Abstract
Women's health in low- and middle-income countries (LMICs) has historically focused on sexual and reproductive health. However, understanding how women acquire, experience, and treat non-reproductive health conditions, such as non-communicable diseases, has become a fundamental public health concern. Special attention to the social determinants of LMIC women's health can provide socially and culturally relevant knowledge for implementation of policies and programs for women increasingly confronting these ‘New Challenge Diseases’. This article uses the example of depression and Type 2 diabetes comorbidity to illustrate how attending to the social determinants of mental and physical health beyond the reproductive years contributes to a more holistic agenda for women's health. For instance, we must address the plurality of experiences that shape women's health from social determinants of depression, such as gendered subjugation within the home and public sphere, to the structural determinants of obesity and diabetes, such as poor access to healthy foods and health care. Attending to the complexities of health and social well-being beyond the reproductive years helps the women's global health agenda capture the full spectrum of health concerns, particularly the chronic and non-communicable conditions that emerge as life expectancy increases.
Highlights
This paper is part of the Special Issue: Epidemiological Transitions Á Beyond Omran’s Theory
This article uses the example of depression and Type 2 diabetes comorbidity to illustrate how attending to the social determinants of mental and physical health beyond the reproductive years contributes to a more holistic agenda for women’s health
Over- and under-nutrition can exist simultaneously in communities, households, or even individuals during different phases of their lives. In light of these complex scenarios, Knaul and Frenk have suggested that we rethink public health paradigms for the challenges of aging populations as ‘New Challenge Diseases’ rather than ‘non-communicable diseases’ [1]
Summary
Reorienting women’s health in low- and middle-income countries: the case of depression and Type 2 diabetes. As opposed to traditional disease-based approaches in medicine and public health, a life course approach encompasses the powerful role of social and economic determinants of health in women’s lives from infancy to old age [2, 3] This approach is important for women who may experience disproportionate social disadvantage, gendered discrimination, and chronic, untreated depression when compared to men [4]. Depression has only become a major global health concern in the past decade, and has proven very difficult to address, not least because of stigma and limited human resources for mental healthcare This is especially true for women in LMICs, whose access to mental healthcare may be virtually non-existent, and whose care-seeking behaviors and budgets typically include little, if any, room for mental healthcare. In this way, integrating a social and psychological approach into health agendas, from the clinical to the policy level, can make a big impact
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