If you knew the greatest risks to your health, what would you do to avoid them?
Earlier this year, the World Health Organization released a report on the most common causes of death for women worldwide. According to recent data, women have a one in three chance of suffering from cardiovascular conditions such as ischemic or hypertensive heart disease. But despite the red-flag statistics around cardiovascular disease, the danger it poses has been too often ignored. Today, 8.6 million lives across the globe are affected by these conditions annually, with that rate expected to rise unless preventative steps are taken.
The 10 leading causes of death for women in the world (2015)
1. Ischemic heart disease*
3. Lower respiratory infections
4. Chronic obstructive pulmonary disease*
5. Alzheimer’s disease and other dementias*
6. Diabetes mellitus*
7. Diarrhoeal disease
8. Breast cancer*
9. Kidney diseases*
10. Hypertensive heart diseases*
Non-communicable diseases (NCDs) – which include cardiovascular conditions as well as cancers, strokes, chronic respiratory diseases and diabetes – figure highly in the top 10 killers over the past decade, especially of those between 30 and 70 years of age, when people are their most productive. The statistics have been aggregated by region – but interestingly, regardless of the development status of a woman’s environment, the causes of death are consistently NCDs. The only exception is Africa, where 56% of deaths are attributed to communicable, maternal, perinatal or nutritional conditions. This is expected to change by 2030, when 85% of NCD-related deaths will occur in low- to middle-income countries, with cardiovascular diseases predicted to top the list once more.
It makes for grim reading. But a better understanding of this data will allow for public health actions to tackle these mass killers. Beyond economic barriers, education, discrimination, exposure to risk factors and restricted access to health services, an additional, silent influence on the top 10 list for women has been a bias in medical research and development.
A 2016 report by the American Heart Association showed that women are underrepresented in cardiovascular disease research, indicating that physicians do not always have the right information on the warning signs of cardiovascular diseases in women, which presents itself differently from in men. Clinical trials, which are conducted disproportionately on men, may also lack evidence about how women respond to treatment options. Consequently, women have been underdiagnosed for cardiovascular diseases, leading many to mistakenly perceive that they are not at a high risk.
The gender gap in research has prompted organizations such as Women Deliver and NCD Alliance to advocate for more women-specific clinical research, to improve the diagnosis and treatment of NCDs – from cardiovascular diseases to cancers, diabetes and chronic respiratory ailments.
They are rallying for a cause that has residual socioeconomic benefits. A Lancet Commissions report, ‘Women and health: the key for sustainable development’, referenced 1987’s Safe Motherhood Initiative as the first to mainstream a global drive for women’s and children’s wellbeing. A World Bank review of the initiative concluded that gender-responsive services enabled women to live more healthy lives – and to increase productivity and earnings. These healthier women invested their wealth into their households, where families benefited in the form of improved nutrition and a higher standard of education. Insights such as these have paved the way towards a better understanding of the healthcare challenges women face – and how targeting them helps us all.
What can be done to improve healthcare equality and boost longevity for all?
Improving the global health outlook for everyone will require a specifically women-centred approach to integrated healthcare services – as proposed by Women Deliver in the illustration below.
In societies where social and economic status depends on marriageability, women with NCDs are more likely to be divorced, separated or abandoned by their husbands, leaving them financially vulnerable. Investing in integrated healthcare services for women in these places will allow patients to receive multiple services from a single provider, which will save time, reduce disclosure concerns over sensitive information, and therefore increase the likelihood that women and girls will seek these services. This model will have a significant impact in societies where women and girls experience stigma for revealing their health status, or for seeking medical treatment.
Meanwhile, multistakeholders such as governments, civil society and the private sector need to advocate for health services and research that do more to include women. Without adequate action, NCDs are forecast to cost more than $7 trillion globally between 2011 and 2025. On the other hand, simply reducing ischemic heart disease and strokes by 10% in developing countries alone could save $25 billion per year.
So there you have it. Providing women and girls with the right education, the right services for prevention and treatment, and better screening for NCDs, will cut costs, save lives and improve the health outlook for everyone.