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‘It’s hard to stay healthy’- experts raise alarm over ‘pervasive’ economic challenges in US
A report highlighting women’s struggle with economic stress in the US has prompted experts to demand change
Experts have raised concerns over the “pervasive” economic and health challenges women in the US are facing, after a damning report exposed significant financial stress.
A national survey of women over 25 has found that American women face significant economic stress, with half of women reporting feeling “uncertain” or “worried” when thinking about how to pay for healthcare later in life and low-income and rural women reporting challenges to staying healthy today.
The report, which highlighted financial difficulties among women for the second year in a row, has prompted experts to speak out and demand change.
“The recent findings from the National Council on Aging (NCOA) and Women’s Institute for a Secure Retirement (WISER) underscore the pervasive economic and health challenges confronting American women, particularly those from low-income and rural communities,” Georgie Kovacs, women’s health expert and founder of Fempower Health, told Femtech World.
“Many women juggle caregiving responsibilities for their children while managing employment, often in environments that offer limited support.
“The scarcity of healthy food options in low-income areas, coupled with restricted access to essential healthcare services, exacerbates their daily struggles, impacting both their mental and physical health and that of their families.”
Underlining the “profound” impact of the menopause transition, Kovacs said women across the country are in desperate need of enhanced workplace policies and better access to specialised care.
“Our approach to addressing these challenges cannot be piecemeal – we require comprehensive systems that integrate childcare, health services, job security and mental health support, ensuring that no aspect of a woman’s health is overlooked,” she explained.
“It is imperative that we view the economic insecurities faced by women through a holistic lens, recognising the interconnectedness of health, employment and wellbeing.
“It’s time for all stakeholders, including government bodies and private sectors, to unite in crafting and implementing solutions that are as multifaceted as the lives of the women they aim to support.”
Katie Higgins, chief commercial officer at fertility benefits platform Progyny, called on employers to do more to support women, arguing that the pressure of financial uncertainty could “erode” self-esteem, strain relationships and compound parental stress.
“Balancing financial pressures with caregiving responsibilities can heighten feelings of guilt and inadequacy, impacting maternal mental health.
“Employers play a vital role in empowering women to prioritise their health without financial barriers through comprehensive benefits that include family building, fertility, maternal leave and menopause.”
Lois Quam, chief executive officer at sexual and reproductive health organisation Pathfinder International, noted that there is an important connection between health and income, meaning that women with the least financial resources often find themselves unable to access health services and modern innovations.
“From rural areas to the wealthiest cities in the world, women everywhere are being left behind. In the US and globally, they get paid and promoted less than men and leave the workforce at greater numbers to raise their children.
“Closing the gender pay gap could help keep women in the workforce, especially when childcare is so costly and inaccessible,” she told Femtech World.
Author and women’s health expert, Dr Mindy Pelz, encouraged women to “take control” of their health.
“It’s hard to stay healthy, even without the added pressure of economic stress,” she said.
“Many women just can’t rely on the American healthcare system to take care of them. That’s why I’m such an advocate for taking your health into your own hands.
“Simple lifestyle changes like intermittent fasting, meditation, cold exposure, walking 10,000 steps a day, avoiding electronics before bed might seem small on their own, but if you add them together and are consistent with them over time, they can make a huge difference.”
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Australia’s drug advisory committee has recommended wider funding of triptorelin for women with breast cancer or endometriosis.
The recommendation comes after AstraZeneca announced plans to remove Zoladex from the market, risking leaving more than 7,500 women with breast cancer without an alternative treatment.
Both medicines block the release of oestrogen and testosterone and can be used as part of treatment, or for fertility preservation, in some forms of cancer.
The Pharmaceutical Benefits Advisory Committee met urgently in July and recommended making triptorelin unrestricted under the Pharmaceutical Benefits Scheme (PBS), which would mean it was funded for all uses.
The drug has been listed on the PBS for prostate cancer since 2006.
Triptorelin and Zoladex can also be used to treat endometriosis and to block puberty for either precocious puberty or gender-affirming care.
Vicki Durston, director of policy and advocacy at Breast Cancer Network Australia, described the recommendation as “a significant step forward” and said access to the medicine could mean the difference between life and death for some patients.
