1. GENDER PRESENTATION.
GENDER AND DISEASES
Gender difference in diseases(gender and prevalent
medical diseases/conditions) Heart disease,DM,
differences in risk factors to heart disease, DM, etc
according to sex/gender, menopause
3. OBJECTIVES
• Definition of terms.
• Explain prevalent medical diseases/conditions
according to sex/ gender Heart disease,DM,
• Explain the differences in risk factors to heart
diseases ,DM, according to sex/gender,
menopause
4. DEFINITION OF TERMS
GENDER
• Is a social construct of norms, behaviors and roles that
varies between societies and over time. OR
• Is the characteristics of women, men, girls and boys
that are socially constructed. This includes norms,
behaviors and roles associated with being a woman,
man, girl or boy, as well as relationships with each
other. As a social construct, gender varies from society
to society and can change over time.(WHO)
5. CONTINUATION OF DEFINITIONS
Disease
• is a particular abnormal condition that negatively
affects the structure or function of all or part of an
organism, and that is not immediately due to any
external injury.
Diseases are often known to be medical conditions that
are associated with specific signs and symptoms OR
• Is any harmful deviation from the normal
structural or functional state of an organism,
generally associated with certain signs and
symptoms and differing in nature from physical
injury(WHO, 11 Jun 2021 ).
•
6. PREVALENCE
• This refers to the total number of individuals in a
population who have a disease or health condition
at a specific period of time, usually expressed as a
percentage of the population.
• Disease prevalence
is the proportion of a particular population found to
be affected by a medical condition (typically a
disease or a risk factor such as smoking or
seatbelt use) at a specific time.
8. HEALTH SERVICE USE
Most of those who had not used health services might be under the
notion that they were in better health, and did not need to visit
healthcare facilities. In contrast, the high prevalence of biomedical
indicators suggests that the use of health services among teachers
needs to improve.
The key barriers to the use of health services were inaccessibility to
healthcare facilities, unhelpful personnel, inappropriate hours of
services that conflicted with the working hours of the participants,
lack of security. Any of these obstacles could also explain the poor
use of health services by males.
Regular health checks are essential for early detection and
management of NCD risk factors. More frequent visits to healthcare
facilities were linked with reasonable control of the lipid profile and
blood pressure.
9. LIFE STYLE BEHAVIORS
Unhealthy lifestyle behaviors are recognized causes of NCDs. Male and
females are exposed to varying behavioral risk factors for NCDs.
Females were found to be less physically active than their male
counterparts.
Traditional norms, cultural values, and/or lack of support in the
community may contribute to women’s poorer engagement in physical
activities. The barriers to women participating in physical exercise,
particularly regular exercise, are numerous and complex. The family’s
patriarchal and conservative social structure has influenced women to
stay at home and avoid physical activities outside the house.
Insufficient physical activity could also be due to insufficient female-
friendly outdoor spaces for physical exercise and a lack of women-only
gyms in both urban and rural areas.
10. CONT…
• The low prevalence of sufficient physical activity
among female might also be due to their lower
awareness of physical exercise benefits and the
lack of sufficient time away from heavy
workloads, childcare, and household chores .
• Sedentary lifestyle in women has been linked to a
high prevalence of BMI values in the
overweight/obesity range. Lack of physical
activity and obesity increases the vulnerability of
women to NCDs
11. CONT…
Physical inactivity is the 4th leading risk factor for global
mortality after high blood pressure, tobacco use and high
blood glucose. Physical Activity is an independent risk factor
for NCD. physical inactivity is responsible for a significant
global health burden:
More than 7% of all-cause and cardiovascular disease deaths and
up to 8% of non-communicable diseases are attributable to
physical inactivity (Katszmarsky PT et al 2022). There are
many health benefits demonstrated from various studies, that
accrue to more physically active individuals when compared to
those who are less physically active
12. HEALTHY DIETS
Men and women have different levels of
knowledge about healthy foods, food choices,
and weight reduction.
In addition, men tend to eat meals not prepared
at home more frequently, and such meals often
contain only small quantities of fruits or
vegetables. Fruit and vegetable consumption is
beneficial to one’s health and is recommended
to reduce the risk of NCDs
13. SMOKING
• Tobacco use and exposure to second-hand
tobacco smoke is a major preventable risk factor
for Non communicable diseases. Tobacco use
continues to kill over 8 million people each year,
including more than 800 000 non-smokers who
die from exposure to tobacco smoke.
• The prevalence of smoking was 14–15% among
men and 1–2% in women in rural Uganda (Asiku
G et al 2015).
14. CONT….
• This higher smoking prevalence among men
could be because tobacco use by women is
considered an unfeminine trait not culturally or
socially acceptable generally. Male and female
smoking trends can be linked to several social
and economic factors, including gender
equality, spread of smoking, economic growth,
and public policies
15. HEALTHY PROFESSIONAL
ADVISE
• Fewer than half of all the people receive advice
from health professionals on the importance of
adequate fruit and vegetable intake, reduced fat
consumption and reduced salt intake, habitual
physical activity, weight loss, and smoking
cessation.
