What we know
What information do we have about the Eastern Board area?
What is the result of this on our health locally?
Policies
What is happening in the Eastern Board area?
References

Women's health has dramatically improved over the last 50 years, largely due to improvements in maternity services, coupled with a reduction in family size.

The main causes of death in women are circulatory diseases such as heart disease and stroke, respiratory diseases and cancers, particularly lung cancer and breast cancer. Although circulatory diseases, respiratory diseases and cancers are also the main causes of death in men, we see different patterns between the sexes. For example, the rate of death from ischaemic heart disease is much higher in men than in women, but when the trends are examined, the gap is narrowing, as the rate is decreasing in men more quickly than in women. Women are less likely than men to die from road traffic accidents or self harm such as suicide and self inflicted injury.

Women tend to live longer than men, with a current life expectancy of 74.8 for men and 79.8 for women (Investing for Health annual report). Reproductive hormones have a protective effect on the development of cardiovascular disease and osteoporosis (thinning of the bones), so women are much less likely to suffer from these conditions before the menopause. Women’s health is closely linked to reproductive trends. Fertility trends including changes in family size and the age at which women give birth have a major impact on the need for a wide range of services including maternity, child health, social services and education.

Lifestyle behaviours such as smoking habits and exercise are particular issues of concern for women's health. More young women are starting to smoke and the rate of lung cancer is staying static in women, whereas it is decreasing in men. This reflects the smoking habits of previous decades. The major concern is now that the rate of death from lung cancer and other respiratory disease is going to increase in the future in women, reflecting the current increase in smoking habits. Smoking in pregnancy can also affect the health of the unborn baby, causing premature births and small babies, so all pregnant women are particularly advised to stop smoking.

Women are also more likely to be inactive. This not only affects their cardiovascular health, but puts them at greater risk of obesity, Type 2 diabetes, osteoporosis and other musculoskeletal conditions. Women are more likely than men to be carers of children and elderly relatives. More women than men report that they have a long-term illness or disability.

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On Census Day in 2001 there were 665,968 people living in the EHSSB area, 318,628 men and 347,340 women. In 2002, there were 6382 deaths from all causes in residents of the Eastern Board area: 2969 males and 3413 females.
Heart disease, stroke, respiratory disease, breast cancer and lung cancer together accounted for over half of all causes of death in women in the Eastern Board area in 2002.

The rate of death from ischaemic heart disease in women over the last decade shows a marked decrease. The rate of death from breast cancer and stroke shows a slight decrease, while the rate of death from lung cancer shows no change.

Fertility rates
The total period fertility rate in the Eastern Board area is lower than the rate in N Ireland and in England. The age profile of mothers has changed markedly with half of all mothers now aged 30 years or more. Delivery by caesarean section has more than doubled since 1990, from 12% to 26% of all births.

The total period fertility rate (TPFR) is the average number of children which would be born to a woman if current age-specific fertility rates remained the same throughout her childbearing lifespan. The TPFR in the Eastern Board area fell from 2.27 births per woman in 1981 to 2.04 in 1991 and then to 1.59 births per woman in 2002. This is well below the level at which a population replaces itself (2.1 births per woman). The TPFR in the Eastern Board area in 2002 was lower than that for N Ireland generally (1.77 births per woman) and also lower than that in England (1.64 births per woman).

Maternal age
Information on maternal age in the Eastern Board area is available from 1990 (Source: Child Health System). The number of births to mothers aged less than 20 years in the Eastern Board area fell from 737 in 1990 to 689 in 2003. Due to the fall in the number of births to women of all ages, there was increase in the proportion of births to teenage mothers, from 7.2% in 1990 to 8.6% in 2003.

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Although women’s health has improved, new health problems are appearing. The dramatic increase in the level of obesity gives cause for concern, as this increases the risk of coronary heart disease, stroke, type 2 diabetes and musculoskeletal problems. Women are encouraged to adopt healthier lifestyles to combat obesity. This includes increasing physical activity, reducing consumption of fats, sugars, salt and processed foods and replacing them with fruit and vegetables and more fibre. Physical exercise also leads to improved mental health and a sense of wellbeing.

The Northern Ireland breast screening and cervical screening programmes offer a high quality screening service to women in Northern Ireland. Screening for breast and cervical cancer detects women who are at a higher risk of breast or cervical cancer and enables them to receive further diagnostic testing and treatment where required.

Women who live in deprived areas often are less likely to access preventive health services such as screening or immunisation for their children. The Eastern Board there are areas of high deprivation and we have to target resources to these areas in order to address these inequalities in health. Depression and mental health problems are also more common in women from these areas. Community development often provides a key for engaging with these groups and meeting the needs which they identify for themselves.

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