Pink of Health, Not Pink Campaigns, Why Women Need Systemic Care, Not Symbolic Gestures
Every year, as International Women’s Day approaches, a familiar transformation takes place. Corporate logos adopt a shade of pink. Social media feeds fill with images of women in vibrant saris at health camps. Newsletters and op-eds celebrate the importance of women’s health. It is a short, intense burst of visibility, a collective performative gesture that, for a few days, places the female body at the centre of public discourse. And then, as the calendar turns, the conversation fades, and the pink recedes. The hard, systemic work of actually redesigning healthcare for women remains largely untouched. The uncomfortable truth, as articulated by Sangita Reddy of Apollo Hospitals, is that women’s health has historically been treated as a “special topic,” an addendum to the main curriculum. The result is a system that responds when disease becomes loud and acute, rather than preventing it when risk is still low and silent. If India is serious about health equity, the time has come to move beyond pink campaigns and towards a fundamental redesign of policy, financing, and clinical protocols.
The colour pink itself has a history that mirrors the very stereotypes that have shaped women’s healthcare. Its association with femininity is a relatively recent invention, solidified in the mid-20th century as a marketing tool to re-establish women in traditional homemaker roles after the upheaval of World War II. Today, it symbolizes nurturing, comfort, and hope. But when it comes to health, hope is not a strategy. What women need is not a symbolic colour, but a system that sees them as whole human beings whose health is shaped by a complex interplay of hormonal transitions, metabolic shifts, caregiving stress, and nutritional deficiencies that unfold over decades.
The scale of the challenge is defined by India’s shifting disease burden. The country is in the midst of an epidemic of non-communicable diseases (NCDs) – heart disease, diabetes, cancer, and chronic respiratory conditions. These are progressive, long-term illnesses that are, crucially, often preventable with early action. For women, the need for prevention is even more acute because their symptoms are so frequently dismissed or misattributed. A woman experiencing crushing fatigue and shortness of breath is often told she is stressed or overworked, while a man with the same symptoms is rushed for a cardiac workup. This “atypical presentation” of heart disease in women has led to a long history of under-diagnosis, under-treatment, and tragically, late presentation when the disease is far advanced.
The evidence for this systemic failure is stark. Screening programs that look beneath the surface reveal a hidden landscape of disease. Among asymptomatic women who undergo advanced screening, a significant proportion are found to have coronary artery calcium deposits, a clear marker of early atherosclerosis. A subset of these women have obstructive coronary artery disease that requires immediate and aggressive intervention. They were walking around with a time bomb in their arteries, completely unaware, because their symptoms were ignored and their risk was never assessed. This is the consequence of a system that waits for women to get sick enough to demand attention, rather than proactively seeking out risk.
The fundamental flaw in the current approach is that it treats women’s health as a series of isolated compartments. There is a gynaecology department for reproductive issues, a cardiology department for heart problems, and an endocrinology department for diabetes. But women do not experience their health in these neat, siloed boxes. A woman’s risk of heart disease is profoundly influenced by her pregnancy history—did she have gestational diabetes or pre-eclampsia? It is shaped by her menopausal status, as the drop in oestrogen removes a protective factor for her heart. It is affected by years of stress from caregiving, by sleep deprivation, by nutritional deficiencies that may have started in adolescence. The system, designed for episodic, single-specialty care, is fundamentally unequipped to see this whole picture.
What is needed is a foundational shift to a “life-stage approach” to women’s health. This means designing care pathways that follow a woman from adolescence through her senior years, with proactive interventions at each critical transition.
In adolescence, the focus must be on primary prevention. This is the phase to aggressively tackle anaemia through nutritional supplementation and literacy. It is the time to address menstrual health without shame or stigma, and to build the foundations of a healthy lifestyle that can prevent metabolic disease decades later. If a girl reaches reproductive age with chronic iron deficiency, her body is already compromised.
During the reproductive years, care must expand far beyond safe pregnancy and delivery, vital as those are. The system should automatically include proactive screening for common but often undiagnosed conditions like thyroid disorders, polycystic ovary syndrome (PCOS), and emerging metabolic risks. Mental health concerns, so often triggered or exacerbated during this demanding life stage, must be integrated into routine care, not treated as a separate, stigmatized issue. This is also the window to capture crucial data, like a history of gestational diabetes, that will be vital for assessing cardiovascular risk two decades later.
The peri-menopausal and post-menopausal years must be treated as the high-risk transition zone they are, not as a mere footnote in a woman’s health journey. This is when the protective effects of oestrogen wane, leading to a sharp rise in metabolic and cardiovascular conditions. It is also a period of increasing “multimorbidity,” where women present with multiple chronic conditions simultaneously. A 60-year-old woman may have heart disease, diabetes, and arthritis. Managing these in separate specialist silos is not just inefficient; it is dangerous. She needs integrated, longitudinal care from a team that sees all of her conditions at once.
