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A Closer Look at Gender Parity in UAE Health Care

Published on: May 2009​
Author:
Genre: Healthcare​ Category: Op eds​

Despite its short history, the UAE has achieved substantial improvements in health for both men and women. These improvements were achieved through a remarkable reduction in communicable diseases through better sanitation, immunisation and improved access to health care in both rural and urban communities. However, economic development has also led to an increased prevalence of non-communicable or " lifestyle? diseases.

In 2008, the World Economic Forum produced the Global Gender Gap Index (GGGI), which evaluates countries on how equitably they distribute resources and opportunities between women and men, assessing gender gaps in four main areas: education, economic opportunity, health and survival and political participation. In the health and survival sub-index, the UAE achieved the worldwide average, having closed 96 per cent of the gender gap in this category.

In the UAE, rapid changes in nutritional habits and the prevalence of sedentary lifestyles have resulted in the increased incidence of such non-communicable ailments as cardiovascular disease, diabetes and cancer, resulting in a lowering of healthy life expectancy in general, and of female life expectancy in particular.

An important finding from the health and survival sub-index relates to "healthy life expectancy" – the number of years men and women can expect to live in the absence of disease, violence and other factors that impact longevity. While the World Health Organisation estimated life expectancy at 75 years for males and 78 years for females in the UAE in 2000, the "healthy life expectancy" score for the UAE was 64 years for both genders.

While it may appear at first glance that the UAE has reached gender parity with an equal healthy life expectancy for males and females, upon close review it is clear that something is amiss. Women in general have both higher life expectancy and healthy life expectancy rates than men worldwide – a phenomenon known as the "gender mortality differential". While the reasons for this differential are not fully understood, it has been largely linked to the efficacy of oestrogen in reducing heart disease, as well as to the increased likelihood of men to engage in risky or violent behaviours that are detrimental to both health and survival. These risk factors usually result in an average two-to-five year difference between men and women in countries that rank highly in the GGGI. However, in GCC countries, the female mortality differential is either completely lost (UAE, Kuwait and Bahrain), reversed in favour of men (Qatar), or is at the lower range of the healthy life expectancy ratio found in the highest scoring countries. Although both men and women have equal access to healthcare services in the UAE, both genders lose a significant number of healthy life expectancy years due to disease, and women in particular are disproportionately affected.

Why are women affected more than men? Unfortunately, we lack the data needed to provide a definitive answer. However, we do know that women suffer from higher rates of obesity and hence Type 2 diabetes. Weight gain and obesity are also linked to an increased risk for endometrial and breast cancer – diseases that further reduce women’s healthy life expectancy, especially when coupled with late detection. Studies of cancer in the UAE indicate that most cancers are diagnosed later here than they are in the West, leading to a more aggressive surgical intervention and lower prognosis.

These factors, coupled with the current sickness-based approach to care in which individuals seek "sick care" when they experience symptoms of chronic diseases, lead to late detection, exceptionally high healthcare costs, loss of productivity, poor quality of life and, all too often, early mortality. With its high rates of obesity and diabetes, the UAE needs to make significant changes to its healthcare delivery model to meet this growing challenge. Changes should be focused on prevention and early detection, as well as on greater consumer responsibility through health education. Increased awareness of the effects of obesity and diabetes, routine testing of high risk groups, accessible and culturally acceptable spaces for exercise, and proper nutritional counselling at schools and workplaces could help to reduce the prevalence rates of diabetes within the UAE population in general and women in particular.

Fatma Abdulla is a non-resident research fellow at the Dubai School of Government, and Managing Director of Global Consulting Associates, a strategic advisory firm focused on the wellness, health care and higher education industries.

This article was originally printed in The National. It can be accessed here.


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