Shared community perspectives on how gender shapes coronary heart disease healthcare in Australia: a participatory systems thinking approach

Introduction Coronary heart disease (CHD) remains one of the leading causes of death in Australia, yet women experience persistent inequities in diagnosis, treatment and recovery. Methods A community-based systems thinking approach was applied using two, three hour online group model building workshops. Participants ( n = 9) included patients, practitioners and advocates. A causal loop diagram was developed to map participant perspectives of gendered influences on CHD care. Analysis of the causal loop diagram was undertaken by two researchers who examined interconnections between factors and domains drawing on methods from system dynamics. Results This study documents the complexity of embedded notions of gender and how these influence patient care in CHD in Australia. The findings demonstrate how professional knowledge, gender bias, community attitudes, and service delivery structures combine in unique ways to reinforce or disrupt inequities in CHD care, particularly for women, affecting the ability for the provision of individualised, tailored CHD care. Conclusions Gendered assumptions during diagnosis, treatment and recovery influence CHD care, with specific impacts on women, resulting in misdiagnoses or delayed diagnosis.