“Back in 1990 there was no market incentive to look after the health of midlife women, because in the eyes of decision makers, they presented no ‘economic value’. Today, we finally have those numbers. But, what isn’t shown, and what economists always find the hardest to estimate, is the indirect costs i.e. the untold story.”
[Georgia Sweet, Health Economist/ MyMT™ Education Course Convenor]
The news this week that United States Philanthropist, Melinda French-Gates plans to donate US$1 billion over the next two years to organisations supporting women and girls around the world is a welcome one.
Although, as we all know, where and how this money gets distributed and spent is crucial and whether it goes to those who matter most – the health and welfare of women and girls’.
This got Georgia and I thinking about how we would spend some of this money.
We would put it towards research into the causes of symptoms, including symptoms that are still not being related by Doctors to the menopause transition as well as lifestyle science solutions.
Through talking to women around the world, as well as Health Professionals studying with us, it is clear that Government’s still do not understand that midlife is a critical window which can determine a woman’s functionality, disease morbidity and mortality in her older years.
If we wrote this article a decade ago, it would have been titled ‘The Moment of Midlife: The Women Who Are Being Forgotten.’ That is exactly what I argued in my thesis.
Fortunately, the status of the menopause transition has come a long way in this time, as the topic becomes more mainstream.
The increased focus on women’s health research, led to better understanding that fundamental differences in physiology and disease states between men and women existed.
This research, has already changed the lives of thousands of MyMT™ women.
However, there remains gaps and inequities in research, especially as the dominant paradigm takes a pharmaceutical focus.
Hence, if I was developing a case for funding from Melinda Gates, I would argue, ‘Women’s Midlife Health Research Remains Unfinished.’
Critical knowledge-gaps remain that require well-funded studies. These include:
- How lifestyle choices across a woman’s life course affect her menopause experience.
- The impact of midlife hormonal changes on cardiovascular disease and lifestyle solutions. Cardiovascular disease is the number 1 cause of mortality in older women.
- The impact of midlife hormonal changes on joint issues and lifestyle solutions.
- Ethnic and cultural differences in menopause symptoms.
- Differences in the gut health of younger females still producing reproductive hormones and middle-age women in menopause.
Perhaps the most important area however, that keeps coming up in conversations we have with Health Practitioners and women from around the world, is to explore the effect of psycho-social stress on menopause symptoms and quality of life, including workplace productivity.
This, it seems, remains an important area of research.
The research that is just starting to emerge, has explored the link between psycho-social stress in midlife women, menopause symptoms, and their ability to engage and be productive in the workplace.
Georgia and I were not surprised by these findings.
As a trained Health Economist, Georgia spent the last 5 years analysing and advising the Government on why and how money might be spent on hospitals and infrastructure.
Health economics is a branch of economics concerned with issues related to efficiency, effectiveness, value and behaviour in the production and consumption of health and healthcare.
Georgia is equally as passionate about supporting women with their health and has now joined me as the Course Convener for MyMT™ Education.
I asked Georgia to share her thoughts on the economic value of investing in midlife women’s health. A demographic which typically gets forgotten about when it comes to their economic value to society. As she says below, there is a risk that the current data does not sufficently capture the exponential indirect effects that the health of midlife women has on society.
Georgia Sweet:
As a Health Economist, when advising on funding decisions, demonstrating that the monetary benefits outweigh the costs is fundamental.
It didn’t take me long to realise that the hard work had already been done for me. Economists around the world have calculated the ‘cost of menopause symptoms’ attributing to loss of productivity, absenteeism, turnover, health care appointments, pharmaceuticals and emergency department visits.
As you can imagine, the numbers are astronomical.
- The Canadian Menopause Foundation estimates that there is a 14% drop in the number of working women in Canada between 45 (85.9% work) and 59 (71.9% work)[1].
- The Mayo Clinic estimates the costs of worker productivity losses due to menopausal symptoms in the USA to be about $1.8 billion and related health care costs total over $24 billion.[2]
- The NZ Institute of Economic Research, conducted one of the first surveys of 1000 midlife working women, including 150 Māori women in 2023. (NZIER, The Silent Epidemic, 2023]. The results revealed that many women struggle with symptoms that impact their wellbeing, productivity and engagement at work and potentially their economic participation.[3]
Can I reiterate, that this study was only undertaken in 2023!
When I was undertaking research for this article, what surprised me was that the majority of papers demonstrating the economic cost of menopause were produced after 2018.
After looking at the history of women’s inclusion in academic research trials (see image below), it’s no surprise that this research has taken so long to come to our attention.
It was only in 1980 that scientific terminology for Menopause was defined.
But, it took another 10-15 years for the first cohort studies on ovarian ageing and menopause symptoms to get underway in the mid 1990s. [NIH, Office of research on Women’s Health]
However, it wasn’t until I saw the following statistic, that the penny dropped.
