There is considerable evidence that risk factors connected with certain life styles strongly influence health outcomes. Policies and programmes that address broad lifestyle issues are therefore being implemented in many countries in the region. Examples are health promotion initiatives in areas such as smoking, alcohol consumption, drugs and HIV/AIDS. Current patterns suggest that the negative effects of behaviour and lifestyle on mortality are more pronounced for men. However, as women adopt lifestyles hitherto attributed to men, the male-female mortality gap is beginning to close in a number of countries.
It is not known how much of the difference in survival between women and men is genetically determined and how much is attributable to differing life styles. However, some evidence seem to suggest that as women and men’s lives and life styles become more alike, the gender gap in life expectancy will decrease. The percentage who smoke and who misuse alcohol is considerably higher for men than women, although among young people the difference is smaller and occasionally reversed. Women also seem to follow healthier diets, to pay more attention to preventive measures, to consult their doctor more frequently and to be more apt to heed medical advice. Still, relatively less is known about women’s health than men’s and about how social, economic and behavioural factors affect health. Medical research does not often focus on gender specific issues, and research on women’s health often lacks funding, as the Beijing Platform for Action points out. Since the concept of good health includes all aspects of well-being (for instance life style and nutrition), measures of physical exercise, alcohol and tobacco consumption, and over- and under-weight are all important indicators in this respect.
Deaths due to injuries, particularly automobile accidents and violence account for more than 10 per cent of all deaths in some developed countries, and gender differences are considerable, with the proportion of male deaths sometimes two or three times as high as female deaths in this category. Rates are particularly high for men in many of the transition countries, but one of the adverse developments accompanying transition has been the sharp and unanticipated deterioration in life expectancy. Accidents, violence and armed conflicts, together with cardiovascular disease are identified as the main factors responsible for most of the increase mainly in male mortality in some of the transition countries. All these factors are strongly associated with the strains of transition and the associated incidence of alcohol abuse, emotional distress, violence and suicide. These factors were abetted by poor nutrition and unhealthy life styles existing in many countries and especially in Russia. Emerging evidence suggests that while men tend to react to stress with the above-mentioned behaviour, women are more prone to depression and deteriorating mental health.
Mental illness and depression, which represent a very serious problem to both men and women, can also stem from a variety of causes, including genetic predisposition and environmental factors. Research has shown that men use preventive health services much less frequently than women. Because of dominant male stereotypes, men can be dissuaded from seeking professional help for problems such as depression or anxiety. Social and economic factors, such as violence, urbanisation, and the disruption of cultural practices and traditional family roles, also contribute to what is a rising incidence of mental illness. Issues of poor access can also be a barrier to early diagnosis and treatment of disease, which can lead to higher incidence of disease or infirmity – in this case, among men. Furthermore, the division of social roles and responsibilities often means that men and women live out their personal and professional lives in different environments. This can mean that they are exposed to different environmental and other risks.
Gender disparities in the incidence of HIV/AIDS can be traced to physiological, socio-cultural and economic factors. Similarly, women are more affected by sexually transmitted diseases than are men due to a combination of physiological and social factors.
Examples of policies in the region:
