by Curswell Tshihwela
Women still face many health problems and lifestyle struggles which require one to stand up, re-commit to addressing these challenges. However, some of the causes of these challenges and struggles are as a result of ignorance or lack of knowledge
when it comes to others. There are certain kinds of factors which have been identified as crucial to improving women’s health over the next two decades such as prevention of chronic diseases through the control of risk factors (targeting chronic disease such as cardiovascular disease, HIV, diabetes and cancer, as well as risk factors such as obesity, nutrition, physical inactivity, alcohol and tobacco consumption); mental health and wellbeing (targeting
Anxiety, depression, and suicide); sexual and reproductive health (targeting sexually transmitted infections, screening/vaccination, and fertility control); and healthy ageing (targeting muscular-skeletal conditions, disability and dementia) as well as no communicable diseases. There has been an increase in the rate of chronic diseases across the world which form a large proportion of the burden of diseases, led by cancer and cardiovascular disease. Cardiovascular (CVD) is the leading cause of death across the world with cancer also being in the second position for leading burden of disease at just 18 percent ( mainly due to premature death ). Sex and gender interact to heighten the risk of cardiovascular disease for women. Heart disease has traditionally been seen as a man’s disease and women have been under-represented in studies.
However, sex differences exist in the symptoms women and men experience during a heart attack. Women are more likely to have less recognised symptoms of coronary heart disease (CHD). While chest pain, pressure, or tightness are leading signs of heart attack for both sexes, women are more likely to report atypical symptoms such as non-specific chest pain, mid-back pain, nausea, palpitations and indigestion which are more difficult for a physician to recognise and can, therefore, lead to delayed diagnosis. Diabetes prevalence has at least doubled in the past two decades and is a National Health Priority Area. While there is a higher prevalence of Type 2 diabetes amongst males (with an age-standardised rate of 7.6 per cent compared to 6.5 per cent) diabetes is still a major concern for women.
Gestational diabetes is a temporary form of diabetes that occurs during pregnancy and is increasingly prevalent with significant associated risks to both mother and baby. It has been diagnosed in between 5 and 12 per cent of pregnant women, who then have a 50 per cent risk of developing Type 2 diabetes within five years. Two of the most common cancers affecting women are breast and cervical cancers. Detecting both these cancers early is key to keeping women alive and healthy. The latest global figures show that around half a million women die from cervical cancer and half a million from breast cancer each year. The huge majority of these deaths occur in low and middle-income countries where screening, prevention, and treatment are almost non-existent, and where vaccination against human papillomavirus needs to take hold.
Women with a history of partner violence are less likely to have adequate health screening. The submission from Women’s Health Australia suggested that there is a need to identify ways of encouraging women with a history of partner violence to undertake regular screening, particularly for cervical cancer. Various social changes have affected women’s experiences in recent decades have had many positive benefits for women, but may also be associated with an increase in higher-risk behaviours, such as binge drinking and smoking. Additionally, as more women participate in paid employment they now find they have less time for health-promoting activities, such as physical activity and healthy eating. This is compounded by full-time working women spending much more of their time doing housework and looking after children than full time working men.
Many diseases (especially lifestyle-related diseases) have in common certain risk factors, and these are closely tied to socioeconomic status. Women living on a lower income are typically more likely to be unemployed, under-educated and to have fewer social networks, which may, in turn, limit their ability to engage in healthy behaviours and physical activity. Disadvantaged women are more likely to have a higher rate of health risk factors, such as being overweight or obese, having fewer or no daily serves of fruit, and smoking tobacco. In 2012, some 4.7 million women died from no communicable diseases before they reached the age of 70 —most of them in low- and middle-income countries.
They died as a result of road traffic accidents, harmful use of tobacco, abuse of alcohol, drugs, and substances, and obesity — more than 50% of women are overweight in Europe and the Americas. Health risks related to unhealthy eating include over-consumption, lack of fruit and vegetables, and saturated fat intake. In 2003, 2.1 per cent of Australia’s total burden of disease and injury was attributed to low fruit and vegetable consumption. Eating sufficient fruit and vegetables can help prevent cancer, ischaemic heart disease and—to a lesser extent—stroke. Women are disproportionately affected by mental illness, and mental disorders have been estimated to represent the highest burden of illness for adult women across the world. A range of social factors may contribute to women’s higher rates of anxiety and depression.
These include higher levels of socioeconomic disadvantage and poverty, lower income and lower participation in the paid workforce; higher exposure to discrimination and harassment, intimate partner and sexual violence; and the burden of caring responsibilities—all of which generally relate to gender, affecting women more than men. Violence against women can have a profound impact on women’s emotional and mental health. Depression, anxiety, and suicide together contributed to 73 percent of the total disease burden for intimate partner violence. Women who have experienced intimate partner violence are twice as likely to be diagnosed with a mental illness. For women, depression is one of the most common consequences of sexual and physical violence and experience of violence results in a higher risk of stress and anxiety disorders, including post-traumatic stress disorder.
Some other psychiatric disorders (for example, phobias and dissociative disorder) are more common in women reporting intimate partner violence than those who do not. Women reporting intimate partner violence are more likely to use medication for depression and anxiety. Adolescent girls face a number of sexual and reproductive health challenges: STIs, HIV, and pregnancy. About 13 million adolescent girls (under 20) give birth every year. Complications from those pregnancies and childbirth are a leading cause of death for those young mothers. Many suffer the consequences of unsafe abortion. Sexual and reproductive health problems are responsible for one-third of health issues for women between the ages of 15 and 44 years. Unsafe sex is a major risk factor – particularly among women and girls in developing countries.
This is why it is so important to get services to the 222 million women who aren’t getting the contraception services they need. Attitudinal barriers relating to perceived stigma, embarrassment and lack of confidentiality in rural areas can also be barriers to access. Aboriginal women and women from culturally and linguistically diverse backgrounds may experience language and cultural barriers, culturally inappropriate services and difficulties navigating the health system. Access to health care services for same-sex attracted women may be significantly inhibited by heterosexist attitudes among health professionals. More information is needed about who accesses services and about barriers to services for disadvantaged women.
Sexually transmitted infections (STIs) remain a major public health issue across the world, particularly in regards to increasing rates of chlamydia. But it is also vital to do a better job of preventing and treating diseases like gonorrhea, chlamydia, and syphilis. Untreated syphilis is responsible for more than 200,000 stillbirths and early foetal deaths every year, and for the deaths of over 90 000 new-borns. Women’s need to stay focused on promoting and encouraging good health amongst themselves and supporting preventative action that will address the particular priority of health issues by women through the consultative process.
Women’s together with governments are advised to consider developing several actions to address barriers that may inhabit women’s access to preventative health services such as explore opportunities to consider the impact of the biological and social context of women’s lives on prevention activities, health communication strategies to consider the whole population and subgroups, education strategies for communities on availability of interpreters, work with primary health workers to increase interpreter awareness and enhance cultural sensitivity, increased awareness of discrimination experienced by women with disabilities, lesbian and bi-sexual women and the use of new technologies to target women who may not be reached by more traditional forms of media.