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Are women less healthy than men?

In the closing minutes of the floor debate over President Obama's Patient Protection and Affordable Care Act in March 2010, then-House Speaker Nancy Pelosi remarked that "after we pass this, being a woman will no longer be a pre-existing condition."

Much of the congressional debate surrounding the health care legislation has centered on its requirements for access to affordable health insurance for every American.

Pelosi's comments referred to the need for women to have better access to health care coverage for conditions particular to their gender. A new government report underlines that need.

Women and time away from work

In the 2007 to 2009 study by the Health Resources and Services Administration (HRSA), a service of the Department of Health and Human Services (HHS), women reported an average of four days per month when their physical health was not good and 3.9 days per month when their mental health was not good. That compares to an average of 3.2 physically unhealthy and 2.9 mentally unhealthy days per month reported among men.

women's health"Women are usually the prime caretakers for their family -- whether or not they themselves are ill," says Dr. Jennifer Wider, a physician and spokesperson for Center for Women's Health Research, an organization that advocates for women's health issues. "There are studies that have shown women's immune systems are actually stronger than that of men."

Wider cites a 2009 study by the Research Institute of the McGill University Health Centre and McGill University in Montreal that supports such a conclusion. The report indicates the natural production of estrogens combats the bacterial agents that create breeding grounds for disease.

Figures in the HRSA report come from a HHS-supported telephone health survey system that tracks health conditions and risk behaviors in the United States. The report found that women at higher income levels with greater access to health care were more likely to engage in healthy behaviors and report a higher level of health quality. Non-Hispanic, Asian women reported the lowest level of physical and mental unhealthy days of any group of women measured.

The cost of health insurance

Judith Waxman, vice president of health and reproductive rights at the National Women’s Law Center in Washington, says the Affordable Care Act will prevent most small businesses from raising health insurance rates based on gender. A provision of the act that goes into effect on Jan. 1, 2014, prevents a business with 100 employees or fewer from raising rates based on gender, she says.

“That part has not been controversial,” she adds.  “In numerous states, it is already illegal for insurers to raise rates based on gender.”

Some medical professionals say women take health care more seriously than men. "Women talk about health care more than men," says Barbara Ehli, a retired Seattle-area registered nurse who has cared for patients from the pediatric level to seniors. She currently volunteers at a Bothell, Wash., senior center where she sees "a lot more women than men." As women reach the late-life stages, she notes, aches and pains become commonplace. "The focus of life becomes different when the fertile cycle ends," she says.

Getting through that cycle can be a challenge. Menopause can bring on emotional distress for a lot of women as hormones perform one last change of life that fires up existing tendencies for depression.

A National Institute of Health study in 2010 by the Group Health Research Institute in Seattle and Harvard Pilgrim Health Care in Boston found a link between depressive symptoms and the severe vasomotor (menopausal-related changes in the diameter of blood vessels) symptoms. The study is one of several recent studies of the relationship between severe depression and menopause in women.

"The hope in these studies is to build a greater awareness of this link, improve the education level among medical professionals, and encourage funding of future research in the topic," says Dr. Susan Reed of Group Health, which participated in the study.

The idea of significant biological and physiological differences between women and men is a recent concept in medical studies. Traditionally, research has focused on men's health while studies of women's issues have lagged behind.

Gender and illness

While much of the world's medical research in gender-based biology is focused on reproductive systems, Wider says a growing number of studies point to differences in the way common illnesses like asthma and basic seasonal allergies affect women and  men. Estrogen can make a significant difference in how major illnesses such as diabetes affect a woman. For poorer women with little access to affordable individual health insurance, the difference can mean life or death.

No matter what their socio-economic status, women seek out primary care for both mental and physical health care far more than men, Wider says.

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