Contributing to Women’s Health Contributes to the Health of the World
Health…what does health mean? Many have similar and varying definitions of health. Many believe that any abnormality means that you are no longer healthy. Some will put health on a continuum, and depending on where you land on that continuum, you are healthy or not. Many will attribute health to a certain body weight or body build. Some consider health to be associated with age. If you search for a definition of health, it is usually described as a person’s physical and mental condition, and good health is equated to being free from illness or injury. In contrast, throughout my education in nursing, the definition of health became more holistic and is defined as one’s comprehensive physical, mental, and social wellness.
Health and wellness are important for EVERYONE. Yet, equity and equality are not synonymous. There are numerous modifiable (choices or free will) and non-modifiable (fate or destiny) components that contribute to health disparities and gaps. Even then, I submit to you that what is considered a modifiable or non-modifiable risk and determinant isn’t always clear-cut, but that is an argument for another day. Globally, there are many health gaps for women.
It is commonly thought that women tend to live longer than men; unfortunately, our longer lives are with poorer health. Compared to men, according to the World Economic Forum, women spend 25% more of their lives in poor health and living in daily physical pain. We are underdiagnosed for certain health conditions and are underrepresented in health research. According to the Hologic Global Women's Health Index billions of women lack diagnostic testing for deadly disorders, continuously struggle with physical or emotional health disorders without improvement, and are not secure with shelter and food. The health gap for women is associated with 75 million years of life lost from poor health or early death annually!
There are many elements that impact our wellness as women, regardless of our demographic and socioeconomic status. Although we may not share the exact same concerns, risks, or health priorities, there have been some conditions identified that impact women’s wellness globally. After reviewing a plethora of sources from 2010 to the present through a global lens, several concerns have emerged and haven’t changed much (outside of the impact of COVID-19).
Four wellness concerns for women include:
Heart disease
Cancer & Reproductive (gynecological) Health
Autoimmune diseases
Mental health
Heart disease
Heart disease describes many conditions that affect one or more of the parts of the heart and system (muscles, vessels, valves, and electrical systems). Some examples are high blood pressure (the silent killer), high cholesterol, valve disease and prolapse, infections, abnormal heart rhythm or beats, strokes, heart attacks, and vascular disease.
Heart disease is the leading cause of death for men and women. Let me repeat…AND WOMEN…. of any age. Many do not acknowledge risks, do not prioritize prevention, and do not seek treatment because of not “feeling bad” or having symptoms. As a nurse, I have educated many that by the time you “feel” symptoms, there is likely already some irreversible damage. This damage will negatively impact your quality of life and longevity.
Unfortunately, many women simply do not recognize that heart disease is a significant threat to OUR health. According to the CDC, just about half of U.S. women recognize that heart disease is our number 1 killer even though almost half of us are living with some form of heart disease. While more men die from heart disease, women are likely to die at younger ages or have restricted lives. There are many contributors, including underrepresentation in medical research.
Men have outnumbered women in cardiovascular research under the assumption that male bodies represent all bodies. This may lead to a misrepresentation of symptoms. If I question what are the signs of a heart attack, what would you say? Most people think of chest pain, left arm or jaw pain. The classic theatrical scene is of a man clutching his chest and collapsing to the ground. For women, some of the symptoms may not be as intense. Other symptoms associated with heart attacks include shortness of breath, nausea or vomiting, flu-like symptoms, acid reflux, back pain, dizziness, or tiredness. These symptoms are often mistaken for other less-serious illnesses, as part of our normal stressful day-to-day symptoms, or as part of aging. This leads to a delay in testing or seeking medical care, or delay in testing and misdiagnosis by healthcare.
Depending on the source, 1 in 3 to 5 women will die from heart disease. Let me make it more real. There are usually at least 3-4 of us in a circle of friends. Either you or one of your friends will succumb to heart disease! I know that was a very gloomy and macabre statement. Ladies, do not despair, there is optimism. Some risk factors for heart disease are not modifiable, but there ARE MANY that we can change or improve on.
Cancer & Reproductive (Gynecological) Health
I combined these two concerns. Breasts are included in the female reproductive system and have reproductive functions. Breast cancer is the leading cancer diagnosis in the world indiscriminate of gender. For women, breast cancer is the leading cause of cancer deaths in women globally. Risk factors are often classified as modifiable and non-modifiable. Breast cancer may also be classified as reproductive and non-reproductive. Economic development does affect both classifications.
Some reproductive-related increased risk factors:
Female gender
Starting your period before age 12
Starting menopause after 55
Not having children, having your first child after age 30, and not breastfeeding. The risk of breast cancer is reduced by 7% for each birth and then by 4.3% for every 12 months of breastfeeding.
Obesity. Obesity is not inherently a reproductive issue; however, I included it as hormonal changes, abnormalities, and hormone replacement therapy affect weight and also increase the risk of breast cancer.
Although other cancers list higher for commonality in diagnosis and mortality, gynecological cancers have a significant impact on women’s quality of life, ability to reproduce, sexuality and sensuality, mental health, and longevity. Gynecological cancer starts in and invades the cervix, ovaries, uterus, fallopian tubes, vagina, and vulva.
Common symptoms include:
Pelvic pain, discomfort, pressure
Abnormal bleeding
Abnormal vaginal discharge
Changes in urine or bowel habits
Back and/or abdominal pain
Changes in reproductive skin (discoloration, rashes, sores, warts, itching, burning, etc.).
