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"Health is linked to status in society. It benefits from equality and suffers from discrimination. For women, the rapid rise in noncommunicable diseases not only affects their health directly, it can also severely impact on their assumed gender role as unpaid carers of the sick." (1)
Nearly everywhere in the world, women live longer than men. But a longer life is not necessarily a healthier life. A woman's health is affected by her role in her society, the culture in which she lives, unique female biological characteristics, the choices she makes, and an array of socio-economic factors. In turn, women's health has an enormous effect on the health of those around them. Women give birth to and nurture the next generation. They procure and cook food for their families, friends, and communities. In some cultures, girls begin caring for other family members at a very young age. As women grow older, they often find themselves taking care of their own children, their children's children, their older parents, their in-laws, and their male partners--who often are less healthy. Focused on taking care of others, women may necessarily neglect taking care of themselves physically or financially. Poverty disproportionately affects women's lives and their health, according to WHO, which estimates that 70% of the 1.2 billion people living in poverty are female. Twice as many women as men are illiterate.
Heart disease and stroke are already the leading causes in women in developed countries and will be the leading causes of death in women in poor countries by 2020. CVD currently causes about one-third of women's deaths globally, with a majority of these deaths occurring in low- and middle-income countries. Unfortunately, the enormous global toll of cardiovascular disease among women, is not generally recognized. Heart disease and stroke are responsible for twice as many deaths as all cancers combined, but many women are more aware and more fearful of cancer than CVD.
The need for increased awareness, education, and action is clear, not only to promote women's health and well-being, but for the health and well-being of our communities and countries.
A comprehensive overview of determinants and challenges relevant to women's heart health, and an outline of opportunities and recommendations on which we can act, are presented in "Women and the Rapid Rise of Noncommunicable Diseases." Published by the World Health Organization in 2002, its contents are illuminating, useful, and highly relevant. Thank you to Derek Yach, one of the report's authors, for bringing it to our attention as we highlight women's heart health issues in anticipation of International Women's Day on Sunday, 8 March 2009. The report should be included, as a valuable reminder and a useful, usable resource, in everyone's library of CVD literature, and can be downloaded at no cost at: (PDF 111 KB) http://whqlibdoc.who.int/hq/
The report advocates several specific responses to the challenges we face in addressing women's health issues globally:
- Obtain more and better gender-sensitive information with data collection and analysis that seeks to understand gender differences in morbidity, mortality, and risk.
- Create linkages among existing programs that address infectious disease and maternal and child health with programs preventing chronic disease-for example, by promoting tobacco cessation in TB clinics, or providing nutritional advice to new mothers that can help prevent CVD in adulthood.
- Develop policies that address the determinants of noncommunicable diseases. Global and national interventions that are affordable can effectively reduce risk factors for chronic diseases. Banning tobacco advertising requires political will rather than funding; in countries like Poland, Iran, and Thailand, tobacco taxes generate fiscal resources that are used to support health programming.
- Refocus health systems on chronic disease and primary health care instead of acute disease. Implicit in this is the need to reduce barriers' to women's access to care in terms of cost, convenience, service provider genders, etc.
- Expand partnerships among programs that address the full range of issues affecting women's health, like gender equality and sexual and reproductive rights.
As International Women's Day approaches, let's all take a moment to honor the contributions of women everywhere, as well as to take a look at what more our organizations or projects can do to promote women's health and wellbeing.
Catherine Coleman
Editor in Chief, ProCor
Citation:
1. Yach D, Brands A. Women and the rapid rise of noncommunicable disease. World Health Organization: NMH Reader, Issue 1, January 2002, http://whqlibdoc.who.int/hq/
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