Women's Health?

Sep 27 2010 Published by under Medicine

Last week, my colleague Scicurious sent out an email about the lack of quality health reporting in magazines aimed at women. She was particularly appalled by what she saw when she picked up a copy of Women's Health at the gym.   I was also appalled, if not surprised, by the poor quality of the information, including the usual propaganda about vitamin supplements, the immune system, and sexual health.

The broadest view of the problem of media portrayal of women's health  in the U.S. indicts our society's view of women.  Media aimed at women focus on and magnify society's desire to see women cook better, look better, and fuck better.  There is little quality reporting in popular magazines about the most common health problems women face.

Let's start by looking at what you believe kills people in the U.S., then we can look at the data (the observant reader will notice some interesting details about the poll templates, named "Thinking Woman" and "Thinking Man", respectively.)

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The failure to communicate the real health problems facing women is not limited to popular media.  Take this statement from the NIH:

Women and men have many of the same health problems, but they can affect women differently. For example, women may have different symptoms of heart disease. Some diseases or conditions are more common in women, such as osteoarthritis, obesity and depression. And some conditions, such as menopause and pregnancy, are unique to women.

Women sometimes neglect their own health and focus instead on their partner's and their children's. Take care of yourself first:

The first paragraph is certainly true.  The second contains good advice, but leaves the impression that pregnancy and cancer are the most important health problems that women face (and that early detection is the most important intervention).

To understand more about the health of our population, we need to understand quantitatively what makes us ill (morbidity) and what kills us (mortality).

Morbidity

It's not easy to find a rank listing of the most common diseases in women, but condition-specific data are available.  Smoking leads to heart disease, lung disease, and cancer.  Around 18% of adult women in the US are smokers.  Hypertension is usually without symptoms and leads to heart disease, stroke, blindness, and kidney failure.  Thirty-three percent of US women have diagnosed hypertension.  Nearly 25% of women surveyed in the U.S. reported violence from an intimate partner.  About 9.5% of women in the US have diabetes, a disease which leads to heart disease, stroke, blindness, kidney failure, and other serious problems.

Mortality

How well did you do on the questions above? This table lists causes of death in the US by sex.  Be careful in reading it as it is listed in rank order determined by male mortality, making it easy to confuse the rank order for women.  For women, the top killers are heart disease, cancer, and stroke. For men, they are heart disease, stroke, and accidents.

Reality

The NIH landing page quoted above focuses on the wrong diseases.  So do most of the health articles commonly seen in women's magazines.   An effective message about women's health should include educating women as to what conditions are common and serious, and how to get proper screening and care.  Hypertension and diabetes lead to premature disability and death, and the diagnosis and treatment of these diseases is relatively simple and inexpensive.  Women in North America are not dying in large numbers due to vitamin supplement deficiencies, sexual inadequacy, or un-boosted immune systems.   Obesity contributes to many of the diseases that affect men and women, and is an independent risk for premature death, but is not as potent a risk as smoking, untreated high blood pressure, or uncontrolled diabetes.

The focus of women's magazines is not to educate; it is to sell more magazines.  But there is nothing wrong with holding them accountable for their skewed focus on cosmetic health, sexy diseases, and supplement articles that are thinly-veiled infomercials.

16 responses so far

  • Dianne says:

    I'm not sure what the NIH thinks it's about advising women to get screened for breast, uterine, and ovarian cancer. Early detection is certainly helpful-often key-to cancer treatment. However. Cervical cancer screening is available, cheap, and effective. Mammography is moderately effective at finding early cancers, depending on the circumstances and pre-test suspicion. Screening makes sense in certain populations. Uterine cancer (cancer of the uterine corpus) is one of the few cancers where symptoms appear early in the disease. Better advice than screening is don't ignore abnormal bleeding. Bleeding that occurs twice in a month is not just having heavy periods. Menopause does not reverse and if you're bleeding now after 2-3 years of no periods, something is likely wrong. I am unaware of any ovarian cancer screening that is effective in average risk women.

    • I agree. And better advice than early mammograms is this: If one of your breasts changes and the other one doesn't, CALL YOUR DOCTOR!

