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yasmeen_SHARIFF@np.edu.sg
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Women continue to live longer than men on average, but women have higher rates of disability and disease. In each age group, men have higher rates of fatal disease, whereas women have higher rates of non-fatal chronic disease. “Women get sicker but men die quicker” might be a way of summing this up (Lorber, 2000).
While men’s lower life expectancy is often attributed to three factors—their tendency to engage in riskier behaviour or riskier work than women, their lower use of the health care system (which prevents symptoms from being diagnosed earlier), and their innate biological disposition to higher mortality at every stage of life—it is not as clear why chronic disease affects women in higher proportions. Spitzer notes that gender roles and relations lead to different responses and exposures to stressors, different access to resources, different responsibilities with regard to domestic work and caregiving, and different levels of exposure to domestic violence, all of which affect chronic health issues in women disproportionately.
Life expectancy—the average number of years a person would live if he or she experienced the age-specific mortality rates of a given country in a particular year—is one of the most widely used measures of the health status of populations. Disparities in life expectancy among ethnic groups and between genders within a country often imply the presence of health inequalities. Studies have found important determinants to explain this variation, such as differences in the prevalence of chronic disease risk factors, preventive health behaviour, access to and utilisation of healthcare service, as well as socio-economic status .
Life expectancy at birth (a & b) and at age 65 (c & d) by ethnicity and gender, Singapore, from 1965 to 2009.
A Chinese girl born in 2005 can expect to live to 86.6 years. In contrast, a Malay boy can expect to live only to 74.8 years, a gap of nearly 12 years. Life expectancy for children of other ethnicity /gender combinations can expect a life expectancy between these extremes.
Singaporeans have enjoyed a steady increase in life expectancy between 1965 and 2010. Males and females have similar overall life expectancy gains, accounting for the persistent gap between the genders. Although significant increases in life expectancy have occurred in all 3 ethnicities, the differential overall gains have been greatest for Indians (both genders), followed by Chinese and Malay, resulting in the convergence of life expectancy gap between the Indians and Chinese, while leaving a substantial gap between the Malays and the other two ethnic groups.
The life expectancy gap reflects differences in ethnic and gender-specific mortality rates, which might be attributable to amenable mortality (consisting of both 'treatable’ conditions such as appendicitis for which timely therapeutic care is available, and 'preventable’ conditions such as lung cancer where primary preventive measures are available) leading to disparities in non-communicable disease deaths after Singapore has completed its epidemiological transition, as cancer, coronary heart disease and stroke are the 3 leading causes of mortality across the 3 ethnic groups and gender from 1970 to the present.
Full article of the excerpt can be found here: Ethnic and gender specific life expectancies of the Singapore population, 1965 to 2009 – converging, or diverging?
The healthcare community is not immune to the deleterious effects of ageism.
Experts in aging often underscore the profound heterogeneity of the elderly population by saying, “If you’ve seen one 85-year-old, you’ve seen one 85-year-old.” Unfortunately, the reported experiences of older adults suggest that healthcare providers remain prone to stereotyping older adults or “applying age-based, group characteristics to an individual, regardless of that individual’s actual personal characteristics”
In a cross-sectional survey design, Davis et al. (2011) used the Expectations Regarding Aging Scale to assess primary care clinicians’ perceptions of aging in the domains of physical health, mental health, and cognitive function. The majority of providers surveyed were physicians, but the sample also included nurse practitioners and physician assistants who serve as primary care providers (PCP). Most PCPs agreed with the statements “Having more aches and pains is an accepted part of aging” (64 percent), and, “The human body is like a car: when it gets old, it gets worn out” (61 percent ). More than half of PCPs (52 percent) agreed that one should expect to become more forgetful with age, and 17 percent agreed “mental slowness” is “impossible to escape.”
Older adults often possess very negative views of aging, not realizing the potential impact on their health. Older adults who believe pain, fatigue, depressed mood, dependency upon others, and decreased libido are a normal part of aging are less likely to seek healthcare (Sarkisian, Hays, and Mangione, 2002) and therefore are at risk for being under-treated. In one study focusing on depression, older participants who attributed feeling depressed to aging were four times less likely to believe they should discuss the symptom with a doctor (Sarkisian, Lee-Henderson, and Mangione, 2003). Those with low expectations for aging are less likely to engage in physical activity (Sarkisian et al., 2005) and other preventive behaviors like having regular physical examinations, eating a balanced diet, using a seatbelt, exercising, and limiting alcohol and tobacco use (Levy and Myers, 2004). Providers can routinely ask about pain, mood, energy level, functional status, and sexual health, and then educate patients about options for evaluation and treatment.