Barbra Streisand is co-founder of the Women’s Heart Alliance.
My eyes were opened to gender inequality when I was 26.
I’d decided I wanted to make a movie based on Isaac Bashevis Singer’s story of Yentl, a young woman who has to pretend she’s a man to get an education. It was hard to convince anyone that an actress could direct, that a woman could manage a budget or that a mainstream audience would care about this scholarly female protagonist. Multiple studios turned us down. Yentl took 14 years to get made. I’m proud to say it came in on budget and went on to win several major awards. But, more important, it ignited my passion for ensuring women get the same chances in life as men.
Many years later, I was staggered to learn about something called “the Yentl syndrome” — a phrase coined in 1991 by then-director of the National Institutes of Health Bernadine Healy to illuminate a medical disparity. Healy found that women who had heart attacks were not getting the same quality of care as men. Unless a woman’s symptoms looked just like a man’s, too often she would be misdiagnosed or undertreated — which helps explain why, for the past 30 years, more women than men have died of heart disease.
In other words, when it came to heart disease, women weren’t getting the same chance in life, literally. And that’s still true. Too many women are dying before their time — our mothers, sisters, daughters, friends and co-workers.
We’ve got to focus people’s minds on the battle for women’s hearts.
Many people have no idea that heart disease kills a woman almost every minute or that the incidence of heart attacks in younger women has been increasing. Many don’t know that women’s heart disease symptoms are frequently different from or more subtle than men’s, that their first signs of a heart attack may be nausea, backache, extreme fatigue or shortness of breath, instead of crushing pain in the chest.
Many people are unaware that women who have heart attacks are more likely than men to die within a year. Most have no clue that heart research is primarily done on males, right down to the mice in the labs.
So, while we’ve made important progress against heart disease in women, we need to finish the fight. And we need everyone, women and men, to make this a priority.
First, we need to create vigorous awareness campaigns that reach the groups most at risk. Nearly half of African American women have some form of cardiovascular disease, yet only 36 percent are aware that heart disease is the leading cause of death for this demographic group. Let’s take inspiration from the fight against breast cancer, which has helped reduce death rates by a third from their peak. Today, breast cancer kills about 1 in 31 women, while heart disease kills 1 in 3.
Second, we need to maximize the screening opportunities we already have. Heart disease is largely preventable, but people need proactive screening and support. More than 86 percent of U.S. women say they met with a health-care professional in the past year, so let’s make sure patients and doctors alike prioritize assessing heart health as a part of those encounters. What we don’t know can hurt us: 64 percent of women who die suddenly of coronary heart disease show no prior symptoms.
Third, we need more aggressive investment in diagnostics and treatments and to develop new tools and testing standards specifically for women. Cardiovascular disease claims more lives than all cancers combined; let’s attack it with the same intensity and determination we’ve brought to cancer.
Fourth, we need to ensure women’s full representation in biomedical studies. I’m encouraged that the NIH recently imposed new requirements to ensure experiments include female lab animals and cell lines, but there’s more work to be done. The Food and Drug Administration’s new online “Drug Trial Snapshots” reveal the persistent gender and racial imbalances in pharmaceutical trials. I hope these revelations will spark changes in how products and devices are approved. Women account for more than half of heart disease deaths, so why are they only one-third of participants in cardiovascular disease trials?
We must inspire everyone to join forces against this killer, with all the energy and ingenuity that make this country great. Let’s not miss a beat in promoting heart health and saving women’s lives.