High Rates of Arthritis among Female and Cardiovascular Disease among Men

GENDER, SEX, AND HEALTH
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Gender, Sex, and Health 1.    Introduction The prevalence of specific ailments in the United Kingdom relates to gender-based modalities where more women or men are affected by particular disease conditions than the other. Since each gender undertakes different jobs and duties within the employment sector, they become afflicted by diverse health concerns that differ according to their gender roles. The gender disparity in which some ailments affect more women or men than others has received much attention from the public in recent research to determine such causes (Swain et al., 2020). In various dimensions, distinct health disorders, either psychological or physical, have varied incidence rates among male and female groups in the UK. On the other hand, experts have developed some theoretical concepts to explain why such cases occur among various genders and seek to determine the causes of such health problems. The theories shed light on how the health issues remain linked to gender differences and how they arise among the general population. Thus, it is imperative to critically discuss two health issues that affect more men or women than the other gender and evaluate them through theoretical analysis. 2.    Discussion 2.1         Critical Analysis of First Health Topic 2.1.1        High Rates of Arthritis among the Female Gender Arthritis is among the most common long-term diseases, resulting in substantial physical damage to the body. It can impact several joints, exacerbating functional disability and participation limitations. The lack of a known cure has caused the global burden of arthritis to increase. Evidence indicates that it has been rising by an estimated 28% among people aged 60 and above in the UK (Abhishek et al., 2017). Moreover, knee osteoarthritis emerged as the 11^th leading cause of worldwide functional impairment and the 23^rd leading causal factor of disability-oriented late-life years in 2017 (Swain et al., 2020). Trends anticipate that this disease will become the 4^th major cause of disability-adjusted life years by 2020 because of the rising life expectancy and ageing population among the public and a considerable rise in functional body impairment from 2010 to 2019. The prevalence rate among the people in the UK is 0.5–1%, or 45 people per 100,000 people (Brennan-Olsen et al., 2017). However, the disease affects more women than men. In 2021, the total number of people diagnosed with osteoarthritis or rheumatoid arthritis was 10,495,497, 6.8 people per 100,000 women (NHS, 2018). Among women, the rate was higher since they recorded a combined incidence of 7.9-8.3 persons per 100,000 with a ratio of 8:1, compared to males with 5.3–5.7 persons per 100,000 men (Swain et al., 2020). In terms of percentage, in 2018/2019, 49.1% of females compared to 33.6% of males aged 60–64 had arthritis, and 62.9% of females, as opposed to 41.5% of males aged 80 and above, had been diagnosed with arthritis (See Figure 1.1). The rate in females was much higher than in males, making it a public concern. Figure 1.1 Rates of diagnosed individuals with arthritis among 50 and above years old individuals in the UK from 2018 to 2019, by age and gender Source: (Statista, 2022) Health researchers and practitioners have indicated several reasons why there is such a case among women. Stakeholders have funded various studies in the UK to comprehend this problem, and investigations have revealed different physiological elements linked to the illness discrepancy between men and women. The autoimmune relationship is one of these variables since most types of arthritis (osteoarthritis or rheumatoid arthritis) arise from autoimmune complications, which affect more women than males for particular reasons (Yu et al., 2020). For instance, rheumatoid arthritis is an inflammatory and autoimmune condition with a higher prevalence, coined at three times more in women than in males. Lupus is considered an autoimmune illness where arthritis emerges as one of the main symptoms, and studies suggest that 9 in 10 people with lupus in the UK are female (Tschon et al., 2021). Such a factor linked to lupus indicates why arthritis has a higher rate in females than males. Another reason for the greater arthritis prevalence in females than in men is that the condition affects different joints in both genders. Men are more likely to suffer from arthritis around their hip joints, whereas women are more likely to develop arthritis in their knees and hands. The design of female tendons suits more movement than male tendons because they allow childbearing (Plotnikoff, 2015). Moreover, the tendons are more prone to damage and injury due to their higher elasticity. Women’s broader hips also impact the arrangement of the knees, making them more susceptible to specific accidents. As a result of these structural differences, they are more likely to acquire arthritis (Morgan et al., 2019). Thus, practitioners have highlighted the structural elements as a significant issue of concern in the prevalence differences between males and women. Hormonal aspects in women also play a part in the prevalence because estrogen keeps inflammation inactive, explaining why younger women have less severity of arthritis than males (Yu et al., 2020). However, as estrogen levels drop with menopause onset, arthritis becomes more severe and develops further. Researchers are also investigating other medical discoveries about how hormones impact arthritis risk levels, including close links between childbirth, puberty, and menopause. Combining these aspects worsens the vulnerability of one gender towards the disease than the other. 