ABSTRACT
Spatial differences in gendered health problems have rarely been considered but are becoming increasingly complex as international flows of population increase (Dyck et al. 2001). An epidemiological transition is now under way in all regions of the world, indicating a shift from a predominance of infectious and parasitic diseases to one of chronic and degenerative diseases. But this is not a linear unidirectional change and counter-transitions also occur (Salomon and Murray 2002). Many developing countries, and countries in transition, are confronting a double burden of fighting emerging and re-emerging communicable diseases, such as HIV/AIDS, tuberculosis and malaria, in parallel with the growing threat of non-communicable diseases, such as those caused by increasing use of alcohol and tobacco. In 2002, according to the World Health Organization, the three leading health problems, measured in disability adjusted life years (DALYs), in low-income countries were malnutrition (14.9 per cent), unsafe sex (10.2 per cent) and unsafe water, sanitation and hygiene (5.5 per cent), while in middle-income countries the most
common causes of poor health were alcohol (6.2 per cent), high blood pressure (5.0 per cent) and tobacco (4.0 per cent) (Dyer 2002). Indoor exposure to smoke from solid-fuel fires was the fourth cause of poor health in low-income countries, especially for women, while in middle-income developing countries malnourishment and obesity were the fourth and fifth leading health problems. Currently 30,000 people die each day in developing countries from infectious diseases partly because world trade rules on drug patents restrict poor people’s access to essential medicines but this availability may now be improving (Pearson 2002). Need for medicines is gendered, as women’s experience of illness differs from that of men, and women generally have to care for other sick members of the family.
