Medicare, Australia’s universal health insurance scheme, guarantees all Australians access to a wide range of health and hospital services at low or no cost.

Although access to the scheme is universal across Australia (regardless of geographic location or socioeconomic status), one analysis suggests women often spend more out-of-pocket on health services than men.

Other research has found men and women spend similar amounts on health care overall, or even that men spend a little more. However, it’s clear women spend a greater proportion of their overall expenditure on health care than men. They’re also more likely to skip or delay medical care due to the cost.

So why do women often spend more of their money on health care, and how can we address this gap?

Women have more chronic diseases, and access more services

Women are more likely to have a chronic health condition compared to men. They’re also more likely to report having multiple chronic conditions.

While men generally die earlier, women are more likely to spend more of their life living with disease. There are also some conditions which affect women more than men, such as autoimmune conditions (for example, multiple sclerosis and rheumatoid arthritis).

Further, medical treatments can sometimes be less effective for women due to a focus on men in medical research.

These disparities are likely significant in understanding why women access health services more than men.

For example, 88% of women saw a GP in 2021–22 compared to 79% of men.

As the number of GPs offering bulk billing continues to decline, women are likely to need to pay more out-of-pocket, because they see a GP more often.

In 2020–21, 4.3% of women said they had delayed seeing a GP due to cost at least once in the previous 12 months, compared to 2.7% of men.

Data from the Australian Bureau of Statistics has also shown women are more likely to delay or avoid seeing a mental health professional due to cost.

Women are also more likely to need prescription medications, owing at least partly to their increased rates of chronic conditions. This adds further out-of-pocket costs. In 2020–21, 62% of women received a prescription, compared to 37% of men.

In the same period, 6.1% of women delayed getting, or did not get prescribed medication because of the cost, compared to 4.9% of men.

Reproductive health conditions

While women are disproportionately affected by chronic health conditions throughout their lifespan, much of the disparity in health-care needs is concentrated between the first period and menopause.

Almost half of women aged over 18 report having experienced chronic pelvic pain in the previous five years. This can be caused by conditions such as endometriosis, dysmenorrhoea (period pain), vulvodynia (vulva pain), and bladder pain.

One in seven women will have a diagnosis of endometriosis by age 49.

Meanwhile, a quarter of all women aged 45–64 report symptoms related to menopause that are significant enough to disrupt their daily life.

All of these conditions can significantly reduce quality of life and increase the need to seek health care, sometimes including surgical treatment.

Of course, conditions like endometriosis don’t just affect women. They also impact trans men, intersex people, and those who are gender diverse.

Diagnosis can be costly

Women often have to wait longer to get a diagnosis for chronic conditions. One preprint study found women wait an average of 134 days (around 4.5 months) longer than men for a diagnosis of a long-term chronic disease.

Delays in diagnosis often result in needing to see more doctors, again increasing the costs.

Despite affecting about as many people as diabetes, it takes an average of between six-and-a-half to eight years to diagnose endometriosis in Australia. This can be attributed to a number of factors including society’s normalisation of women’s pain, poor knowledge about endometriosis among some health professionals, and the lack of affordable, non-invasive methods to accurately diagnose the condition.

There have been recent improvements, with the introduction of Medicare rebates for longer GP consultations of up to 60 minutes. While this is not only for women, this extra time will be valuable in diagnosing and managing complex conditions.

But gender inequality issues still exist in the Medicare Benefits Schedule. For example, both pelvic and breast ultrasound rebates are less than a scan for the scrotum, and no rebate exists for the MRI investigation of a woman’s pelvic pain.

Management can be expensive too

Many chronic conditions, such as endometriosis, which has a wide range of symptoms but no cure, can be very hard to manage. People with endometriosis often use allied health and complementary medicine to help with symptoms.

On average, women are more likely than men to use both complementary therapies and allied health.

While women with chronic conditions can access a chronic disease management plan, which provides Medicare-subsidised visits to a range of allied health services (for example, physiotherapist, psychologist, dietitian), this plan only subsidises five sessions per calendar year. And the reimbursement is usually around 50% or less, so there are still significant out-of-pocket costs.

In the case of chronic pelvic pain, the cost of accessing allied or complementary health services has been found to average A$480.32 across a two-month period (across both those who have a chronic disease management plan and those who don’t).

More spending, less saving

Womens’ health-care needs can also perpetuate financial strain beyond direct health-care costs. For example, women with endometriosis and chronic pelvic pain are often caught in a cycle of needing time off from work to attend medical appointments.

Our preliminary research has shown these repeated requests, combined with the common dismissal of symptoms associated with pelvic pain, means women sometimes face discrimination at work. This can lead to lack of career progression, underemployment, and premature retirement.

Similarly, with 160,000 women entering menopause each year in Australia (and this number expected to increase with population growth), the financial impacts are substantial.

As many as one in four women may either shift to part-time work, take time out of the workforce, or retire early due to menopause, therefore earning less and paying less into their super.

How can we close this gap?

Even though women are more prone to chronic conditions, until relatively recently, much of medical research has been done on men. We’re only now beginning to realise important differences in how men and women experience certain conditions (such as chronic pain).

Investing in women’s health research will be important to improve treatments so women are less burdened by chronic conditions.