Have you noticed that many of these symptoms overlap with other non-cancerous issues of the reproductive system such as infections (including sexually transmitted diseases/infections), endometriosis, fibroid tumors, menstrual abnormalities, polycystic ovarian syndrome (PCOS), pregnancy, and menopause? Many times, we will dismiss pelvic pain, bleeding, discharge, and changes in our reproductive system as a normal part of womanhood and aging. It is important for women to educate themselves and each other, engage in conversations, and advocate for testing and seeking care to improve our reproductive health.
Autoimmune disease
Autoimmune disease is a category that describes more than 80 diseases caused by the body turning on or attacking itself. Some examples of autoimmune diseases are type 1 diabetes, lupus, rheumatoid arthritis, multiple sclerosis, thyroid disease, inflammatory bowel disease, and psoriasis. Each individual disease is rare, but as a category, autoimmune disease is the 3rd most leading category of diseases for women following heart disease and cancer. It is estimated that 75-80% of autoimmune diseases occur in women and are the 4th leading cause of disability for us. The exact cause is unknown, but genetics, hormones, and environmental factors have been associated. Symptoms depend on the specific disease, but many commonly shared symptoms are:
Fatigue or tiredness
Feeling bad (malaise)
Pain
Mild fever
Skin changes (rashes, dryness, & irritation)
Early detection is the best defense against autoimmune diseases; although it may take 5 years or more for a diagnosis. General recommendations to help manage autoimmune diseases are reducing sugar, fat, toxins (alcohol & tobacco), and stress.
Mental health
Mental health is a crucial element of one’s overall health. Globally, men are more likely to die from mental disorders, but women are more likely to report negative emotions and be prone to mental disorders. Women are more likely to experience depression and anxiety attributed to increasing stress levels from the numerous roles, hormonal changes, life-altering experiences and trauma, cultural and societal pressures, and socioeconomic conditions.
Depression may negatively impact all aspects of life. Symptoms include:
Tiredness or low energy
Difficulty with concentration
Excessive feelings of guilt, low self-worth, hopelessness, or losing happiness
Changes in sleep, eating habits, or weight.
Thought of self-harm or dying
Anxiety, stress, and worry are connected to the lack of security .
Nearly 1 billion women are still struggling to afford food and shelter.
One-third of women (approximately 1 billion women globally) do not feel safe walking alone at night.
According to the World Bank Gender Data Portal, in 2022, 30% of women (approximately 736 million women) have experienced gender-based trauma (intimate partner violence or non-partner sexual violence). Gender-based trauma or violence may be physical, sexual, emotional, and/or psychological in nature and includes female genital mutilation, rape, sex trafficking, physical abuse, and forced or child marriages. Gender-based trauma also increases the risk of Post-Traumatic Stress Disorder (PTSD).
Stress, lack of a healthy diet, depression, and anxiety may also negatively impact sleep quality. Proper rest and sleep are two of the most important aspects of health and wellness. Impaired sleep often accompanies mental disorders. Other mental disorders also complicate other mental disorders. As with physical health concerns, the health gaps for women also contribute to negative mental health. For example, girls and women may present differently for Autism and ADHD, which leads to misdiagnoses, delayed diagnosis, delayed treatment, and other mental health problems that manifest in the body as physical health complaints.
It is not uncommon for women to feel guilty for feeling depressed, anxious, or overwhelmed like they’re failing all of their roles, and even guilty for considering self-care. In addition, misinformation, stigma, costs, and access are barriers to seeking professional help.
Conclusion:
These are just a few of the health concerns facing women globally. All 4 of these concerns may negatively impact the others. There are many social, economic, cultural, geographical, psychological, and physical barriers to wellness and improved health for women. On a global scale, much is needed to improve our health and close the gaps. Closing the gap would add 7 healthy days per year or 500 days over a lifetime to every woman in the world and raise the global economy by $1 trillion by 2040. It does seem like a great challenge and a great deal of work to increase our access, representation, safety, and confidence to seek help, but it is fundamental and essential.
On a smaller scale, there are many things we could implement and practice to positively impact our health and promote wellness. We might do these alone. We might also do them with the women in our circle, other loved ones, and within our communities for accountability, and support, and to improve all of our health and wellness.
Here are 4 things you can do starting today:
Regular exercise, healthy eating, and increased water intake. Dance party anyone? Walking, hiking, Pilates, yoga, swimming, going to the gym, and sports are all good options. Chair and bed exercises are alternatives for those with certain limitations. Always check in with your healthcare provider for the best recommendations and limitations for your current status. Yes, food is delicious and enjoyable, but food is also medicine for mental health and physical health. The majority of our bodies are water, it just makes sense to replenish it and keep our fluids balanced.
Abstain from chemicals (avoid tobacco and drugs, limit alcohol intake, exposure to hazardous chemicals and pollution).
Reduce stress and get enough rest and sleep. Stress doesn’t just make you feel bad, but it is harmful to your body and functions. You’d be amazed at how stress affects you! Yes, there is a difference between rest and sleep. Physical, mental, emotional, social, sensory, creative, and spiritual are 7 types of rest. I strongly recommend Saundra Dalton-Smith, M.D.’s book Sacred Rest: Recover Your Life, Renew Your Energy, and Restore Your Sanity.
Increase testing and seek medical care. You don’t have to wait until there is a problem. Wellness exams and frequent checkups are great for prevention and early detection. Prevention is key, but early detection and treatment are truly the MVPs to maintain and improve wellness.
