Story: Women’s health
Page 1 – Health and life expectancy
Biology and gender are both factors that shape life experience and health. The experiences of women and men tend to differ not only because of women’s capacity to bear children and the associated hormonal flows, but also in terms of their paid and unpaid work, recreation and socialising, and even their readiness to consult doctors.
Ethnicity affects health. The health experiences of Māori and Pākehā women have been very different over the whole period since colonisation. Māori women have been far more likely to suffer ill health and die at an earlier age. The health of Pacific Island women has not, generally, been as good as that of Pākehā, although was often better than that of Māori.
The 19th and first half of the 20th centuries saw a major improvement in the health of Pākehā women. Driving this shift were the benefits of colonial life for settlers, including better nutrition, along with a greater understanding of hygiene and infectious disease, and new drugs. These factors caused what is known as an epidemiological transition – a major change in the pattern of illness during life and as a cause of death. Rates of infectious diseases such as polio and measles dropped, and infant mortality also reduced, while rates of degenerative diseases (such as cancer and heart disease) increased.
This epidemiological transition occurred in the second half of the 20th century for Māori women. It followed earlier transitions. The first, during the 19th century, was from relatively good health prior to European settlement to very poor health. From the end of the 19th century another transition began, as immunity to introduced diseases built up.
Changes in life expectancy – the number of years a newborn baby can expect to live – gives an indication of how women’s health has improved.
A non-Māori girl born in 2007 could expect to live 83 years (a non-Māori boy, 79 years). In 1876 life expectancy for non-Māori girls was 54 (three and a half years more than that of non-Māori boys). Two thirds of the increase in female life expectancy was gained by 1921, when it reached 72.1. Decreases in infant mortality and infectious and respiratory diseases contributed to this leap.
International high point
Pākehā life expectancy in the late 19th century was internationally the highest ever recorded up to that time. Delighted politicians trumpeted New Zealand’s status as the healthiest country in the world.
A Māori girl born in 2007 could expect to live 75.1 years (and a Māori boy, 70.4 years). Before European arrival, life expectancy for a Māori woman at birth was about 28 to 30 years – this matched life expectancy in many European countries at the time. In the 19th century Māori women had a lower life expectancy than men. In 1891, for example, a newborn girl could expect to live 25 years, a boy, 28 years.
Pacific Island girls born in 2007 had a life expectancy of 77.5 years (73.2 for boys), and that of Asian girls was 84.2 (81.2 for boys).
Socio-economic status also affects female life-expectancy rates. In 2005–7 the most economically deprived women could expect to live 5.9 years less than the most advantaged (78.7 versus 84.6 years). For males the difference was even greater: 8.8 years between most and least deprived (73.3 versus 82.1).
Ill health has tended to concentrate in particular communities or groups of people. Some women endured multiple difficulties: childhood deprivation, ill health, accidental injury, and interpersonal violence and abuse. This effect is compounded by difficulties in accessing health care and sometimes lower quality of care.