The construction of a modern epidemic: the implications for women of the gendering of coronary heart disease.

Abstract

This aim of this paper is to examine critically the implications for women of a gendered construction of coronary heart disease. The paper takes the form of a literature review between 1969 and 2002 of nursing, medical and social science literature written in the English language that explores the experience of women with coronary heart disease. Coronary heart disease has been constructed during the 20th century as a disease of affluence that affects high achieving men. However coronary heart disease is a major cause of morbidity and mortality among women. The literature suggests that this gendered construction has influenced not only health professionals' perceptions of coronary heart disease but also lay theories of candidature, so that the collective consciousness sees women as being at low risk. Moreover, that this construction of coronary heart disease as a male disease has led to a service provision engineered to meet male needs that arguably can be seen to militate against women. This has resulted in women being diagnosed when they are further along the disease trajectory. It also means that once diagnosis has made then they are less likely to be referred for investigations, treatment and rehabilitation. The implications of this construction for the care of women with coronary heart disease may result in 'gender-neutral' care. This may mean that decisions about care are made in the light of nurses' own knowledge and experience of nursing male patients, with the consequence that women patients' individual needs are not met.