Relationship between health, beauty and senior life part 2

Men and women age the same way - exploding the myth!

There are some people we see with our eyes but we do not really know them because we don't know what their internal life nor what their dreams are like. There are others whom we have never seen but whom we know intensely because we know of their love and affection for us. We cannot endure some of those whom we see physically because we do not truly know them. The beauty of their inner self remains hidden until some outward sign reveals it.

From: Beauty of the inner self: Letter 205, 1

Spirituality is one of those impressive words that are sufficiently vague as to mean anything you want. In its most broad sense it can encompass how one sees the world and deals with it in a worthy human fashion. In this meaning it includes knowledge of my "self", knowledge of the world outside my "self", and the development of rules of action for making wise and prudent decisions about living in the world.

Men and women age differently. First of all, women live longer than men. With respect to life expectancy part of women's advantage is biological. Far from being the weaker sex they seem to be more resilient than men at all ages, but particularly during early infancy. In adult life too, women usually have a biological advantage, at least until their 50's (menopause) as hormones protect them from illnesses like ischaemic heart disease.

Currently, female life expectancy at birth ranges from just over 50 years in the least developed countries to well over 80 in many developed countries, where the typical female advantage in life expectancy ranges from five to eight years. As a result, the oldest people in most parts of the world are predominantly women. However, longer lives do not necessarily translate into healthier lives and patterns of health and illness in women and men show marked differences.

By comparison with men, women's longevity makes them more likely to suffer from the chronic diseases commonly associated with old age: for instance, osteoporosis, diabetes, hypertension, incontinence, and arthritis. By reducing mobility, chronic disabling diseases such as arthritis have an impact on the capacity to maintain social contacts and thus on the quality of life. Men are more likely to suffer from heart disease and stroke; but as women age, these diseases become the major causes of death and disability for women too. The common view that heart disease and stroke are exclusively men's problems has obscured recognition of their significance for older women's health. We need more research in this area.

Gender and health in older age
While some of the differences between women and men are due to biological characteristics, others are due to socially determined roles and responsibilities, that is, gender divisions and gender roles. Historically, women have not always lived longer than men. This gap is growing in Australia (as in other industrialised countries) only as economic development and social change has removed some of the major risks to women's health. With greater control and improvements in living conditions and hygiene, women's risk of dying in childbirth has decreased. The gender division of labour has meant that many men are taking on more occupational risks as industrialisation spreads to more countries. Thus, male deaths from occupational causes are often higher than among females.

Men also tend to take more risks when it comes to life styles. They tend to smoke more than women, for example, resulting in higher levels of death from lung cancer. Recent figures from the Australian Bureau of Statistics (ABS) show that the life expectancy for both men and women has increased over the years. However, there continues to be a steep decline in life expectancy among men in the indigenous groups. Research suggests that life style factors contribute to such decline - premature deaths caused by accidents and violence; pneumonia; and sudden cardiac death are usually linked with alcohol consumption and smoking.

The impact of gender discrimination
In some societies, the biological advantage of women is reduced by their social disadvantage. The natural advantage in women's life expectancy is significantly reduced in remote indigenous communities where female infant mortality is higher. Social and economic disadvantages also have important repercussions in many other areas. For example, inequalities in income and wealth in earlier life may mean that many older women tend to be poorer than older men. Historically, women in most countries earned less than men and were often concentrated in lower-paid jobs. Even in many industrialised countries, women's income from pensions and social security is lower than that of older men. It is lower because women more often than men interrupt their careers to take care of children and other family members. On the whole, in both developed and developing countries, women's entry into paid work only rarely frees them from domestic responsibilities, and this double burden on women often takes its toll on their health. In traditional societies, where most people may not benefit from public income security schemes in old age, older women are almost always dependent on their families.

Because women live longer than men, they are also more likely to become widowed. This trend is compounded by the fact that most women marry older men. These women can expect widowhood to be part of the later years of their adult life. In some population groups, social norms of widowhood impose inhibitions that have negative effects on the widow's wellbeing.

