Women’s Health Care Disparities: Crossing the Great Divide - Samantha Butts
The growth in FemTech solutions for women’s health issues continues to surge. Yet industry observers have noted an ongoing challenge: these products and services are often geared toward health-literate women from privileged socioeconomic groups, leaving behind many who may be more marginalized. How can we bridge the gaps?
We’re in conversation with Samantha “Sam” Butts, MD, physician leader and abiding advocate for health care access and equity.
Sam, we have many disparities in women’s access to reproductive health care. Where are the gaps, from your perspective?
When we talk about disparities, the gaps are found along many lines, from geographic limitations to socioeconomic and racial factors. In taking into account geography, we see that densely populated areas, like the northeast, the southeast, Texas, and California, have a plethora of medical practices that specialize in infertility. Yet some states have as few as one or two. We need to remember, too, that the definition of those seeking fertility care transcends the traditional mindset of a man and a woman in a coupled relationship. It spans a much broader spectrum — for example, prospective parents who are single, people who identify as LGBQT+, or those whose complex medical histories impact their reproductive health. Services for these groups are far more accessible in some parts of the country than in others.
The key socioeconomic driver of disparities is the high cost of infertility treatments, which are not uniformly covered by insurance. Some states — New York, for example — are beginning to move forward with mandates requiring employers to offer insurance that covers these services. These mandates are surely a step forward and are improving access for many, but the requirements have some exclusions. We need to set our sights on advocating for more inclusive insurance throughout the country, as without coverage, most of these treatments are prohibitively expensive — in the tens of thousands of dollars.
In considering race and ethnicity, several studies have demonstrated that women of color experience many barriers to accessing care, not only long distances and high costs but also steep challenges in their interactions with providers. These hurdles can delay care by as much as two years and reduce the likelihood of successful treatment.
As providers, understanding why these delays are happening is critical to achieving health equity — and ensuring those we serve have the networks they need to be fully supported in their health care goals.
How far along are we in addressing disparities in care?
We’re getting there. RESOLVE, the national infertility advocacy group, is deeply involved in lobbying elected officials. The Cade Foundation provides guidance and grants for individuals with infertility. And the Broken Brown Egg, a patient-facing organization, helps women of color to have honest, empowering conversations that break through the stigma of infertility.
We’re encouraged by the strong advocacy initiatives that continue to emerge in the FemTech space — empowering historically marginalized patients to access care, find community support, and embrace the many pathways before them for enhanced health and wellbeing.
Thank you, Sam, for your thoughtful observations and guidance for the way forward.
Connect with Samantha on LinkedIn.
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Samantha Butts, MD MSCE, is a reproductive endocrinologist and sought-after thought leader in FemTech. She specializes in treating individuals and couples who require fertility treatments to achieve pregnancy. Currently, Sam serves as a professor of obstetrics and gynecology and chief of the Division of Reproductive Endocrinology and Infertility at Penn State Health. She is devoted to building the next generation of medical leaders, who will lead the way in health tech, patient education, and reproductive health equity.