The number of women aged 55 – 64 in the workforce in New Zealand has increased from 31% in 1990 to 75% in 2022. An increase of 44% in just 32 years! [3]
Very simply, back in 1990 there was no market incentive to look after the health of midlife women, because in the eyes of decision makers, they presented ‘no economic value’.
Today, in 2024, we finally have the data to present some numbers to decision makers.
But, what that data may not capture, and what economists always find the hardest to estimate is the indirect costs i.e. the untold story.
Talking everyday with women in the MyMT™ Community has allowed me the privilege of glimpsing into those untold stories. From what I can see, their symptoms and health challenges have an effect on every corner of society.
For example, the majority of essential public service roles in health care, education and social services are held by midlife women. Many of the MyMT™ women were deemed essential workers during Covid-19 and had to travel into work.
Australian Paramedic, Wendy, in the image above, is one of these women. She nearly gave up her job without any consideration of the financial consequences due to her crippling menopause symptoms.
Therefore, when midlife women cannot do their job, we lose many of the foundations of our society. When we think back to the Canadian report which found that 14% of women stop working in midlife, we can visualise the impact menopause is likely having on critical services in our society such as nursing, teaching, and government agencies.
Let alone the fact that many of these women who remain in the workplace aren’t as productive, or as attentive, because of the brain fog, anxiety or fatigue they may be experiencing.
The economic analysis may also not have taken into account the cost of unpaid work that midlife women engage in.
These costs cannot be underestimated – their ability to pick up a child from school, to look after grandchildren while parents are at work, to take an ageing parent to the hospital, and everything else that is undertaken in between! Menopause symptoms often significantly affect or prevent these important tasks from happening.
But from our conversations with women and Health Professionals, one of the most important aspects these these economists may have forgotten to consider is the influence that midlife women have on those around them.
From the knowledge and wisdom they pass on to their families and friends, the food they cook, to their caring roles, midlife women shape the health of those around them.
When we think about these important roles that midlife women fulfil in the communities they engage in, we can see the exponential effect that their health has on society.
From what we observe every day and what Health Professionals tell us, midlife women often put their health behind everyone else’s around them.
We can’t let decision makers do the same. It just doesn’t make economic sense!
The health of midlife and older women matters. Society is a better place when this demographic have their health and can continue to contribute in ways that are meaningful to them.
That’s why, Wendy and I both hope that some of the generosity of Melinda French-Gates, is also directed to research specific to their needs, and addresses the known gaps in lifestyle research.
Georgia Sweet, B.Com/ Health Economist/ MyMT™ Education Course Convenor
Dr Wendy Sweet (PhD), MyMT™ Founder/ Member: Australasian Society of Lifestyle Medicine
References:
https://menopausefoundationcanada.ca/pdf_files/Menopause_Work_Canada_2023EN.pdf
https://www.forbes.com/sites/aparnarae/2023/10/18/beyond-hot-flashes-a-deep-dive-into-menopause-work-and-the-economy/?sh=5b8872496596
NZIER. (2023). The silent transition: Understanding the impacts of menopause in New Zealand workplaces. A Report for Global Women.
Dean E, Moffat M, Skinner M, Dornelas de Andrade A, Myezwa H, Söderlund A. Toward core inter-professional health promotion competencies to address the non-communicable diseases and their risk factors through knowledge translation: curriculum content assessment. BMC Public Health. 2014 Jul 14;14:717.
Sioban D. Harlow, Lynnette Leidy Sievert, Andrea Z. LaCroix, Gita D. Mishra
and Nancy Fugate Woods. Women’s midlife health: the unfinished research agenda. Women’s Midlife Health. 2023. doi:10.1186/s40695-023-00090-5
Douthard R, Whitten LA, Clayton JA. Research on Women’s Health: Ready for the Future. J Womens Health (Larchmt). 2022 Feb;31(2):133-144. doi: 10.1089/jwh.2022.0014.
Griffiths A, Ceausu I, Depypere H, Lambrinoudaki I, Mueck A, Pérez-López FR, van der Schouw YT, Senturk LM, Simoncini T, Stevenson JC, Stute P, Rees M. EMAS recommendations for conditions in the workplace for menopausal women. Maturitas. 2016 Mar;85:79-81
Macpherson BE, Quinton ND. Menopause and healthcare professional education: A scoping review. Maturitas. 2022 Dec;166:89-95. doi: 10.1016/j.maturitas.2022.08.009.
Whiteley J, DiBonaventura Md, Wagner JS, Alvir J, Shah S. The impact of menopausal symptoms on quality of life, productivity, and economic outcomes. J Womens Health (Larchmt). 2013 Nov;22(11):983-90.