She said some women had already chosen to have their ovaries removed because of uncertainty over Zoladex supplies.
Marilla Druitt, Victorian state chair of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said it remained unclear whether triptorelin would work exactly the same way as Zoladex, but the recommendation was likely to be positive for patients with endometriosis and pelvic pain.
She said: “I’m glad we’ve got an alternative.”
“That’s fantastic, and it remains to be seen whether or not it will be as good, but pain is so complex, pain is a really hard thing to study because it’s got so many contributors.”
Druitt said further research would be needed after the medicine was introduced.
If accepted by the federal government, the recommendation would also allow PBS funding of triptorelin for puberty suppression in precocious puberty and gender-affirming care.
This would make gender-affirming care federally funded through the PBS for the first time and would remove a financial barrier for transgender children in Queensland and the Northern Territory.
Stuart Aitken, medical director of Gender Health Australia, said the recommendation had sparked “absolute joy” among his patients.
He said: “It takes away a huge barrier to accessing evidence-based care.”
“It means that the ban has a very limited effect.”
By Women’s HealthX
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- Health Systems & Providers “What is the biggest women’s health priority for health systems over the next 24 months?”
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- Employers & Benefits Leaders “Which women’s health challenge creates the greatest workforce impact?”
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Encore Boston Harbor | December 3-4 2026
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Sahar Abid is a Science Associate at Ema EQ, where she works on cultural sensitivity and bias in AI.
A woman asks an AI health assistant about postpartum depression.
She mentions that her in-laws are telling her to “push through” and skip medical help, even as her symptoms get harder to manage. She never says where she is from or names her background.
The assistant describes the condition and gives her a hotline number. It sounds correct, but it misses what she needs.
That gap is more common than the industry admits, and it points to a blind spot in how we test health AI for bias.
Most bias testing looks at what people explicitly say.
The typical way to check an AI for bias is to label a prompt with someone’s demographic details and see if the answer changes. That catches some problems but misses a bigger one.
Most people do not lead with their identity. They lead with their situation. The woman above told the assistant everything it needed to help her, just not in the form of a label.
Her real question was not only “what is postpartum depression?” It was “how do I get care when the people around me don’t want me to?
When family members hold sway over health decisions, and in many communities they do, advice that asks someone to overrule their family is not something they can act on.
The AI didn’t say anything factually wrong. It answered a different question than the one she was living.
We call this culturally implicit bias, meaning the AI misses the cultural context a situation implies rather than the context a person spells out.
When systems are trained to notice only the explicit cues, they fall back on a default answer built for the majority. For everyone else, the response can feel generic, off-target, or discouraging enough that they stop looking for help.
In health, that is not small. The people most likely to be missed are often the ones the system already underserves.
What we set out to test.
At Ema, we wanted to know how well AI picks up on cultural context that is implied but never stated. So we built our own way to test for it, across a range of communities and real situations like postpartum depression and fertility, using questions that carried cultural meaning without announcing it.
The patterns were consistent. Models often missed the meaning underneath the question. They dropped the specific details a person did share and smoothed them into something generic.
And even when they pointed toward real care, they tended to offer one option instead of choices that might actually fit a person’s life. Any one of those can be the difference between someone following the advice and walking away from care.
Why this matters for anyone building health AI.
Getting this right is the right thing to do, and it also works better.
When an answer reflects a person’s real context, people trust and act on the recommendations more, so they get the help and support they need.
Testing for it is harder than the shortcut most teams use. Swapping a name or a demographic label in and out is easy. Checking whether a model actually understands the human context around a question takes more care.
The shortcut teaches models to perform cultural competence instead of practicing it. No matter how much or how little someone chooses to share, they deserve an answer that is warm, complete, and usable.
A better question.
The bar for equitable health AI should be “does it serve someone who never told you who they are?” It is the harder test, but it determines whether real people get help.
The work of getting there is far from finished, and it is exactly what we are building toward at Ema.
Sources: Naidoo, V., & Chadha, K. K. (2025), Culturally responsive AI chatbots: from framework to field evidence, Computers in Human Behavior: Artificial Humans. Souligne, N., & Subbian, V. (2026), FairLogue: A toolkit for intersectional fairness analysis in clinical machine learning models.
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