In the 2024–25 federal budget, the government committed $160 million towards a women’s health package to tackle gender bias in the health system (including cost disparities), upskill medical professionals, and improve sexual and reproductive care.

While this reform is welcome, continued, long-term investment into women’s health is crucial.

Mike Armour, Associate Professor at NICM Health Research Institute, Western Sydney University; Amelia Mardon, Postdoctoral Research Fellow in Reproductive Health, Western Sydney University; Danielle Howe, PhD Candidate, NICM Health Research Institute, Western Sydney University; Hannah Adler, PhD Candidate, Health Communication and Health Sociology, Griffith University, and Michelle O’Shea, Senior Lecturer, School of Business, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Would you give up your sense of smell to keep your hair? What about your phone?

A 2022 US study compared smell to other senses (sight and hearing) and personally prized commodities (including money, a pet or hair) to see what people valued more.

The researchers found smell was viewed as much less important than sight and hearing, and valued less than many commodities. For example, half the women surveyed said they’d choose to keep their hair over sense of smell.

Smell often goes under the radar as one of the least valued senses. But it is one of the first sensory systems vertebrates developed and is linked to your mental health, memory and more.

Here are five fascinating facts about your olfactory system.

1. Smell is linked to memory and emotion

Why can the waft of fresh baking trigger joyful childhood memories? And why might a certain perfume jolt you back to a painful breakup?

Smell is directly linked to both your memory and emotions. This connection was first established by American psychologist Donald Laird in 1935 (although French novelist Marcel Proust had already made it famous in his reverie about the scent of madeleines baking.)

Odours are first captured by special olfactory nerve cells inside your nose. These cells extend upwards from the roof of your nose towards the smell-processing centre of your brain, called the olfactory bulb.

From the olfactory bulb they form direct connection with the brain’s limbic system. This includes the amygdala, where emotions are generated, and the hippocampus, where memories are created.

Other senses – such as sight and hearing – aren’t directly connected to the lymbic system.

One 2004 study used functional magnetic resonance imaging to demonstrate odours trigger a much stronger emotional and memory response in the brain than a visual cue.

2. Your sense of smell constantly regenerates

You can lose your ability to smell due to injury or infection – for example during and after a COVID infection. This is known as olfactory dysfunction. In most cases it’s temporary, returning to normal within a few weeks.

This is because every few months your olfactory nerve cells die and are replaced by new cells.

We’re not entirely sure how this occurs, but it likely involves your nose’s stem cells, the olfactory bulb and other cells in the olfactory nerves.

Other areas of your nervous system – including your brain and spinal cord – cannot regenerate and repair after an injury.

Constant regeneration may be a protective mechanism, as the olfactory nerves are vulnerable to damage caused by the external environment, including toxins (such as cigarette smoke), chemicals and pathogens (such as the flu virus).

But following a COVID infection some people might continue to experience a loss of smell. Studies suggest the virus and a long-term immune response damages the cells that allow the olfactory system to regenerate.

3. Smell is linked to mental health

Around 5% of the global population suffer from anosmia – total loss of smell. An estimated 15-20% suffer partial loss, known as hyposmia.

Given smell loss is often a primary and long-term symptom of COVID, these numbers are likely to be higher since the pandemic.

Yet in Australia, the prevalence of olfactory dysfunction remains surprisingly understudied.

Losing your sense of smell is shown to impact your personal and social relationships. For example, it can mean you miss out on shared eating experiences, or cause changes in sexual desire and behaviour.

In older people, declining ability to smell is associated with a higher risk of depression and even death, although we still don’t know why.

4. Loss of smell can help identify neurodegenerative diseases

Partial or full loss of smell is often an early indicator for a range of neurodegenerative diseases, including Alzheimer’s and Parkinson’s diseases.

Patients frequently report losing their sense of smell years before any symptoms show in body or brain function. However many people are not aware they are losing their sense of smell.

There are ways you can determine if you have smell loss and to what extent. You may be able to visit a formal smell testing centre or do a self-test at home, which assesses your ability to identify household items like coffee, wine or soap.

5. You can train your nose back into smelling

“Smell training” is emerging as a promising experimental treatment option for olfactory dysfunction. For people experiencing smell loss after COVID, it’s been show to improve the ability to detect and differentiate odours.

Smell training (or “olfactory training”) was first tested in 2009 in a German psychology study. It involves sniffing robust odours — such as floral, citrus, aromatic or fruity scents — at least twice a day for 10—20 seconds at a time, usually over a 3—6 month period.

Participants are asked to focus on the memory of the smell while sniffing and recall information about the odour and its intensity. This is believed to help reorganise the nerve connections in the brain, although the exact mechanism behind it is unclear.

Some studies recommend using a single set of scents, while others recommend switching to a new set of odours after a certain amount of time. However both methods show significant improvement in smelling.

This training has also been shown to alleviate depressive symptoms and improve cognitive decline both in older adults and those suffering from dementia.

Just like physiotherapy after a physical injury, olfactory training is thought to act like rehabilitation for your sense of smell. It retrains the nerves in your nose and the connections it forms within the brain, allowing you to correctly detect, process and interpret odours.

Lynn Nazareth, Research Scientist in Olfactory Biology, CSIRO

This article is republished from The Conversation under a Creative Commons license. Read the original article.