Non-communicable diseases (cancer, cardiovascular disease, diabetes, chronic respiratory conditions, and musculo-skeletal conditions) are the number one cause of death and disablement for women and men globally and in Australia, with increasing recognition that women and men experience those conditions differently. This position paper examines the gender dimensions of those diseases to raise awareness, and to inform prevention and treatment guidelines. Building on the inequities for women documented in the AWHN Position Paper on Women’s Health and Wellbeing, this paper highlights the specific areas where gender blindness is occurring and the areas where change is needed.
Despite the prevalence of Non-communicable diseases (NCDs) among women, there has been little emphases and even less action, on the differences that women experience in these diseases. Most guidelines and policies on NCDs are gender neutral. This has meant that women with non-communicable diseases have not received the level of support and services needed to ensure the best possible outcomes or that necessary research and education into gender differences has been funded.
The lack of research into gender differences and the consequent lack of education for health providers and the population generally, potentially promotes poorer outcomes for women and increases gender inequities. When there is mounting evidence that women’s experience of NCDs is different to that of men’s experience, the gender neutrality of policies, research and education programs contributes to gender inequities.
The impact of NCDs on women’s lives, the differences in risk factors for women than for men and the social determinants of NCDs are highlighted. Specific risks include, that:
- Lung cancer is responsible for more women’s deaths than breast cancer although more women are diagnosed with breast cancer than lung cancer
- Mortality rates from lung cancer in women are continuing to rise while they have plateaued or are dropping among men
- Chronic Obstructive Pulmonary Disease (COPD) occurs at lower levels of exposure to tobacco smoking in women than men
- women with diabetes have a higher risk of stroke than their male counterparts
- women with diabetes have poorer survival after stroke than men.
This paper also highlights the low rate of women in research trials and the low levels of reporting of sex-disaggregated findings. These indicate that treatment recommendations are more generalisable for males than females and the research benefits are therefore greater for men. In turn, this accords a lower status in research to women’s health.
Failure to act on gender differences in non-communicable disease costs lives. It is no longer satisfactory for prevention and treatment guidelines to remain gender neutral. Leadership from governments and peak health bodies is required to drive change in both policy and research. Understanding the ways in which gender interacts with NCDs will be enhanced by explicitly mainstreaming gender in policy, research, treatment guidelines and professional and public education. This paper recommends actions that can be taken to redress these problems, and achieve gender aware, gender sensitive and gender transformative care for women.