If you’ve got some spare time, you might want to read two or three articles summarizing the work of Claudia Goldin, the first woman to be a solo winner for the Nobel Prize in Economics. Most involves gender inequalities, especially in marriage and the workplace. The results of which I observe with painful regularity in a healthcare setting, where about 95% of the patients are female. Here’s an interesting article from Forbes: A Century Of Women, Work – And Juggling Family.
For example: although men undeniably score higher on SAT tests than women in the math/science sections, it’s mainly because as children, it’s been drummed into girls to be “bad at math” and “leave science to the boys”. For years, young women went to college to get a “Mrs.” degree, and failing at that, be a nurse or an elementary ed teacher. Yet these days more women graduate high school than men; more women attend college and universities than men. One recent study even showed you’ll do better in the long run if your surgeon is female.
Real gender differences occur in the workplace. Two young lawyers may start at the same salary, but as they climb toward partnership (brutally long hours) and “big bucks”, what Goldin calls “greedy work”, now the men pull ahead, make the money, because they are unencumbered by the impossible combination of a high-stress, time-consuming job, children, and home management.
This, by the way, is when I often see women. Drained, exhausted, depressed, guilty about ‘something’.
When I followed the career tracks of medical students and residents I trained with (maybe 5% of any class was female, it’s 50% now), most of the women did indeed leave early to raise families, some never to return. In every program I was in (Illinois, Rush, Vanderbilt, Northwestern), one professor or another would make a snide remark that a woman had stolen the place of a “real” doctor who would stay in the system.
Fortunately, as Goldin is quick to point out, women are steadily inching toward progress in the past twenty years but need to guard that progress carefully: control of their bodies; equal pay for equal work; lawsuits for sexual harassment; paid maternity leave; work at home. However, you can lose everything. The newly elected speaker of the House, Mike Johnson, is straight out of “The Handmaid’s Tale”, and concerned women should read this summary of his very frightening views from The Guardian.
ALZHEIMER’S DISEASE AND A.D.D.
The following may seem unrelated to women’s economic issues but be patient.
A recent research paper linked mid- and late-life development of Alzheimer’s Disease to untreated and/or undiagnosed Attention Deficit Disorder (ADD). This study, a joint project of several universities around the world, tracked over 100,000 patients over 17 years.
If a patient knew he/she had ADD and remained on their psychostimulant (e.g., Adderall, Vyvanse), the risk of dementia was the same as the general population. If a person knew of their diagnosis, but refused medication, their risk increased substantially. If they had undiagnosed ADD but was suspected/diagnosed/treated, their risk was the same as the general population.
I mention all this because it’s well known that Alzheimer’s Disease is statistically higher in women than in men. Originally, this was attributed to the simple fact that women lived longer and longevity was the greatest risk factor for Alzheimer’s Disease. Other risk factors were amyloid, a protein associated with autoimmune disease susceptibility, and then genetics (the APOe4 gene).
But this new link with ADD is especially interesting. Young women with ADD are very often misdiagnosed with Generalized Anxiety Disorder, started on an SSRI med like sertraline, and when that doesn’t work, then another, like Lexapro, and then another. I have seen far too many forty and fifty-year-old women with poorly treated anxiety who actually had ADD all along (see my articles “Women and ADD“). Once started on Adderall or Vyvanse, their anxiety (and now apparently their risk for developing Alzheimer’s Disease) can drop dramatically.
Interested patients can schedule with any of the WholeHealth Chicago team.
David Edelberg, MD