International action plans developed at recent UN world conferences encouraged a review of legal frameworks for eliminating barriers to economic independence of women in particular population groups. These types of early interventions against inequality are setting a life course trajectory that is more conducive to healthy and active ageing. In addition, non-government organizations (NGOs) and women's organizations are giving more attention to the issues faced by older women today. There are some encouraging examples of older women forming advocacy groups and self-help initiatives that lead to empowerment and a better quality of life.

Gender analysis examines the origins of biological differences, disadvantage, and inequality between women and men. The objective of gender analysis is to improve the quality of life of both women and men as they age.

The World Health Report
Every one of us started to age before we were born and we continue to do so throughout our entire life course. Ageing is a natural process and should be welcomed, because the alternative would be premature death.

Life expectancy is expected to continue to rise, in virtually all populations throughout the world. The number of people reaching old age is therefore increasing. In 2000, there were 600 million people aged 60 and over; there will be 1.2 billion by 2025 and 2 billion by 2050. Today, about two thirds of all older people are living in the developing world; by 2025, it will be 75%. In the industrialised world, the fastest growing population group is the very old (age 80+).

Women outlive men in virtually all societies; consequently in very old age, the ratio of women to men is 2:1.

Health is vital to maintaining wellbeing and quality of life in older age, and is essential if older citizens are to continue making active contributions to society. The vast majority of older people enjoy sound health, lead very active and fulfilling lives, and can muster intellectual, emotional and social reserves often unavailable to younger people.

On 30 October 2002 World Health Organisation (WHO) officially launched its report Reducing risks, promoting healthy life, which represents one of the largest research projects ever undertaken by this United Nations Specialised Agency for Health. The report, measures the amount of disease, disability and death in the world today that can be attributed to some of the most important risks to human health. It also calculates how much of this present burden could be avoided in the next 20 years, opening the door to a healthier future for people in all countries.

How does Australia measure?
On 30 July 2003 at 10:34:39 (Canberra time), the resident population of Australia is projected to be 19,903,737. Like many other developed countries, Australia is experiencing fundamental changes in its demographic structure. This is characterised by three significant trends: (i) Growing longevity - increase in life expectancy from 66.1 years in 1947 to 76.2 years in 1999 for men, and from 70.6 years to 81.8 years over the same period for women. These trends have been driven by lower mortality rates at all ages; (ii) Declining fertility - In 1976, the total fertility rate (TFR) fell below replacement level (2.1 births per woman) and has fallen even lower since. A record low of 1.7 births per woman occurred in 1999, and the TFR is predicted to fall further still; and (iii) Baby boomer' progression - The peak of this large generation (born between 1946 and 1966) will be entering the over 65 age group between 2011 and 2031.

In Australia, the number of people aged over 65 is expected to grow from 2.3 million in 1999 to between 6.2 million and 7.9 million by 2051. Structural ageing, in this context, describes the relative increase or growing proportion of older people within the total population. This reflects the impact of falling fertility on population age structures; as the proportion of people aged under 15 falls, the proportion of Australians aged over 65 years increases. The proportion of people aged over 65 years is expected to grow from 12% of the population in 1999 to around a quarter of the population by 2051. The over 85 age group is expected to almost quadruple as a proportion of the population, from 1.3% today to around 5% by 2051.

Ageing presents challenges and opportunities for individuals, families, communities, businesses and governments. The social dimensions may include changes to caring and disability support needs, housing demands and recreation patterns.

The United Nations Policy Document for Health and Ageing, of which Australia is a signatory, has suggested ways that individuals and policy makers may turn principles into practice to make active ageing a global reality. These principles help maintain health and creativity throughout the lifespan and especially into the later years. Towards Policy for Health and Ageing, www.who.int/hpr/ageing

30 july 2003

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