Nowhere is this redesign more urgent than in cardiovascular health. For decades, heart disease has been framed as a “man’s disease.” The stereotype of the middle-aged man clutching his chest has dominated the imagery, leading to a catastrophic underestimation of risk in women. Yet, cardiovascular disease is the single biggest killer of women globally. The symptoms in women are often more subtle—profound fatigue, nausea, jaw pain, shortness of breath—and are too easily dismissed as anxiety or stress. By the time a woman’s heart disease is diagnosed, it is often more advanced and harder to treat.
A transformed system would replace this reactive approach with a robust, risk-stratified screening framework. A woman’s basic check-up cannot stop at a blood pressure reading and a lipid profile. It must integrate her full life story: her pregnancy history, her menopausal status, her family history, her exposure to smoking (even second-hand), her weight and activity patterns. For those identified as high-risk, this must be followed by appropriate imaging and diagnostics, such as a coronary calcium scan, to get a true picture of her arterial health. This is not a luxury; it is a necessity for early intervention.
Hospitals and health systems must be physically and operationally redesigned to support this vision. The future is the “integrated women’s health clinic,” a physical or virtual space where cardiology, endocrinology, gynaecology, nutrition, and mental health collaborate as a single care continuum. In such a clinic, a woman coming for a routine gynaecological visit would automatically be checked for cardiovascular risk, and a woman seeing a cardiologist would have her bone density and thyroid function reviewed. “Default” check-ups would be designed to include a comprehensive suite of preventive assessments, removing the burden from the patient to know which specialist to see for which symptom.
Policy and financing must follow this clinical logic. Screening programs funded by the government should reflect the real disease burden across women’s lives, not just focus on maternal and child health. Insurance models, both public and private, should reward early detection, continuity of care, and clinical outcomes, rather than simply reimbursing for high volumes of procedures. Workplaces, where millions of women spend their days, must become partners in this effort, making preventive screening accessible, affordable, and normal.
Technology can be a powerful accelerator. AI-enabled risk prediction tools can analyze a woman’s health data across her life to identify those at highest risk long before symptoms appear. Digital platforms can personalize prevention plans and support clinicians with real-time decision-making. But technology must be applied with purpose and caution. It must not create a new form of exclusion, leaving behind women without digital access or literacy. The goal is not just smarter hospitals, but easier access, especially for the women whose days are already a marathon of work and caring.
The ultimate test of our commitment to women’s health is simple. We will know we have succeeded when we stop asking, “How do we run a better women’s health campaign?” and start asking, “How do we build a health system where women’s care is routine, continuous, preventive, and dignified?” The answer requires moving from the pink of a single day to the enduring health of a lifetime. It requires building a system that sees women not as a special topic, but as the central, indispensable thread in the fabric of a healthy society.
Questions and Answers
Q1: What is the central criticism of “pink campaigns” for women’s health?
A1: The article criticizes “pink campaigns” as being largely performative and symbolic. They provide a short burst of visibility around events like International Women’s Day but fail to address the deep, systemic problems in how healthcare is designed for women. What is needed is not symbolic gestures, but fundamental reform in policy, financing, and clinical protocols.
Q2: What is meant by a “life-stage approach” to women’s health?
A2: A life-stage approach means designing care that follows a woman through her entire life, with proactive interventions at each critical transition: adolescence (preventing anaemia), reproductive years (screening for thyroid, PCOS, mental health), and peri-menopausal/post-menopausal years (treating this as a high-risk zone for metabolic and cardiovascular disease). It moves beyond episodic, symptom-driven care.
Q3: Why has women’s heart disease been so underestimated and under-diagnosed?
A3: Heart disease has been historically framed as a “man’s disease,” leading to a systemic bias. Women’s symptoms are often atypical—including fatigue, nausea, and jaw pain—and are frequently dismissed as “stress” or anxiety. Furthermore, risk assessment for women has been inadequate, failing to account for crucial life events like pregnancy history (gestational diabetes) and menopause status.
Q4: What does a redesigned, integrated health system for women look like?
A4: A redesigned system would feature integrated women’s health clinics where cardiology, endocrinology, gynaecology, nutrition, and mental health collaborate seamlessly. It would include risk-stratified screening protocols that account for a woman’s full life history, not just basic vitals. “Default” check-ups would automatically include cardiovascular risk assessment, ensuring no aspect of her health is overlooked.
Q5: What role can technology and policy play in this transformation?
A5: Technology can accelerate change through AI-powered risk prediction, personalized prevention plans, and digital tools that support clinical decision-making. Policy must follow by funding screening programs that reflect real disease burden and by reforming insurance models to reward early detection and continuity of care, rather than just the volume of procedures. Workplaces should also be partners in making preventive screening accessible.
