Women’s health

March 2012

Key facts

  • On average, women around the world live six to eight years longer than men.
  • But in low-income countries, the difference is less than in high-income countries.

Infancy and childhood (0-14 years)

  • Unlike in most part of the world, the Western Pacific Region features greater female infant and under-5 mortality rates compared with male rates. This sex differential in mortality rates has persisted through nearly two decades, although the gap appears to be narrowing.
  • Son preference and the practice of sex-selective abortion of the fetus exist in some countries in the Region, resulting in a skewed sex ratio at birth and neglect of the girl child.
  • Unintentional injuries takes a heavy toll of life (41%) among girls 5-14 years old, while intentional injuries rank sixth as a cause of death in the Region.
  • It is important to ensure that inequities in the delivery of key child health interventions are addressed, not only between boys and girls, but also among various socioeconomic groups and geographic areas.

Adolescents and young women (10-24 years)

  • For women in the 15–29 years age group, injuries account for 46% of deaths, non-communicable diseases 30%, communicable diseases and nutritional conditions about 18% and maternal causes 6%. Injuries from road traffic accidents are the leading cause of death among adolescent girls (10-19 years) in high- and middle-income countries.
  • The mental health of adolescent girls and young women is a major public health priority, as depression and suicidal ideation and suicide attempts and the preponderance of symptoms in girls are higher than boys.
  • Early initiation of sexual activity within or outside marriage and early childbearing pose major health risks to adolescents and young women.
  • Adolescent girls are at risk of unsafe and often unwanted and forced sexual activity that can lead to HIV/AIDS, other sexually transmitted infections, unwanted pregnancy and unsafe abortion.
  • In the Region, a trend towards feminization of the HIV epidemic is observed in some countries, with an increasing proportion of young women compared with young men being newly infected with HIV.
  • Between 50% and 98% of girls from some countries did not have a comprehensive knowledge of AIDS.
  • The prevalence of physical and sexual violence is another area of concern and is associated with unwanted pregnancy and abortion, low use of contraception and poor mental health.
  • Adolescent girls are increasingly using tobacco and alcohol, which risks compromising their health, including in later life, as do poor diet and physical inactivity. There is evidence that tobacco advertising is increasingly targeting young girls and women.

Reproductive age (15-44 years) and adult women (20-59 years)

  • Women in the reproductive age group bear an unfair share of ill-health from communicable and non-communicable diseases and injuries as well as reproductive causes.
  • Maternal mortality ratios have successfully been reduced in middle- and high-income countries but continue to be high in low-income countries of the Region, such as in Lao People's Democratic Republic, Papua New Guinea and Cambodia.
  • For the 30-44 years age group, non-communicable diseases account for 52% of deaths, and injuries account for one third.
  • Approximately 12% of deaths in the 30-44 years age group are due to communicable diseases and nutritional conditions, while maternal causes contribute to 3% of deaths.
  • In the Region, the 10 leading causes of deaths reveal that self-inflicted injuries and road traffic accidents are the leading causes of death among women aged 15-44 years. Tuberculosis is the third leading cause of death among women of reproductive age (15-44 years) in the Region and worldwide.
  • For women in the Region in the 15-29 years range, HIV/AIDS is the 10th leading cause of death. Biological factors, lack of access to information and health services, economic vulnerability and unequal power in sexual relations expose young women to HIV infection.
  • Cervical cancer is the second most common type of cancer among women, with virtually all cases linked to infection with the human papillomavirus. Almost 80% of cases today and an even higher proportion of deaths from cervical cancer occur in low-income countries, where access to cervical cancer screening and treatment is extremely limited.
  • Gender-based violence against women is an important public health concern affecting women in the Region. Its prevalence and lifetime prevalence rates for physical violence by an intimate partner were estimated to be between 5.8% and 61% among women aged 15-49 years, while the prevalence of sexual abuse was estimated to be between 4% and 50%.
  • Women are more susceptible to depression and anxiety than men. Adult women in the Region appear to bear a higher burden of mental and neurological disorders (26.6% of all DALYs lost), compared with women worldwide (21.7% of total DALYs lost).
  • Obesity is a significant noncommunicable risk factor among adult women in the Region. In several countries of the Pacific, more than 90% of all women were either overweight or obese.
  • Prevalence of alcohol use among women is higher than in other regions. In several countries, women’s average consumption levels of alcohol were higher than global averages for women and the prevalence of weekly episodic drinking among women also was higher.

Older women (60 years and over)

  • Women’s life expectancy exceeds men’s in all countries of the Region and women make up more than half of the elderly population. A large proportion of them are widowed and living alone.
  • For older women living in low- and middle-income countries in the Region, strokes are the leading cause of death. Chronic obstructive pulmonary disease ranks next. A lifetime of exposure to indoor air pollution, together with the presence of other risk factors may be associated with this.
  • Cancers and mental health problems are other leading causes of death and disability in all countries in the Region. Compared with men, women in this age group have a greater proportion of deaths attributable to diabetes mellitus.
  • Old age for women is marked by loss of hearing and vision, difficulties in movement and disabilities related to poor mental health and chronic diseases.
  • Access to health care is limited by affordability, limited physical mobility, provider attitudes towards older people and long waiting times, among others.

Table1. Leading causes of deaths in women aged 60 years and over in low-, middle- and high-income countries of the WPR, 2004.

Table2. Leading causes of death and DALY's lost among women aged 15-44 years in the WPR, 2004

Table3. Leading causes of death in adult women (15-59 years) by country Income groups, in WPR 2004

Table 4. Leading causes of DALY's lost in adult women (15-59 years) by country income group, WPR 2004

Source: World Health Organization, Women and Health in the Western Pacific Region, 2011