February 27, 2014
Doyle “Gender and Global Health”
Men and Women: Patterns of health and illness
• To compare the health and well-being of men and women is a considerable challenge;
o Limitations greatest in LICs, where data is not always accurate and inclusive.
o However, this data offers useful indication of various health inequalities.
• Women’s longer life expectancy throughout every country in the world, but the gender
o Male’s life expectancy gap highest in Iraq (19 years) due to rapid growth of
poverty in the post-communist era that has led to male unemployment and
o Reversal of male and female life expectancy in Africa due to HIV/AIDS and
o The varying gap suggests that the underlying reasons are due to a range of more
complex influences of biological and social factors.
• Men and women are dying from similar causes—TB, HIV/AIDS, and respiratory
infections, for example.
o However, men more likely to die from intentional and non-intention injury,
homicide, or conflict.
o Women face hazards of reproduction, dying from childbirth and pregnancy
complications, miscarriage/termination effects—although this reflects only 2% of
female deaths, it is a preventable area.
o “Women get sicker, but men die quicker.”
Women report poorer Self-reported Health, but this may also reflect
wording and cultural perceptions of survey questions.
o Composite health indicators;
HALE (Healthy Life Expectancy); life expectancy at birth and then
adjusted downwards to reflect an estimate of time spent during life in poor
• Reveals that 14 out of 192 countries had males living a better
HALE than females.
• This might seem like a small number, but only four countries didn’t
have women losing a greater proportion of their life from illness
and disability. DALYs have only found a narrow gap between women and men’s
morbidity; however, DALYs have been criticized for their focus on
economic rather than social costs of disease.
o Use of health services;
In some settings, men more reluctant to seek service due to not wanting
to seem weak.
Women more responsible for care of children and vulnerable dependents
which may limit them asking for help.
More women treated for hypertension, depression, and anxiety; more
men treated for coronary heart problems and diabetes.
Thus, women have poorer self-reported health, use services more,
experience more chronic problems while men have higher levels of
illness and disability that contributes to their higher mortality rates,
as well as under-using healthcare.
Sex, Gender, and Health
• Difference between biological sex and social gender has continuing confusion.
o Gender as a term came into the use during the 1960s to describe how gendered