2.1.2        Gender Schema Theory Sandra Bem theorized the Gender Schema Theory. She was an American psychologist and termed it a societal-cognitive hypothesis that examines how persons in communities become gendered in their early stages of life and how that gendering affects their mental and role processing over time (Canevello, 2020). At an early age, children establish gender schemas, which are beliefs and standards based on the definition and roles linked to masculinity or femininity. They apply these schemas to classify social data, use them in decision-making, and govern their behaviour. As a result, males and females in the family unit have different responsibilities, resulting in disparities in health outcomes and diseases. For instance, people make young girls aware that their role in motherhood is imperative for their development in society. Hence they become attached to childbirth responsibility early (Starr and Zurbriggen, 2017). People with a gender schema are more prone to partitioning their communities and managing their roles according to their gender. In this light, youthful women of 20–45 years are at their prime childbearing age, as predetermined by society. Hence, they cannot escape such responsibility even when some are prone to developing health conditions such as arthritis. The gender schema theory indicates that one can consider British culture gender polarizing in its social structures, modalities, and norms. Children develop gender stereotypes devoid of recognition and identification since culture builds them to adhere to customs. Gender schematics or polarization assist children in developing traditional sex types (Starr and Zurbriggen, 2017). In this context, youngsters evaluate diverse approaches to acting based on cultural norms of gender expectations and avoid any behaviour that fails to align with their sex by complying with gender-oriented categorization in British society. During late teenage life and adolescence, gendered thoughts and actions become more rigid since individuals expect young boys and girls to have structured roles in family and society (Mayor, 2015). A gender schema translates to a collection of physical characteristics, actions, and psychological traits matched to a particular gender. This aspect develops in youth. Starr and Zurbriggen (2017) indicate that as soon as a youthful person establishes gender identification, they act consistently in their perceived gendered ways. In this case, the UK culture based on gender roles explains why women become more prone to joint injuries caused by arthritis since their requirements comprise a higher work rate of raising children and taking care of the family. Since gender schemas have such a firm hold on the female gender, they undertake home chores with much pressure and stress related to family life and responsibilities. Trends indicate that they have minimal flexibility as males due to heavy family pressure and balancing it with work-life in terms of adhering to gender schemas developed from childhood (Canevello, 2020). They appear to be developing a variety of ailments due to their extreme disregard for themselves. Based on the notion, a woman suffers enormous pressure to conform to societal gender schemas to maintain the societal womanly depiction portrayed by civilization (Chen et al., 2014). Furthermore, even as women become older and transition through their menopause years, society still confers on them the role of motherhood and care for their offspring, despite their old age. For centuries, women have been the primary caregivers for their families, and they remain expected to balance this standard with work and other responsibilities. 2.2         Critical Analysis of the Second Health Topic 2.2.1        Cardiovascular Disease among Men in the UK Cardiovascular disease (CVD) emerges as the global leader in mortality causes. In the United Kingdom, there are approximately four million men and 3.6 million women living with heart-related and circulatory ailments (BHF, 2022). BHF (2022) indicates that males in Scotland have a higher prevalence of 12% than in Wales (11%), England (10), and Northern Ireland (7%), in contrast to women having lower rates of an average range of 3.4% to 4.5% in the four states (See Figure 1.2). Although women die from CVD at a greater rate than males, researchers still see the disease as primarily a male-dominating illness. This notion arises from the historical misconception that CVD in women is infrequent or does not present with similar severity as it does in males (Bots, Peters and Woodward, 2017). These statistics indicate that men have a much higher prevalence than women. Men are more likely than women to acquire cardiovascular disease (CVD) at a young age and develop further complications. As a result, middle-aged male CVD death rates are often more significant than females, a disparity that lingers for extended periods. Figure 1.2 CVD, IHD, and Stroke Percentage Rates in the United Kingdom Source: (Bhatnagar et al., 2016) For particular reasons based on physical differences between genders and activities in society, CVD rates are higher in men. The cardiovascular systems of males and females differ in structure and size. Men have relatively bigger hearts and broader blood arteries than women, increasing their risk of cardiovascular disease (Gao et al., 2019). CVD conditions such as heart attacks might proceed differently in males than women. In the case of heart attacks, cholesterol plaques accumulate inside the arterial walls and cause damage to the main blood vessels that transport blood to the heart (Maas and Appelman, 2010). Dong et al. (2022) suggest that males face a higher likelihood than women to acquire plaque formation in the major arteries that feed blood to the heart, which raises CVD risk. Women are more prone than males to develop plaque accumulation in the tiniest blood vessels in the circulation system, defined as microvasculature, which has much fewer risks and poses a lower risk of CVD (Regitz-Zagrosek et al., 2015). This distinction demonstrates the high threats linked to CVD in men due to physical differences. Another difference between men’s and women’s CVD focuses on hormonal advantage, especially in young and middle-aged women. Estrogen in women protects women in their youth and middle age, meaning that CVD risk is much lower in females than in males, giving women an added advantage (Gheisari et al., 2020). However, changes in older age after menopause occur since CVD in women is more likely to develop in females over 70 years of age due to limited hormonal protection. On the other hand, although total cholesterol is a concerning CDV risk factor for both males and females, heightened low-density lipoprotein cholesterol in males raises the threat of cardiovascular disease (Gae et al., 2019). Women tend to have high-density lipoprotein cholesterol (HDL-C) ratios, which is not a significant risk factor regarding CVD. As a result, the differences in lipoprotein cholesterol levels mean that women have a lower CVD risk than men. Research considers cardiovascular disease to correlate to ageing, although it differs by gender. Experts deem the CVD’s health threat to grow linearly in males as they age. It also draws influence from the changes in atherosclerotic processes that are constantly changing (Gao et al., 2019). In contrast, since estrogen protects a female’s cardiovascular system, their reproductive period can avert atherosclerosis, reducing their risk significantly. Another difference is hypertension, which links to cardiovascular illness and is a leading risk factor for left ventricular hypertrophy, diastolic heart issues, and stroke development. Regarding genders, studies have detected a distinct trend in diastolic and systolic blood pressure, where youthful men have a more significant systolic blood pressure than young women (Peters, Muntner and Woodward, 2019). This aspect leads to a higher threat level of CVD among men due to riskier hypertension issues. Researchers have found that isolated systolic hypertension is the most common hypertension in men aged 18 and 45. Thus, this aspect demonstrates the value of distinguishing causative factors in men and women. In the United Kingdom, alcohol and smoking are two of the most common causes of cardiovascular disease, accounting for about 6 million fatalities annually (NHS, 2018). Medical practitioners have found that smoking and drinking alcohol are more harmful to males than females at young ages, mostly below 50 years, since men have a higher consumption rate than women (Mosca, Barret-Connor and Wenger, 2011). Furthermore, smoking has a more significant harmful impact on men than on women when they consume the same number of cigarettes daily. Gao et al. (2019) indicate that the link between smoking and CVD risk was more vital in men than females, with males having a 50% higher CVD vulnerability than women. Furthermore, several research studies have proven the connection between body weight and CVD. More men develop weight issues related to body mass index, and men have a 1.45 increase in risk for CHD and CDV compared to 1.35 in women. The distinction follows the different risk factors for weight problems and obesity. . 2.2.2        Social Role Theory The social role theory is a societal and psychological model that interprets gender distinctions as the outcome of social, physical, and biological forces. In the 1980s, Alice H. Eagly proposed social role theory, which posits that social interaction, gendered myths and stereotypes, gendered roles, and physical gender differences influence men and women’s behaviour (Holman and Borgstom, 2016). Based on the theory, gender tropes and gendered responsibilities lead to social differences among men and women. Regarding CVD prevalence in men, the high-risk factors, including smoking cigarettes and drinking alcohol, remain associated with men’s behaviour due to social pressure for men to be the ultimate financial providers for families and balance work and life (Talley et al., 2012). Due to psychological stress and tension from society, alcohol and smoking become relative relievers of such mental issues. Thus, men are more prone to CVD than women. The social role theory reveals that youths learn about gender roles and tropes due to correspondence bias. The public’s propensity to generate assumptions about specifically gendered dispositions linked to observed behaviour is correspondence bias (Cislaghi and Heise, 2018). Correspondence bias leads to the belief that some characteristics and behaviours arise from societal encounters and biological nature instead of being the results of social influences. Blakely and Dziadosz (2015) note that men are frequently viewed as decision-makers in critical situations and are subjected to more significant economic, social, and political pressures, putting them under more strain. As a result, hypertension, a CVD risk factor, has become increasingly common among males in the United Kingdom. On this note, human civilization’s biological and natural aspects follow how men are born leaders. Hence, they have more responsibility and roles in societal actions in various dimensions. The theory also confers gendered actions where labor roles become divided according to social exp...