      This advice is saving lives, as more women become informed about the other signs of breast cancer -- and a kind of breast cancer that doesn't even form with a lump, inflammatory breast cancer.

      I'm a physicist and a three-year-survivor fighting metastatic disease -- thanks for this great article, and for letting me weigh in.

  • PalMD says:

    Thanks for that, Dianne. I wanted to elaborate but couldn't find a spot for the explanation.

    Add to that Gardasil...

    • Dianne says:

      Definitely add Gardasil or another HPV vaccine for any woman of the appropriate age who is not already known to be infected with a carcinogenic strain of HPV. Maybe even for those who are-it may be better to be infected with "only" one strain versus multiple. Men should probably get vaccinated too, but the studies need to be completed.

  • scicurious says:

    Wow, this is such a fantastic post, Pal!!! Thanks so much for highlighting this issue. Reading women's magazines, you'd be convinced we die of nothing but breast and ovarian cancer, and I think it's really important to make people aware of other, much more common, and just as tragic, risks and conditions.

  • daedalus2u says:

    If you look at the age groups that the magazines are aiming for the main cause is the same for males and females, accidents. Only after age 35 does something else become #1. In both genders assault, suicide, cancer and heart disease are the other main causes for those under 35.

    The magazines should focus on accident prevention.

    • James Sweet says:

      Except that preventing accidents is kinda tricky.

      Outside of auto accidents, is there a single class of accidents that ranks particularly highly? Maybe there is, but I am not aware of it (I would like to know if there is!) Being generally safety-conscious is a good thing, but there are risk/benefits in everything we do, and it can be difficult to plug all the holes, unless there is some low-hanging fruit.

      Of course, the biggest low-hanging fruit of all: Wear your fucking seatbelt!

  • JM_Shep says:

    Great post. Thank you for sharing all of this!

  • DryerBuzz says:

    You had me at the poll templates - wow - sharing with our afternoon readers.

  • becca says:

    awesome post. but (there's always a but with me, right?) what about the fact that an immense amount of heart disease and cancer (and possibly stroke) involves the immune system?
    Also, "health" just isn't about "risk of death" but "quality of life". While I WANT to see a magazine called women's health deal with things rigorously and with appropriately scientific background, I don't expect or even desire it to deal with stroke instead of sexual health. There's only so much fun you can have reading about how to prevent stroke. Optimal sexual health, on the other hand...
    I don't know that this entertainment-centric view of media is even necessarily so much at odds with your efficiency-of-transmitting-information view of media as one might suppose. There's only so many times you can tell people "loose weight and stop smoking" before they start to zone out.

    • Vicki says:

      The thing about stroke is that the main thing they tell you is check/monitor your blood pressure, and treat it if it's dangerously high. (After my brother-in-law had a serious stroke, my sister started reminding everyone she knew to get checked.) And some people's idea of "quality of life" is that they want to keep eating lots of salty foods.

      I also suspect that I can't get as depressed reading about stroke as about optimal sexual health: articles on the latter are too good at conveying "if you aren't having this really wonderful, satisfying sex all the time, there's something wrong with you." And maybe the woman wants to change things, and can use hints. Or maybe she has a low libido and doesn't mind that any more than she minds not having a craving for almonds. Or she's tired of taking care of things herself, and reads it as "there must be something wrong with you if you're single." It's a lot easier to get treated for high blood pressure than to find a good partner, and nobody will mock you if you say you want help finding a good doctor.

  • Candid Engineer says:

    Great post, Pal. Agree with others that the real problem is that information on stroke and heart disease prevention just doesn't sell. My least favorite thing about these mags is their propensity towards fear-mongering. Sometimes I'm so glad I'm a scientist.

    And off-topic, but I just love the name of your blog. And the picture up top really does it for me.

  • BB says:

    I thought the NCI was now on the fence about regular mammograms. Data published last week from a ten year study done in Scandinavia (if I recall correctly) showed no statistical increase in survival due to mammograms.

  • [...] White Coat Underground: Women’s Health. Pal does an excellent writeup of what diseases among women are focused on, and whether this lines [...]

  • JD says:

    Followed a link here from Sci's blog. Good stuff. Write more.