Current trends show that women now have a higher life expectancy compared to the past (Journal of Women and Aging, 2009). At the same time, they have a longer lifespan than men (Vamos & Vamos, 2008). However, longer life does not always translate to a healthy and therefore quality life. This is so because economic, social and political factors limit an older woman’s access to adequate health care. This point can be illustrated by looking at aging women and their experience with heart disease.
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Ischemic heart disease (IHD) belongs to the top 5 leading causes of morbidity and mortality for older women. Recent trends show that IHD remains a health problem for women 75 years old and above but that it is now becoming common in women beginning at age 55 (Gender and Health Collaborative Curriculum, 2008). Although IHD is also prevalent in men, more women die from this disease compared to men or when they survive, women usually stay longer in the hospital and suffer greater disability (Davidson, Daly, Hancock, Moser, Chang & Cockburn, 2003).
Poverty is the main factor affecting health. In developed countries, older women tend to be poorer than their male counterparts and reflect women’s economic status within the course of their lifespan (WHO, 2000). Insufficient income contributes to heart disease in terms of a greater probability of being uninsured/ underinsured and affects access to health services. Compounded with gender perceptions that their symptoms are not important or serious enough to warrant medical attention, they are more likely to defer diagnosis or engage in self-medication (Scott, 2005 and Richards, Reid & Watt, 2002). Poverty also limits women’s food choices and predisposes them to greater psychological stress (Warren-Findlow, 2006).
As a modifiable disease, literacy contributes to how women understand the causes and development of ischemic heart disease. It also leads to the understanding of the rationale behind instituting lifestyle changes - involving exercise, diet, substance use and stress, for disease management or prevention. Literacy level is also a major determinant for early diagnosis and treatment compliance behaviors. However, data reveals that women’s literacy rates are significantly lower than men (WHO, 2000).
Concerning the quality of health care, the belief that women and men are affected by disease in a similar manner and so should be diagnosed and treated in a similar manner is due to women’s underrepresentation in clinical trials (Franklin, 2002). This is proven to be untrue in terms of IHD as recent studies now show that it affects women differently from men. When subjected to the same diagnostic procedures, women are more likely to be underdiagnosed than men (Hellwig, 2007). Nursing interventions are also shown to be lacking in their responsiveness to the specific needs of older women (Davidson, Daly, Hancock, Moser, Chang & Cockburn, 2003).
The understanding of disease as it occurs in men or conversely, the lack of focus on women’s health has led to underdiagnosis, undertreatment and poorer outcomes. This gender bias reflects the general bias that society accords to women. Along with other factors such as poverty and lower level of literacy throughout most of women’s lives, this impacts negatively on the health of women suffering from heart disease.
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