Documento(s) 10 de 13

The health of women must be seen in the context of global changes and emerging trends in the world today. These changes are occurring rapidly, and their effects are being felt in the most isolated parts of the globe. Human health is, and will continue to be, profoundly affected during this continual and accelerating process of change.

-- A. El Bindari Hammand, Global Commission on Women's Health, WHO, Geneva, Switzerland

The research areas that have been discussed -- AIDS, the working environment, tropical diseases, and barriers to quality health care -- are only a sample of the areas that urgently require more research from a gender perspective. During the regional workshops that formed the basis of this publication, six more priority research themes that have, until now, received relatively little attention from researchers and policymakers were identified: the health of older women, the health of girls during childhood and adolescence, mental health, women and tobacco, the effects of war on health, and violence against women. Although a thorough examination of these topics is beyond the scope of this book, they are briefly described.

Health of older women

More research is needed on the health issues that affect older women. There has been close scrutiny of women's health related to reproduction, but the rest of women's lifespan has been largely ignored. Very little is know about the causes of morbidity and mortality in women over 45 years of age. Although women live longer than men in most societies, they do not necessarily live better. Many elderly women suffer from poor nutrition, reproductive ill-health, violence, alienation, loneliness, lifestyle-related diseases, and chronic and degenerative diseases.

The well-being of the growing aging population has health implications for the next generation of women. Females traditionally are the caregivers. As the population ages, the carers will eventually need care themselves -- "who will care for the carers in their later years?" In the absence of government assistance, this responsibility tends to fall on the shoulders of daughters more often than sons. This represents yet another obligation assumed by women and added to their busy lives.

Health of adolescent girls

Research also needs to focus specifically on the health of girls during childhood and adolescence, times in women's lives when their health status in future years is often determined. Girls who are fed and nurtured less, given minimal access to health services and education, and denied the skills required for economic autonomy suffer the effects of this devaluation for the rest of their lives. The cumulative effects of illnesses, deprivation, and malnutrition in childhood can lead to impaired intellectual development and ill health later in life. Learning disabilities, anemia, and obstetrical complications, which entail significant social and economic costs, are the result. Tropical diseases and stds, including AIDS, can have unique health implications for young girls. Young girls can also suffer health consequences associated with heavy work burdens, such as chronic back pain, distorted pelvis, spontaneous abortions, detrimental effects on unborn children, and disability in old age.

Mental health

In both the industrialized and developing world, mental health issues faced by women have been grossly neglected. There is a need for more work on depression, which is a widespread psychiatric illness that is consistently more prevalent among women than men. There is also a need for more research on gender differences in overall rates of psychological distress and in the prevalence of specific symptoms.

Women and tobacco

Tobacco use, a major cause of morbidity and mortality throughout the world, is associated with higher rates of lung cancer, cardiovascular disease, and a host of other health problems. There is also well-accepted evidence that smoking during pregnancy is associated with higher risks for the fetus and eventual child, including higher rates of spontaneous abortions and low birth weight. Individuals exposed to second-hand smoke in their homes or workplaces may also suffer detrimental health effects.

There is a significant lack of data on women and tobacco in developing countries. Although the rates of female tobacco use are relatively low in developing countries (2-10%) compared with industrialized countries (20-35%), there is evidence that smoking prevalence rates for women in developing countries are increasing. In addition, in some developing nations, the percentage of women smoking cigarettes (or using other forms of tobacco such as reverse chutta, pan, and bidis) is already relatively high (for example, in Brazil, Chile, India, Nepal, and Papua New Guinea).

Concern has been expressed that the tobacco industry has identified women in the developing world as a huge potential market and is systematically targeting these women by exploiting ideas of independence, power, beauty, and emancipation to sell their products. As well, more women may soon take up smoking because it is rapidly becoming a new status symbol in the developing world. More research attention should be placed on women and tobacco in the developing world, and strategies to prevent increased tobacco use among women should be given full attention.

Effects of war on health

In Asia, the effects of war continue to influence the health of women and men, particularly in Cambodia, Laos, and Viet Nam. Cambodia, for example, is one of the most densely mined countries in the world. Men continue to be maimed or killed by bombs and mines left in the fields and villages. Women are left with the additional responsibility of looking after these victims of war as well as their fatherless families. In addition, women have to face the acute social and environmental consequences of war because of their capacity as resource managers and providers for their families. The effects of these conditions on women's health should be addressed.

Research is also needed to explore the psychological effects of war. Over the last two decades, women in Cambodia, for example, have witnessed the execution of their husbands, watched loved ones die of starvation, or were raped and tortured. These horrific experiences have left psychological scars in the form of depression and post-traumatic-stress syndrome. More research attention should be placed on these health issues.

The negative health impact of forced migration also needs urgent attention. Current estimates of the number of refugees, immigrants, and displaced persons worldwide range from 40 to 100 million people. Because they live in unhygienic surroundings with few health resources, these individuals are prey to numerous health problems including cholera, malaria, chronic diarrhea, and AIDS. Crowded living conditions, combined with unemployment and lack of education, also foster addictions, sexual and physical abuse, depression, anxiety, and posttraumatic stress syndrome. According to the United Nations High Commissioner for Refugees (UNHCR), repeated and often brutal rapes are a common dimension of women's refugee experience.

Violence against women

Violence against women, a major public-health issue, is reaching alarming proportions in both developing and industrialized countries. Domestic violence and rape, for example, are significant causes of female morbidity and mortality. Assaults on women by their husbands or male partners are the world's most common form of violence. Surveys in recent years have indicated that about a quarter of the world's women are violently abused in their own homes, and community-based surveys have yielded even higher figures. Violence against women leads to psychological trauma, depression, substance abuse, injuries, stds and HIV infection, and suicide. There is an urgent need for more research on violence against women in developing nations.

Documento(s) 10 de 13