.png)
Key points
Women’s health has traditionally focused on sexual and reproductive health
Other health issues also disproportionately affect women, such as non-communicable diseases
Socioeconomic disparity contributes to female disease burden, particularly in LMICs
A gendered approach to health should no longer be restricted to maternal issues
When you consider the topic of global “women’s health”, what is the first thing that comes to mind? For many, it invokes a simple picture of reproductive and sexual health: pre-eclampsia, post-partum depression, gynaecological issues - the diseases that threaten a woman’s wellbeing in pregnancy and childbirth. In the past, women’s health has largely focussed on sexual and reproductive health, and indeed, this agenda remains a crucial part of improving mortality rates and quality of life for women worldwide. Yet, women make up more than half the global population and comprise groups who have fought obstinately, and still do, so that they might be seen as more than their reproductive parts. Now, we argue, is the time that the concept of women’s health should also expand to encompass not only those ailments that affect women as a distinct epidemiological group in the reproductive sense, but also those that affect their health in every other manner.
Global epidemiological research has unearthed new trends, which show that women are disproportionately dying from ‘non-communicable diseases’ (NCDs). This is now the leading cause of death and disability in women worldwide. These NCDs are not necessarily related to pregnancy; they include cardiovascular diseases, lung cancer, dementia and diabetes. It follows that further research must hone in on those factors which lead to gender disparities in development of disease and access to healthcare. Thus, our research with Polygeia will aim to explore NCDs that increasingly affects women.
It is reported that nearly 80% of all NCDs occur in low-income and middle-income countries (LMICs), and in 2012 an estimated 18.1 million women died from NCDs, of which 8.8 million were due to cardiovascular disease. Women across the globe are disadvantaged with regards to NCDs. Firstly, medical research into gender disparities in the development and treatment of NCDs is sparse. Research regarding sex differences in the development of NCDs has emerged only recently. While smoking has been a long known risk factor for cardiovascular disease, emerging research suggests that it impacts women’s cardiovascular health more profoundly than men’s. One avenue for our group’s work would be to explore how the effects of risk factors for NCDs vary between men and women.
Socioeconomic and cultural factors throughout the world contribute to increased burden of NCDs among women and restriction of access to healthcare. For instance, women worldwide who remain financially dependent on others can be restricted from prioritising their own health. In developing countries where the women’s health agenda may have been driven by charitable bodies targeting maternal health problems, finding ways to incorporate wider health services into existing maternal healthcare services may be crucial to improving NCD-related outcomes in women. Furthermore, in many LMICs, there are low levels of literacy amongst women, owing to barriers to education. As a result, limited access to information may lead to greater exposure to modifiable risk factors such as smoking and alcohol consumption. Education to improve knowledge could mean that women are able to take better care of their own health and, as the primary caregivers in many societies, their family’s health also. Thus, these socioeconomic barriers to healthcare must be determined, and ways to break them down duly considered.
The WHO’s goal to reduce premature mortality due to NCDs by one-third by 2030 cannot be fulfilled without a gendered approach to the problem. We must acknowledge the need to improve access to healthcare for women of all ages globally. Perhaps this will be by finding ways to incorporate wider health services into existing infrastructure focused on maternal and child health. But, most crucially, to meet this goal we must identify local socio-cultural factors that play a part in limiting access, especially in developing countries, and encourage more research into gender variations in how diseases manifest.
Further reading
Peters SAE, Woodward M, Jha V, et al. Women's health: a new global agenda. BMJ Global Health 2016;1:e000080.
Women’s Health and NCDs: A Call to Action, NCD Alliance
Kidney Disease in Women: A Call to Action, Taskforce on Women and NCDs (an example of emerging work focused on different NCDs among women)
About me
Fourth Year medical student at Cambridge with a keen interest in public and global health. Likes reading, Tchaikovsky and tea.