Gender disparities in health
has defined health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." Identified by the 2012 World Development Report as one of two key human capital endowments, health can influence an individual's ability to reach his or her full potential in society. Yet while gender equality has made the most progress in areas such as education and labor force participation, health inequality between men and women continues to harm many societies to this day.
While both males and females face health disparities, women have historically experienced a disproportionate amount of health inequity. This stems from the fact that many cultural ideologies and practices have created a structured patriarchal society where women's experiences are discredited. Additionally, women are typically restricted from receiving certain opportunities such as education and paid labor that can help improve their accessibility to better health care resources. Females are also frequently underrepresented or excluded from mixed-sex clinical trials and therefore subjected to physician bias in diagnosis and treatment.
Definition of health disparity
has been defined by WHO as the differences in health care received by different groups of people that are not only unnecessary and avoidable, but also unjust and prejudiced. The existence of health disparity implies that health equity does not exist in many parts of the world. Equity in health refers to the situation whereby every individual has a fair opportunity to attain their full health potential. Overall, the term "health disparities", or "health inequalities", is widely understood as the differences in health between people who are situated in different positions in a socioeconomic hierarchy.Gender as an axis of difference
Bias against females
The social structures of many countries perpetuate the marginalization and oppression of women in the form of cultural norms and legal codes. As a result of this unequal social order, women are usually relegated to positions where they have less access to and control over healthcare resources, making women more vulnerable to suffering from health problems than men. For example, women living in lower-income areas have acutely restricted protection of their health because they are less likely to have access to tertiary education and employment. As a result, female life expectancy at birth, nutritional well-being, and immunity against communicable and non-communicable diseases, are often lower than those of men.Bias against males
There are situations in which men tend to fare poorer. One example is lower life expectancy for men in most countries. Another such instance is armed conflicts, where men are often the immediate victims. A study of conflicts in 13 countries from 1955 to 2002 found that 81% of all violent war deaths were male. Apart from armed conflicts, areas with high incidence of violence, such as regions controlled by drug cartels, also see men experiencing higher mortality rates. This stems from social beliefs that associate ideals of masculinity with aggressive, confrontational behavior. Lastly, sudden and drastic changes in economic environments and the loss of social safety nets, in particular social subsidies and food stamps, have also been linked to higher levels of alcohol consumption and psychological stress among men, leading to a spike in male mortality rates. This is because such situations often make it harder for men to provide for their families, a task that has been long regarded as the "essence of masculinity." A retrospective analyses of people infected with the common cold found that doctors underrate the symptoms of men, and are more willing to attribute symptoms and illness to women than men. Women live longer than men in all countries, and across all age groups, for which reliable records exist. In The United States, men are less healthy than women across all social classes. Non-white men are especially unhealthy. Men are over-represented in dangerous occupations and represent a majority of on-the-job deaths. Further, medical doctors provide men with less service, and less advice, and spend less time with men than they do with women per medical encounter.Bias against intersex people
Another axis of health disparity is within the intersex community. Intersex, also known as disorders of sex development, is defined as "physical abnormalities of the sex organs".Intersex is often grouped into categories with the LGBT community. However, it is commonly mistaken that they are the same when they are not. Transgender persons are born with sex organs that do not match the gender they identify with, whereas intersex persons are born with sex organs or hormones that are neither clearly male nor female, often having to choose one gender to identify with.
Healthcare of intersex persons is centered around what may be considered "cultural understandings of gender" or the binary system commonly used as gender. Surgeries and other interventions are often used for intersex persons to attempt to physically change their body to conform with one sex. It has been debated whether or not this practice is ethical. Much of this pressure to choose one sex to conform to is socially implemented. Data suggest that children who do not have one gender to conform to may face embarrassment from peers. Parents may also pressure their children to having cosmetic surgery to avoid being embarrassed themselves. Particular ethical concerns come into play when decisions are made on behalf of the child before they are old enough to consent.
Intersex people can face discrimination when seeking healthcare. Laetitia Zeeman of University of Brighton, UK writes, "LGBTI people are more likely to experience health inequalities due to heteronormativity or heterosexism, minority stress, experiences of victimization and discrimination, compounded by stigma. Inequalities of LGBTI health vary depending on gender, age, income, and disability as well as between LGBTI groupings." James Sherer of Rutgers University Medical School also found, "Many well-meaning and otherwise supportive healthcare providers feel uncomfortable when meeting an LGBT patient for the first time due to a general lack of knowledge about the community and the terminology used to discuss and describe its members. Common mistakes, such as incorrect language usage or neglecting to ask about sexual orientation and gender at all, may inadvertently alienate patients and compromise their care."
Types of gender disparities
Male-female sex ratio
At birth, boys outnumber girls with the ratio of 105 or 106 male to 100 female children. However, after conception, biology favors women. This is because women, on the whole, are more resistant to diseases and less prone to debilitating genetic conditions. However, the ratio of women to men in developing regions such as South Asia, West Asia, and China can be as low as 0.94, or even lower. This deviation from the natural male-to-female sex ratio has been described by Indian philosopher and economist Amartya Sen as the "missing women" phenomenon. According to the 2012 World Development Report, the number of missing women is estimated to be about 1.5 million women per year, with a majority of the women missing in India and China.Female mortality
In many developing regions, women experience high levels of mortality. Many of these deaths result from maternal mortality and HIV/AIDS infection. Although only 1,900 maternal deaths were recorded in high-income nations in 2008, India and Sub-Saharan Africa experienced a combined total of 266,000 deaths from pregnancy-related causes. In Somalia and Chad, one in every 14 women dies from causes related to childbirth. However, some countries, such as Kenya, have made great strides in eliminating maternal and neonatal tetanus.In addition, the HIV/AIDS epidemic also contributes significantly to female mortality. The case is especially true for Sub-Saharan Africa, where women account for 60% of all adult HIV infections.
Health outcome
Women tend to have poorer health outcomes than men for several reasons, ranging from sustaining greater risk to diseases to experiencing higher mortality rates. In the Population Studies Center Research Report by Rachel Snow that compares the disability-adjusted life years of both males and females, the global DALYs lost to females for sexually transmitted diseases such as gonorrhea and chlamydia are more than ten times greater than those of the males. Moreover, the female DALYs to male DALYs ratio for malnutrition-related diseases such as Iron-Deficiency Anemia are often close to 1.5, suggesting that poor nutrition impacts women at a much higher level than men. Additionally, in terms of mental illnesses, women are also two to three times more likely than men to be diagnosed with depression.In developed countries with more social and legal gender equality, overall health outcomes can disfavor men. For example, in the United States, as of 2001, men's life expectancy is 5 years lower than women's, and men die at higher rates from all top 10 causes of death, especially heart disease and stroke. Men die from suicide more frequently, though women more frequently have suicidal thoughts and the suicide attempt rate is the same for men and women. Men may suffer from undiagnosed depression more frequently, due to gender differences in the expression of emotion. American men are more likely to consume alcohol, smoke, engage in risky behaviors, and defer medical care.
Incidence of melanoma has strong gender-related differences which vary by age.
Women outlive men in 176 countries. Data from 38 countries shows women having higher life expediencies than men for all years both at birth and at age 50. Men are more likely to die from 13 of the 15 major causes of death in the U.S. However, women are more likely to suffer from disease than men and miss work due to illness throughout life. This is called the mortality-morbidity paradox, or Health Survival paradox This is explained by an excess of psychological, rather than physical, distress among women, as well as higher smoking rates among men. Androgens also contribute to the male deficit in longevity.