Gender differences play a role in manifestation of disease and health outcomes. They also play a role in health care delivery including issues associated with access. Women are perceived as the decision-makers for the source of health care for their families. Women often delay self-care as they attend to the care of their family or children. Women are not just men with reproductive capacity, and not all women are alike. Women share many experiences (e.g., domestic violence) that cross economic and racial lines. Additional examples of issues that impact all women are listed as follows:
• Lack of economic parity with men
• Responsibility for childrearing
• Delay of self-care because of accessing health care for others (e.g., children)
• Domestic violence
• Poverty in elderly
• Coping by using social networks
• Using relationships to identify resources
Delineating between the commonality of being a woman and the difference or uniqueness of health issues of the individual woman is key for physicians. Health care providers need to assess the global health risks of the individual patient in front of her or him. Most useful are the skills and strategies to gain information from the patient, and appropriate data collection as needed from the laboratory or radiology.
Why invest energy exploring this issue? Most physicians have patient panels including women, and increasingly these panels are comprised of minority women. The United States is rapidly becoming more racially diverse. Currently, 40 million of the 140 million women in the United States are minority women. Population growth in minority groups exceeds that of nonminorities. Gender differences in health are gaining increased recognition. Women fare more poorly following certain diseases and events, such as myocardial infarction, than men. As a group, invasive or highly technologic diagnostic and therapeutic options are used less frequently for women. Despite this, women still live longer than men. From an economic perspective, however, quantity of years does not equate to quality. Economic issues can lend considerable impact to quality of life and health outcomes. Elderly women may exist in poverty and have, in general, lower quality of life. To improve the quality of life, physicians and patients are slowly shifting their awareness and screening habits from more than just highly feared illnesses in women (e.g., breast cancer) to also include those that are more likely causes of death, such as heart disease, malignant neoplasm, cerebrovascular diseases, and diabetes mellitus. Women are not a homogeneous group and do not receive homogeneous care. Similarly, within the larger group of women, subgroups of minority women are not all the same. Components that are likely to vary depending on culture and ethnicity are outlined as follows:
Health beliefs
Perception of health risks
Health practices
Expectations from health
Co-treatment with culturally connected health care provider
Gender role in marital setting
Views of modesty
Reproductive options
Primary language other than English
Perception of optimal patient-physician relationship
Expectation of physicians
Patient role and degree of collaboration with physician
Perception of role of male physicians in care
Food selections and acceptable nutrition
Attire
Over-the-counter care products
Dermatologic products (hair and skin care)
Other self-care products
Religious practices including those with fasting |