Gender a factor in who gets bypass surgery

A study published in the latest issue of Psychology of Women Quarterly found gender biases and long-standing gender discrepancies in who gets bypass surgery. In 1988, twelve percent of female patients who had profiles consistent with the bypass surgery received it-- as compared to twenty-four percent of men. In 1998, among similar types of patients, twenty percent of females received heart bypass, compared to thirty-three percent of men. The relative odds of a woman meeting the criteria but not receiving the surgery were approximately double that of comparable men. The author, Cheryl B. Travis, explains, "There was compelling evidence of a pernicious gender bias and a general failure to treat women in a proactive manner that extended over a decade."

Her study examined the common reasoning behind the discrepancy by using patient information from the National Hospital Discharge Survey for 1988 and 1998. The common explanations are: 1) women do not have the appropriate diagnoses, 2) they have complicating conditions that made them a poor risk 3) they are too elderly and frail to benefit, and 4) the surgery carries a greater risk of mortality for women. None of these explanations was supported, suggesting that the real explanation may be a gender bias. Controlling for primary diagnoses of heart attack, obstructed blood flow to the heart, or angina had little effect on the gender disparity. Data from 1998 showed that among patients with heart attacks who received bypass, there were only 59 women recipients for every 100 men who received bypass surgery. Women with comorbid conditions, i.e. diabetes or hypertension, were found to have significantly more conservative treatment decisions than men with the same conditions. Similarly, women were twice as likely not to receive the surgery as compared to men in the same age group; for example, women in their 40s experienced over a three-fold risk of not receiving the surgery over men in their 40s. Medical literature has typically reported a higher risk of mortality among women patients, but always in comparison to men. "For purposes of women's decision making, mortality risk should be considered as it is assessed among and referenced to women with comparable medical profiles," advises the author. Contrary to the supposition that women are too frail to benefit from the procedure, women having medical conditions consistent with bypass are more likely than control women to survive hospitalization if they receive the surgery.

This study is published in the current issue of Psychology of Women Quarterly. Media wishing to receive a PDF of this article please contact journalnews@bos.blackwellpublishing.net

Psychology of Women Quarterly (PWQ) publishes primarily qualitative and quantitative research with substantive and theoretical merit, along with critical reviews, theoretical articles, and invited book reviews related to the psychology of women and gender. It is published on behalf of the Society for the Psychology of Women, Division 35 of the American Psychological Association.

Cheryl B. Davis is a full professor of psychology and Chair of Women's Studies at the University of Tennessee Knoxville. Her work on women's health has focused on medical decision making and variation in physician practice patterns,

Dr. Travis is available for questions and interviews.

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