A gendered lens on global disease burden

Governments must pivot their health systems to improve public health surveillance and incorporate a gender perspective. Enhanced surveillance is crucial for detecting health threats quickly, ensuring timely responses that prevent outbreaks. Rapid environmental changes and increased global mobility amplify this need, heightening the risk of disease spread.

Additionally, recognising gender-specific health impacts is vital. Diseases like cardiovascular conditions manifest differently between genders due to biological, social, and environmental influences. Addressing these differences through tailored health care can dramatically improve effectiveness and efficiency, optimising resource allocation.

Moreover, collecting and analysing gender-disaggregated data is crucial. It not only helps tailor health interventions to specific needs, enhancing outcomes and equity, but also supports economic empowerment by providing insights into the unique economic barriers and activities faced by different genders. This targeted approach can boost economic participation and overall health system performance.

A recent study published in the Lancet by Vedavati Patwardhan and colleagues, titled “Differences across the lifespan between females and males in the top 20 causes of disease burden globally: a systematic analysis of the Global Burden of Disease Study 2021,” delves into the pervasive and significant health disparities between genders.

Morbidity rather than mortality

Utilising data from the Global Burden of Disease Study 2021, the researchers systematically quantified and compared the disability-adjusted life-year (DALY) rates for the top 20 causes of disease burden among individuals over the age of 10, on a global scale and across seven world regions, from 1990 to 2021. The study raises 7 key issues.

First, among the 20 conditions analysed, females exhibit higher age-standardised DALY rates than males for seven conditions: low back pain, depressive disorders, headache disorders, anxiety disorders, other musculoskeletal disorders, dementia, and HIV/AIDS. These conditions are significant contributors to the global disease burden among females, often driven by morbidity rather than mortality.

Second, the study differentiates the contributions of morbidity (years lived with disability, YLDs) and mortality (years of life lost, YLLs) to the overall health burden. It finds that morbidity accounts for a larger proportion of the disease burden in females for their predominant conditions, whereas males experience a greater burden from premature mortality in their leading conditions.

Third, the conditions where females exceeded males in DALY rates are predominantly chronic and non-communicable diseases. For example, depressive disorders showed a global DALY rate of 1019.0 per 100,000 for females, significantly higher than the 670.6 for males.

Fourth, the study also highlighted significant disparities in mental health disorders across regions, with the highest differences in DALY rates noted in high-income regions, followed by Latin America and the Middle East.

Fifth, pronounced regional variations are observed in DALY rates between genders. For instance, females in South Asia and in Central Europe, Eastern Europe, and Central Asia face substantially higher DALY rates for low back pain and other musculoskeletal disorders compared to males. Additionally, mental health disorders consistently show higher DALY rates for females across all regions.

Sixth, over the 31-year period from 1990 to 2021, the analysis revealed widening health disparities between genders in conditions such as diabetes and mental health disorders. This trend highlights an ongoing and increasing challenge within global health, emphasising the need for gender-specific research and policy development.

Seventh, from an age perspective, disparities were evident early in life and exacerbated over time. For instance, the DALY rates for musculoskeletal conditions and mental health issues in females not only started higher but also increased with age.

To address the crucial challenges including the pervasive and significant health disparities between genders, governments worldwide must prioritise a comprehensive reorientation of their health systems. This includes enhancing public health surveillance systems to effectively monitor and respond to emerging health threats, which is vital in a rapidly changing global environment.

Appropriately tailored strategies

Additionally, governments need to integrate gender-specific data analysis more deeply into health system planning to ensure that gender disparities in disease burden are adequately addressed. This approach should involve investing in systems that can accurately track and analyse the varying impacts of health conditions on different genders over time, ensuring that both prevention and treatment strategies are appropriately tailored.

Furthermore, there is a pressing need for governments to commit to sustained funding and policy support for gender-specific health research. This will facilitate the development of targeted interventions that address the unique needs of different genders, particularly in areas where disparities are widening, such as mental health and chronic diseases.

By adopting a life-course approach in health planning and intervention, governments can better manage the health needs of their populations at all stages of life, improving overall health outcomes and ensuring equitable access to health care services.

Aditya Sinha is Officer on Special Duty, Research, Economic Advisory Council to the Prime Minister of India. Views Personal.