• More women seek advice from the health workers
than men about lifestyle modifications at each
appointment where they can be persuaded to
change their practices to prevent and manage
NCDs.
16. ALCOHOL CONSUMPTION
• Harmful use of alcohol is one of the main factors
contributing to premature deaths and disability and has a
major impact on public health. The harmful use of alcohol
encompasses several aspects of drinking such as the volume
of alcohol drunk over time; the pattern of drinking that
includes occasional or regular drinking to intoxication; the
drinking context if it increases the public health risks; and
the quality or contamination of alcoholic beverages.
• The STEPS survey revealed that 19% (male 33%, female
5%) of Kenyans drink alcohol regularly. Heavy Episodic
drinking in Kenya is approximated at 12.7%.
• The prevalence of heavy episodic drinking in the 15-19
years old population is 6% (12% males, 1.7% females).
17. OBESITY AND HEAVY WEIGHTS
• Overweight and obesity are a major risk factor for non-communicable
diseases such as cardiovascular diseases, diabetes, and some types of
cancer. They are associated with increased rates of chronic disease and
death globally.
• According to Baalwa etal (2010), The overall prevalence of obesity and
overweight was 2.3% and 10.4%, respectively. The prevalence of obesity
was 4.4% in Kampala and 0% in Kamuli while the prevalence of
overweight was 10.2% and 10.6% in Kampala and Kamuli, respectively.
• Compared to males, females were more likely to be obese (2.9% vs. 1.8%)
or overweight (17.4% vs. 3.3%). Residing in the city, alcohol consumption,
smoking, non-engagement in sports activities, commuting to school by taxi
or private vehicle and being from a rich family were the main factors
significantly associated with obesity. Being female and not engaging in any
sports activities were two factors significantly associated with being
overweight.
18. DISEASES OF THE HEART
• Cardiovascular diseases (CVDs) are a group of
disorders of the heart and blood vessels. They include:
• coronary heart disease – a disease of the blood vessels
supplying the heart muscle;
• cerebrovascular disease – a disease of the blood vessels
supplying the brain;
• peripheral arterial disease – a disease of blood vessels
supplying the arms and legs;
• rheumatic heart disease – damage to the heart muscle
and heart valves from rheumatic fever, caused by
streptococcal bacteria;
19. • Although gender is increasingly perceived as a
key determinant in health and illness, systematic
gender studies in medicine are still lacking. For a
long time, cardiovascular disease (CVD) has been
seen as a “male” disease, due to men's higher
absolute risk compared with women, but the
relative risk in women of CVD morbidity and
mortality is actually higher: Current knowledge
points to important gender differences in age of
an individual
20. • CVD; however, concerning gender differences,
The results have been inconsistent. Current
evidence suggests that depression causes a
greater increase in CVD incidence in women,
and that female CVD patients experience
higher levels of depression than men.
21. • One of the factors explaining differences in
morbidity and mortality is gender. in contrast to
the term “sex,” “gender” is a multidimensional
construct including biological/genetic,
psychological, and social differences between
men and women.
• Although gender is based on biology, and
biological factors in men and women may affect
behavior and vulnerability differently, these
factors do not influence the entire
22. • scope of gender-related behavior, emotions, and
attitudes. Beyond genetic and biological
differences, gender refers to the socially
constructed roles for men and women, Implicating
different social norms and expectations.
• These define which emotions, behaviors, and
attitudes are typical and desirable for males and
females. They even result in classifying disorders
as male and female, such as “male” heart disease
and “female” depression.
23. CONT..
• Although traditional gender norms have
changed during the last three decades, and
concepts of being male and female have
become more individualistic, normative
notions of typical male and female attributes
still remain influential in social perception and
evaluation, including health care (gender bias).
24. prevalent medical diseases/conditions
heart disease according to sex/ gender
• Although CVD remains the leading killer of both
women and men in the United States, there are
substantial sex/gender differences in the
prevalence and burden of different CVDs, For
both women and men
• Coronary heart disease (CHD) is the leading
cause of morbidity and mortality in the more
economically developed areas of the world, being
two to five times more common in men than in
women in the younger age groups.
25. Continuation of heart diseases
• CHD risk increases with age in both men and
women, but shows a more prominent increase
in women older than 50. Despite better
medical treatment of CHD, It remains the
leading killer of women in old age.
• In Europe, about 55% of all female deaths are
caused by cardiovascular disease (CVD),
especially CHD and stroke, compared with
44% of all male deaths
26. CONT..
• The older age at onset of CVD in women (70
years) com_ pared with men (60 years),
probably related to estrogen deficiency post-
menopause, correlates with an increase in
comorbid diseases and consequently an
increase in mortality; 38% of women die
within 1 year of an initial unrecognized
myocardial infarction, compared with 25% of
men.
