college must act to ensure equitable health-care outcomes for women, marginalized communities

in december 2021, christopher wallis and colleagues published an article in  jama surgery  with a starkly grim revelation: between november 2020 and march 2021, women in ontario who underwent surgery were 32 per cent more likely to die if operated on by a male surgeon rather than a female surgeon and 15 per cent more likely to suffer a negative outcome of any kind. men operated on by female surgeons, on the other hand, were only 2 per cent more likely to  have complications

though this study’s shocking findings have been  shared  widely  across  international  news  outlets , the response in ontario is chillingly silent. as angela jerath, a co-author on the study said to  the guardian,  “this result has real-world medical consequences for female patients and manifests itself in more complications, readmissions to hospital and death for females compared with males. we have demonstrated in our paper that we are failing some female patients and that some are unnecessarily falling through the cracks with adverse, and sometimes fatal, consequences.”

the ontario college of physicians and surgeons has yet to publicly acknowledge these findings, failing to speak to the ways that death is a preventable outcome for women accessing surgeries in the province. this reality not only warrants concerted action but also demonstrates that despite social and political advancements in gender equity, women continue to experience disproportionate harms in the equitable distribution of health-care and positive health outcomes. though this research reported on people identified via the gender binary, these findings warrant further investigation into the outcomes that gender-diverse people (e.g., two-spirit, transgendered, non-binary and gender-fluid) experience during surgery, given the  known  barriers  faced for these populations when attempting to access primary, emergency and gender-affirming care.

these findings verify what women across all social strata have testified to for decades. in fact, wallis and colleagues’ recent work adds to some members of the study team’s previous work published in the british medical journal in 2017. that  research  found that across ontario, between 2007-2015, “patients treated by female surgeons had a small but statistically significant decrease in 30-day mortality and similar surgical outcomes (length of stay, complications and readmission), compared with those treated by male surgeons.”

particularly for black women, this finding is no surprise. though wallis and colleagues’ groundbreaking work does not stratify women’s outcomes based on race,  systemic anti-black racism  is a reality across canada as a whole.

the findings necessitate a significant reframing of the negative health outcomes being presented passively across surgeries and demonstrates that health-care environments are providing differential quality of care, particularly in times of extreme vulnerability. what’s more, we know that “ vulnerability ” is a destination individuals and communities arrive at through systemic oppression, which produces and reproduces preventable illness and death.

the findings shared by wallis and colleagues cannot be separated from the broader context of the health-care sector in ontario. female surgeons are “ paid 24 per cent less per hour of operating time than their male counterparts.”  further, women in the medical field hold significantly  less power  than their male counterparts, on average, and the issue of  gender inequity across medicine is well known.

and the findings cannot be separated from other inequities in health care. in the context of the covid-19 pandemic, the inequities in working conditions as well as accessing health care have emerged with disturbing clarity. black women working in  frontline health-care positions  are more likely to be employed in precarious, low-paid, unsafe working conditions. as the provincial government continues to vote down paid sick days, has largely privatized covid-19 testing, and refuses to improve working conditions for groups such as nurses and personal support workers, the devaluation of women – and black women’s lives in particular – is clear.

this article is republished from healthy debate under a creative commons license. read the  original article   .

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college must act to ensure equitable health-care outcomes for women, marginalized communities

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