Aetna 2002 Annual Report Download - page 27

Women’s Health: Gender Matters
 , ..
President, University of Pennsylvania
Professor of Psychology, Medicine and Psychiatry
 . , ..
Associate Professor of Epidemiology and Public Health and
of Psychology, Yale University
Women’s medicine must integrate behavioral as well as
biomedical approaches to enhance health and well-being.
At the turn of last century, women lived an average of  years. By , life expectancy
increased to  years. Although women have lower rates of mortality, they have higher rates
of morbidity than men. A commitment to health promotion and disease prevention can
nurture not just longer life, but better quality for these added years.
Many normal physiological functions as well as pathological functions are influenced by
sex-based differences in biology. Many sex differences can be traced to effects of hormones
associated with reproduction such as estrogen. Other differences are attributed to sexual geno-
types. Although an individual’s genetic blueprint affects health susceptibilities, the expression
of a gene is determined in interaction with the environment and behavior. For example,
genetic propensity for obesity determines only one-quarter of a woman’s weight, the other
three-quarters is accounted for by diet and exercise.
Biological, behavioral and environmental differences also result in women’s greater vulner-
ability to certain diseases and to differences in the ways that other illnesses are expressed.
Lung cancer is the leading cause of cancer death among women, and female smokers are up
to  percent more likely to develop lung cancer than male smokers. Women are - times
more likely to suffer from depression, in part because a woman’s brain makes less of the
hormone serotonin. Women are up to eight times more likely to contract a sexually trans-
mitted disease from an infected partner during unprotected intercourse because of greater
susceptibility of mucosal tissue in the vaginal tract. It is important to note that women also
have certain “social vulnerabilities” that affect health due to sex differentials in socioeconomic
status and interpersonal power.
Health statistics indicate that cardiovascular disease is the leading cause of death for
women, responsible for  percent of all deaths annually ( times more than breast cancer).
However, the actual causes underlying cardiovascular disease are modifiable risk factors such
as obesity, smoking, hypertension and hypercholesterolemia. Therefore, to best promote
women’s health, we must integrate biomedical and behavioral approaches. Perhaps the single
most important health-enhancing activity for girls and women of all ages is exercise: It benefits
the heart and bones, regulates weight, and contributes to a sense of well-being.
The past decade has witnessed revolutionary advances in molecular biology, genetics and
pharmacology that have held tremendous promise for enhancing women’s health. Prevention
can do even more to maximize good health throughout the life span.
Standing: Jeannette R. Ickovics, Ph.D.; seated: Judith Rodin, Ph.D.
 