmorewomentoprovideforthemselvesandtheirfamilies.Addressingthedriversofthisgap,namelylowereffectivenessoftreatmentsforwomen,worsecaredeliveryandlackofdata,wouldrequiresubstantialinvestment,butalsoreflectnewmarketopportunities.Whileimprovingwomen'shealthhaspositiveeconomicoutcomes,itisforemostanissueofhealthequityandinclusivity.Addressingthewomen'shealthgapcouldimprovethequalityoflifeforwomen,aswellascreatingpositiveripplesinsociety,suchasimprovingfuturegenerations'healthandboostinghealthyageing.FIGURE1:Thewomen,shealthgap2040Genderhealthgapof75millionDA1.YsEquivalenttosevendaysperwomanperyearofadditionalhealthburdenGenderhealthgapEffectivenessgapCaredeliverygapDatagapNote:Missedvaluefromundercountingwascalculatedbyaddingtheunderestimateddiseaseburdenforendometriosis(differencebetweenrealendometriosisdiseaseburdenbasedonWHOprevalenceandIHMEdiseaseweightandIHMEreportedendometriosesburden)andmenopause(differencebetweenrealdiseaseburdenbasedonprevalencesizingandPMSdiseaseweight).Source:UniversityofWashington'sInstituteforHealthMetricsandEvaluation,"GlobalBurdenofDiseaseStudy2019",women'shealthmodel,usedwithpermissionThechallengeswomenfacewhenseekinghealthcareplayoutinmultipledifferentwaysandindifferentdiseasesandsectorsofsiety.Whenlookingatthepotentialeconomicimpactofaddressingthesechallenges,allagegroupsandgeographiescouldbenefit,withmostofthepotentialcomingfromwomenintheworkingagegroup(Figure2).FIGURE2Women,shealthgapandGDPimpactbyagegroupsAgegroupAdditionalhealthylifeyears1livedin2040,inDA1.YmillionsWomen'sGDPimpactbyagegroup,GDPimpactin$billions102030405060708090+Total01659.09.31.02580%oftheGDP>impactgeneratedinworkingagegroupAround60%ofadditionalhealthy；lifeyearsgainedinworkingage9.711.Additionalhealthylifeyearsofwomenbyclosingthegenderhealthgapby2040.Source:UniversityofWashington'sInstituteforHealthMetricsandEvaluation,usedwithpermission;OxfordEconomics;International1.abourOrganizationI1.OSTATdatabase:OrganisationforEconomicCo-operationandDevelopment(OECD);Eurostat;NationalTransferAccountsproject:McKinseyGlobalInstituteanalysisEmbracingthefulldefinitionofwomen,shealthWomen'shealthisoftensimplifiedtoincludeonlysexualandreproductivehealth(SRH),whichmeaningfullyunder-representswomen'shealthburden.Thisreportdefineswomen'shealthsascoveringbothsex-specificconditions(forexample,endometriosisandmenopause)andgeneralhealthconditionsthatmayaffectwomendifferently(higherdiseaseburden)ordisproportionately(higherprevalence).ResearchshowsthatSRHandmaternal,newbornandchildhealth(MNCH)accountforapproximately5%ofwomen'shealthburden,9althoughthisisprobablyanunderestimate.Anadditionalestimated56%oftheburdenisduetohealthconditionsthataremoreprevalentand/ormanifestdifferentlyinwomen.Theremaining43%arefromconditionsthatdonotaffectwomendisproportionatelyordifferently(Figure3).Womenaremostlikelytobeaffectedbyasex-specificconditionbetweentheagesof15and50.Otherconditionsoccurthroughoutwomen'slives,butnearlyhalfofthehealthburdenaffectswomenintheirworkingyears,whichoftenhasanimpactontheirabilitytoearnmoneyandsupportthemselvesandtheirfamilies(Figure4).Totalglobalwomen,shealthburdenBreakdownofconditions,%43%areconditionsthatneitheraffectwomendisproportionatelynordifferently(e.g.ischaemicheartdisease,tuberculosis)47%arerelatedtoconditionsthataftectwomendisproportionately(e.g.headachedisorders,autoimmunedisease,depression)4%arerelatedtoconditionsthataffectwomendifferently(e.g.atrialfibrillation,colonCanCeij25%arerelatedtowomen-Specificconditions(maternalandgynaecological)343%47%4%5%Totalglobalwomen'ssuffering1.Conditionsthataffectwomendisproportionatelyaredefinedasconditionswithahigherprevalenceinwomencomparetomenbutnotahigherdiseaseburdenpercase.2.Conditionsthataffectwomendifferentlyaredefinedasconditionswithahigherdiseaseburdenpercaseinwomencomparedtomen.3.Includingmaternalnditionssuchasmaternalhaemorrhage,maternalsepsisandothermaternalinfections,hypertensivedisordersofpregnancy,obstructedlabouranduterinerupture,abortionandmiscarriage,ectopicpregnancy,indirectmaternaldeaths,latematernaldeaths,maternaldeathsaggravatedbyHIV/AIDS,gyae-logicaldiseasessuchasuterinefibroids,polycysticovariansyndrome,women'sinfertility,endometriosis,genitalprolapse,premenstrualsyndromeandwomen,s-specificcancerssuchasuterinecancer,ovariancancerandcervicalcancer.Source:McKinseyanalysisbasedontheUniversityofWashington'sInstituteforHealthMetricsandEvaluation,"GlobalBurdenofDiseaseStudy2019",women'shealthmodel,usedwithpermissionFIGURE4:HowhealthburdensaffectwomenovertheirlivesNearly50%ofburdenaffectswomenofworkingageA0-1920-6465+，1.In2016theaveragepensionageforawomanretiringthatyearwas63.7years.Source:DiseaseburdenfromUniversityofWashington'sInstituteforHealthMetricsandEvaluation,*GlobalBurdenofDiseaseStudy2019",usedwithpermission;OECD,"CurrentRetirementAges".PensionsataGlance,OECDandG20Indicators.OECDPublishing,2017Pregnancycomplicationscanincreaseriskforchronicillnesses(forexample,gestationalhypertensioncanportendchronichypertension,10andwomenwhohavehadgestationaldiabeteshavea50%riskofdevelopingtype2diabetes7-10yearsafterthebirthofthechild).nGoodmaternalhealthhelpsthemotherandbaby,withbenefitsextendingbeyondpregnancyandbirth.Healthequityencompassesaccesstotheinterventionsandoptionsthatarerightforeachindividual,regardlessoftheirgender,sex,sexualidentity,sexualorientation,age,race,ethnicity,religion,disability,education,incomeleveloranyotherdistinguishingcharacteristic.Forwomen,thiscan