Gender Equity: Promoting Healthy Outcomes

Introduction It has been assumed that progress on issues of gender parity, such as better educational and vocational opportunities and increased income would translate into better health outcomes for women. Certainly women's health has generally improved in nations where movements toward parity have occurred. The United Nations has used a gender-related development index, using life expectancy from birth, adult literacy rates, a gross enrollment ration of women to men in primary, secondary, and tertiary educational institutions, and estimated earned income, to determine the relative ranking of societies with regard to gender parity. The results have indicated that the greatest progress in gender parity has occurred among so-called developed nations, with the top 20 ranked societies for gender equality including nations from Europe, Australia, Canada, the United States, and New Zealand (United Nations Development Programme 2006). Generally speaking, improvements in women's health have been attributed to greater educational opportunities leading to increased disposable income (e.g., Hill and Needham 2006). The life expectancy of women in nations in which progress in gender parity has been noted has increased over the last century and often exceeds that of men. However, disturbing trends for women have been noted in developed nations for some health outcomes. In the United States for example, the prevalence for bronchial asthma among women was estimated to be at 8.38% in 1998 and that estimate rose to 14.9% by 2004. The prevalence for diabetes for women in the United States was estimated at 2.7% in 1980 and that estimate had doubled to 5.4% by 2005. In 1998, 18.3% of women in the United States were estimated to be obese, and that estimate had risen to 24.5% by 2006 (Centers for Disease Control [CDC] 2007). For many years, these increased health problems seemed to be associated specifically with American society. However, many of these health trends are occurring in other developed nations. For example, increases in obesity and smoking among women have been noted in many European nations as well (World Health Organization 2007). When asked in the Behavioral Risk Factor Surveillance System questionnaire by the CDC to rate general health, 23.5% of women respondents in the US reported their general health to be excellent in 1995 but that number had decreased to 20.1% in 2006 (CDC 2007). The CDC also found that in 1998, 9.8% of women reported 14 or more days that were unhealthy, and that percentage had increased to 11.9% by 2005. Among women 18-25 years of age, approximately 17% reported significant psychological distress, primarily depression, compared to near 11% for men of the same age range. The percentages reporting significant psychological distress among women aged 26-49 decreased to around 12% and to around 9% for women age 50 and older. Although women reported greater prevalence than men of significant psychological distress at all age cohorts, the disparities decreased as a function of age (Substance Abuse and Mental Health Services Administration [SAMHSA] 2004). Poor mental health has been associated with a wide variety of negative health outcomes that adversely affect length and quality of life (Blehar and Norquist 2002). Although the increases in prevalence of these aforementioned diseases and conditions are mirrored somewhat by men in the United States, the increased reports of mentally unhealthy days by women were not. In some cases the increases of disease prevalence may reflect improved diagnostic services for women by physicians or greater accessibility to health care services for women, but the trends are still disturbing and appear to defy the logic that women's health may be improving as a function of greater parity in American society. Unfortunately, the gender gap seems to have been bridged in the United States in the prevalence of certain health problems that have been traditionally associated with men. …

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