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Quality of life: Why there’s a gender gap and why it’s the right way to measure women’s health
Tia Tackles

Quality of life: Why there’s a gender gap and why it’s the right way to measure women’s health

Updated: August 13, 2026

ByRyann Vernetson, LPC
VP of Clinical Innovation & Growth

11 min read

Too often, we’re sold on health as a “summit” - the thing you’re forever climbing toward, always a little short of, never quite arrived. At Tia, we see it a little differently: health isn’t the destination, it’s the means. Health is what makes a big, full, vibrant existence possible. Life, in all its fullness, is the point.

Think of the last time you were sick. It’s unlikely you were excited to get better because you’d stop going through so many Kleenex. You wanted to feel better so you could run through the sprinklers with your toddler or give your mother a huge hug at Sunday night dinner.

So care should be measured by how much life it gives back to you - not only by how close it gets you to a set of numbers in a report. Healthcare shouldn’t shrink you down to a set of results in a range, a diagnosis, a list of risk factors; it should expand what is possible so you can live the vibrant life you define.

Which raises the obvious question: if life is the goal, how do you actually measure whether your care is giving you more of it?

That is what quality of life is. It may seem like a soft, feel-good extra, but it’s actually a rigorous health metric and one of the most critical ways to tell whether a woman’s healthcare is working at all.

What “quality of life” actually means in care

Quality of life might sound like an elusive, nice-to-have, footnote once the “real” health problems are handled. But far from it! Quality of life is a measured construct: a structured, validated way of capturing how a person actually feels across the domains that make up life - physical energy, emotional wellbeing, ability to do the things a typical day asks of you, and the sense that you have some agency over your body. It’s assessed with researched instruments, scored, tracked over time, and can be studied in the exact way a lab value like A1C or LDL can be. Quality of Life, however, measures something these other biometrics can’t.

Many healthcare metrics measure isolated organs (which is good) but in contrast, quality of life measures a whole person - how she sleeps, thinks, moves, and feels in control of her health. It’s one of the only metrics that integrates across biological systems simultaneously and the research shows it doesn’t just reflect your biomarkers, it can actually predict them.

In Western cultures, generally, we’ve been taught to assume that biology comes first and the feelings follow; if your bloodwork is good, feeling bad is just a perception. But that’s not what the evidence shows; in one long-running study of patients with cardiac disease, those who scored low on a standard wellbeing measure at the outset went on to have significantly higher mortality over the following six years than those who scored higher, even accounting for their physical disease (Topp et al., 2015).

Quality of Life as a metric isn’t measuring your mood instead of your health, it’s helping tell a story that your organs, taken one at a time, can’t always tell on their own.

The gender gap in quality of life

Women, on average, report worse quality of life than men and this is fairly consistent across populations and the validated tools used to measure it. In their 2024 report on the women’s health gap, the World Economic Forum and the McKinsey Health Institute found that although women live longer than men on average, they spend roughly 25% more of their lives in poor health (World Economic Forum & McKinsey Health Institute, 2024).

In one community study that screened primary care patients and had them complete the SF-36, a quality-of-life questionnaire, women scored significantly worse than men on most of its subscales (Prata et al., 2016). It wasn’t just that women scored lower, but the things that predicted their scores were different than the things that predicted men’s, indicating that sex-differences exist not only in the gap but what drives the result.

Much of what actually erodes a woman’s health doesn’t resolve into a single, nameable disease with a single, abnormal number. It’s hormonal, cyclical, it moves and changes across a month and across her life. It’s at the intersection of anatomical, biological and mental/emotional health – it’s characterized by the shape of a woman’s resilience more than her performance at any given moment. It shows up as a pattern of how she feels and functions rather than a single flag in a lab panel collected on a Tuesday morning. A disease-detection tool pointed at that kind of health will very often come back “clean”, not because it's inaccurate, but because it’s looking for the wrong shape of health.

What actually drives quality of life for women

When we study what actually shapes a woman’s quality of life, a similar set of drivers come up again and again in the research, and in talking to women, and most of them don't live clearly on a standard lab panel.