27. CONT…
• The older age at onset of CVD in women (70
years) compared with men (60 years),
probably related to estrogen deficiency post-
menopause, correlates with an increase in
comorbid diseases and consequently an
increase in mortality;
• 38% of women die within 1 year of an initial
unrecognized myocardial infarction, compared
with 25% of men.
28. CVD
• In summary, the management of CVD in men and
women is obviously different, and these differences are
partly due to a gender bias in favor of men. While some
studies did not find a gender bias in the management
and outcome of patients with acute coronary artery
disease, unstable angina, and in selection for coronary
angiography and revascularization early after MI,others
did.
• For example, in a large European study, Daley et
al Identified significant gender bias at multiple levels in
the investigation and management of stable angina.
29. prevalent medical diseases/conditions
DM disease according to sex/ gender
• In the field of endocrinology and metabolism,
sex, and gender differences in diabetes
mellitus (DM) have been identified. Current
literature describes sex differences in
prevalence, symptoms, co morbidities,
outcomes, treatments, and prevention of
individuals with DM. For example, males with
diabetes have a higher risk for micro vascular
complications, such as retinopathy and
nephropathy
30. continuation DM
• Treatment strategies, including screening .
• The higher incidence of cardiovascular complications
in females with diabetes mellitus could be explained by
the fact that females who transition from
normoglycemia to type 2 diabetes mellitus are more
likely to have other cardiovascular risk factors
compared to their male counterparts as inflammation,
central obesity, hypercoagulability, dyslipidemia,
hypertension, insulin resistance, and its associated
endothelial dysfunction.
31. Continuation DM
• Nevertheless it is reported that females are
undertreated when suffering from diabetes
mellitus .
• Still not only biological sex, but also psychosocial
and socioeconomic status influences diabetes
mellitus outcome. For example females are more
likely to follow a healthy diet compared to males.
However, males are more often physical active
than females.
32. Continuation of risk factors
• Diabetes. Diabetes increases the risk of heart
disease in women more than it does in men,
perhaps because women with diabetes more often
have added risk factors, such as obesity,
hypertension, and high cholesterol.
• Although women usually develop heart disease
about 10 years later than men, diabetes erases that
advantage. In women who've already had a heart
attack, diabetes doubles the risk for a second heart
attack and increases the risk for heart failure.
33. continuation
• Diagnosis and treatment.
Women have smaller and lighter coronary arteries than men do.
This makes angiography, angioplasty, and coronary bypass
surgery more difficult to do, thereby reducing a woman's
chance of receiving a proper diagnosis and having a good
outcome.
34. AGE
• A woman’s age as compared to that of a man can also cause
significant differences to arise in their likelihood of being
diagnosed with CHD. In general, women with CHD are
often older than men with CHD.
• Additionally, women over the age of 55 often have a higher
incidence of fatal CHD, which contributes to higher
morbidity and mortality rates in older women with CHD as
compared to women under the age of 55. Although men
typically have a 2-fold higher incidence of CHD and related
mortality as compared to women, this morbidity gap shrinks
when comparing men to women older than 55 years of
age.
35. AGE
• During a woman’s fertile age, estrogens have been found to exert
beneficial effects on the cardiovascular system (CVS), which often
protects women from atherosclerosis during this time. However, after
menopause, estrogen levels deplete, thereby leading to an exponential
increase in a woman’s cardiovascular risk.
• Some of the structural and functional changes that arise in a woman’s
CVS after menopause include altered endothelial function, imbalance
of autonomic activity that leans towards a higher adrenergic status,
visceral adiposity, and increased systemic inflammation.
• Each of these effects of estrogen deficiency in postmenopausal women
can contribute to the development of systemic hypertension, altered
glucose tolerance, abnormal lipid profiles, and insulin resistance.
36. MENOPAUSE
• Blood lipids. Before menopause, a woman's own estrogen
helps protect her from heart disease by increasing HDL
(good) cholesterol and decreasing LDL (bad) cholesterol.
After menopause, women have higher concentrations of
total cholesterol than men do. But this alone doesn't explain
the sudden rise in heart disease risk after menopause.
• Elevated triglycerides are an important contributor to
cardiovascular risk in women. Low HDL and high
triglycerides appear to be the only factors that increase the
risk of death from heart disease in women over age 65.
37. Summary
Generally, men and women have the same heart disease risk
factors; however, some gender differences have been
documented. Men, for example, appear to have less
favorable levels of these risk factors as compared to
women.
More specifically, men have been shown to have less favorable
patterns of cigarette smoking, dietary fiber intake, vitamin
C levels, blood viscosity, uric acid, high-density lipoprotein
(HDL) cholesterol, and triglycerides as compared to
women. While women have similar risk factors for CHD,
studies have shown that the absolute risk of CHD is lower
in women as compared to men.
38. References
“Coronary Heart Disease” – National Heart, Lung and Blood Institute
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