Is women’s health in this country getting better or worse?

Are women entering middle-age now more or less healthy than the previous generation at the same age?

The answer comes in a recent report from the Australian Longitudinal Study on Women’s Health (ALSWH), a joint project between the Universities of Queensland and Newcastle that’s been running since 1996.

Since then, over 57,000 women have been regularly surveyed to build up a picture of Australian women’s health across the lifespan.

The women are from four age groups born in the years 1921-1926, 1946-1951, 1973-1978, and 1989-1995.

The report I’m talking about focused on the 1946-1951 group (now roughly 71 to 76 years old, but aged 68 to 73 when the latest survey was done in 2019).

They were aged 45 to 50 when ALSWH began, so we can now compare their information from that time with recent data from the group born in 1973-1978, who’ll be 45 to 50 years old this year.

Here are a few comparisons between the two groups.

Weight

Both groups gained weight over time, but this happened more quickly in the younger group. While over 20 percent of the older women were obese by their 50s, this occurred for the younger group by their late 30s.

ALSWH data show an increase in weight at an earlier age with every successive generation. Among the women born 1989-1995, over 20 percent were obese by their late 20s.

In addition, there are early signs that the women now in their 40s are tracking higher than expected for diabetes, heart disease and urinary incontinence in comparison with the 1946-1951 group. Incontinence becomes more common with weight gain.

Mental health

The older women had better mental health in their 40s, and this continued to improve with age. In contrast, among women born in 1973-1978, surveys show an increase in depression, anxiety and stress from around 2010 when they were in their 30s – often years of bearing and rearing children.

Since then, bushfires, floods and covid-19, are likely to have taken a toll on this group who’ve been the mothers of children, teens and young adults through this time.

Diet

Information on the diets of Australian women is always interesting, because studies invariably show that only about one in 10 of us across all age groups eat the recommended amount of fruit and vegetables, i.e. two serves of fruit and five serves of veg daily.

We do better with fruit. More than 60 percent of the 1946-1951 group ate that amount of fruit in their 40s, compared with about 40 percent of the 1973-1978 group.

The data also show an association between eating more fruit and vegetables and a lower risk of depression, but if one influences the other, which way does the relationship go? Do the nutrients in fruit and vegetables help improve mental well-being, or do women eat more healthily when they’re mentally healthier? The same issue would occur with physical activity and mental health.

Physical activity

The older cohort were more active than the women now in their 40s, though the typical pattern for Australian women is that we’re relatively active in our 20s, this drops off in our child raising years, then bumps up until we turn 70, when it dwindles again.

That’s been the trend for some time, so we need to get the message to women turning 70 that physical activity helps stave off chronic disease and keep us strong, mobile and independent into our later years.

Abuse and violence

This includes child abuse, domestic violence and sexual abuse. Thirty-six percent of the 1946-1951 cohort said they’d experienced one of these forms of abuse or violence compared with 52 percent of the 1973-1978 cohort.

Moreover, women who have had these types of experiences tend to have more mental and physical health problems.

Other issues

In other comparisons, the older women were more likely to have had a hysterectomy by the time they were in their 40s, and women now in their 40s are more likely to be diagnosed with asthma. A certain amount of this likely reflects changes in medical practice.

Overall, the 1946-1951 cohort had been a healthier weight, had better mental health, were more likely to have met dietary and physical activity guidelines, and dealt with fewer instances of abuse and violence (or were they just less likely to have acknowledged it?). I haven’t mentioned smoking, but the 1973-1978 group were less likely to smoke.

Current health of women in their 70s

Trend data on the health of the 1946-1951 women show them experiencing more chronic illness (e.g. hypertension, diabetes, arthritis) as they’ve aged from their 40s to now, which is unsurprising. More than one in four is also a carer, which can have a negative impact on health.

In 2019 around 40 percent reported slips, trips or stumbles in the previous 12 months. Women who’d had a fall to the ground were more likely to also say they were stressed about various aspects of their life (e.g. relationships, health or money), and were more likely to score lower on measures of physical functioning (such as being able to lift or carry groceries, walk stairs, bend or kneel) or social functioning (which reflects the impact of physical and emotional issues on their social lives).

So while tripping can come about through bad luck, there are often other factors in the background to a fall.

In conclusion

For women now in their 70s, although this research shows that their health has been better overall than that of the subsequent generations, we need to encourage them to stay physically active into their later years, support those who are carers, and address the various issues behind falls.

Among younger women there are several red flags: diet, physical activity, mental health, weight gain, and the need for a constant effort to reduce abuse and violence (which affects all of the other issues).

If women now entering middle-age are tracking poorly in comparison to the previous generation, we should be especially concerned about the health of the women coming after them. Turning this around will take big picture and long-term thinking and action.

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