  • Hormones and hormonal transitions. So much of women’s health runs on a hormonal rhythm, across the menstrual cycle, through pregnancy and postpartum, and through the long arc of perimenopause and menopause. These shifts touch mood, skin, sleep, energy, cognition, libido, metabolism and more, and they rarely announce themselves in one tidy lab abnormality.
  • Symptom burden, especially pain and mood. Fatigue, brain fog, pain, disrupted sleep, mood changes - the symptoms that most degrade a woman's day-to-day life - are often the ones that don’t correspond to a simple, clear diagnosis. The burden of these symptoms is real, even if the workup is unremarkable. In a 2026 study of nearly 10,000 older adults, women reported poorer quality of life than men across more domains, and when researchers looked for what was driving that gap, pain and depressive symptoms accounted for the overwhelming majority of it; pain severity alone explained more than 90% of the difference on the summary quality of life measure (Trakarnwijitr et al., 2026), The authors’ point was hopeful: these are common, modifiable symptoms and largely things that good care can actually treat when addressed properly.
  • Mental load. The invisible, cognitive work of running a life and often a household - the remembering, anticipating, managing of everyone else’s needs - is a genuine and unequally distributed input into how depleted a woman feels and it rarely appears on a chart.
  • Sleep. Sleep sits underneath nearly everything else; mood, metabolism, cognition, resilience. And women’s sleep is disproportionately disrupted by hormonal shifts and caregiving demands across the lifespan.
  • Social connection. The need for social connection may feel cliche at this point, but for women in particular, connection functions as part of the physiological stress-regulation system; isolation isn’t just lonely, it measurably raises the load her body is carrying.

When you look at this list, the problem with organ-based measures or “lists of biomarker medicine” becomes obvious. Not one of these is captured by a one-organ assessment or even hundreds of biomarkers combined. This felt sense of living is what determines whether a woman feels well; wellbeing is the metric that can actually see these factors because it’s designed to integrate all of them at once instead of interrogating them one at a time.

Why quality of life is the right metric for women

It turns out that quality of life isn’t even built the same way for women and men. In a study examining the underlying dimensions of quality of life by gender, the components that made up the concept came apart differently for each. For women, quality of life is organized around psychosocial wellbeing and physical competency, while for men it is organized around vitality and personal resources (Dibble et al., 1998).

This doesn’t simply mean that men and women score differently on the same quality-of-life test ; it’s that the very architecture of what quality of life is differs by gender - so the things we need to pay attention to, ask about, and act on are different for women than they are for men. A single score, read without context and relationship, will miss part of what makes a woman's life feel whole or not.

There is no current, women’s specific survey that solves this on their own. A wellbeing score is a generic instrument by design; its power isn’t that it asks uniquely female questions, it’s that it captures the felt, lived core of how she’s doing, repeatedly and reliably. This is also, in many ways, what separates Tia from care that reduces you to an online form and a prescription. Health was never meant to be cold, hard medicine dispensed at a distance - it’s just as much about how a woman feels in her body as it is about what a scanner or a lab panel reports about her body. That’s because health isn’t separate from life; it can’t be abstracted away from the plain, experiential fact of being a human living in the world.

What makes it work for women isn’t the number itself, rather, the reading of that number in the full context of a woman’s life - her hormonal transitions, her symptom burden, her mental load, and the things research indicate actually drives her quality of life - and knowing her well enough to understand what a change in it is really telling you.

And that’s why, for women especially, quality of life is more than a wellness metric, it’s an accountability metric. Because women’s symptoms are often so cyclical and historically dismissed, tracking how a woman actually feels overtime becomes one of the most reliable ways to answer the only thing that matters: is this care working? Not simply “did we rule out disease?” but “does she feel better, function better, feel vigorous?” That’s a question a biomarker or single organ measurement can’t answer but she can. Tracking is how we keep score of whether care is doing its job.

How Tia measures and improves quality of life

At Tia, we measure this using the WHO-5 Well-Being Index - a short, validated instrument developed by the World Health Organization. It measures subjective well-being, the lived, felt core of quality of life -how good your spirits are, how rested and energized you feel, how much genuine interest you have in your days. It's brief enough to use often and rigorous enough to trust, which is exactly what you want in something you intend to track across a whole care relationship rather than a single visit.

The final score has never been the point on its own; a generic score read by a stranger in an eye-contractless visit, is exactly the thin, decontextualized measurement we argue against. What changes is the context we read it in; we track how a woman feels over time, then we interpret that alongside what we understand about improving women’s health outcomes. The instrument tells us whether something has shifted, the relationship tells us why, and together, we decide what to do about it. This combination - a felt trackable signal plus the context to make sense of it - reflects the new standard of care all women deserve.

And it works. Our 2025 Outcomes Report shows that when women have a care home that actually listens and responds, engagement rises, preventive gaps narrow, chronic conditions stabilize, and women report feeling more in control of their bodies, their health, and their lives - three things which are inextricably linked.

Most of healthcare has been built to ask whether a woman is diseased and if so, what her diagnosis is. We think the more human - and what the research keeps showing - predictive questions is whether she is well: whether she sleeps, thinks, moves, and lives with a sense of wellness. Quality of life is how you measure that, and measuring it seriously over time, is how care finally becomes accountable to the person it’s actually for.

Care that measures what matters

At Tia, we track how you feel over time and use that context to shape care around your health, your life, and what matters most to you.

Explore care at Tia

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