ARCHIVED - Research About – Gender and Health

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The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health-care system. Composed of 13 Institutes, CIHR provides leadership and support to more than 13,000 health researchers and trainees across Canada. Through CIHR, the Government of Canada invested approximately $47.6 million in 2008-09 in gender-related health research.

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The Facts

• Gender makes a difference in whether Canadian seniors live alone or not. Older women most often live alone (43%), while it is the least common living arrangement among elderly men (16%).
• Men and women shared the same 10 leading causes of death in 2004 – although not in the same order. For both, the top three were cancer, heart disease and stroke. Differences between sexes were observed in the ranking of unintentional injuries and suicide. Unintentional injuries were the fourth leading cause of death among men, but seventh among women. Suicide was the seventh for men, but 10th for women.*
• Regardless of age, women are more likely than men to report chronic pain. The largest gap was among seniors living in households, where 31% of women reported chronic pain compared with 21% of men.**
• About 16% of women in Canada will experience major depression in the course of their lives. For men the prevalence is 11%.***

Sources: * Statistics Canada, Leading causes of death 2000 to 2004;
** Statistics Canada, Study: Chronic pain in Canadian seniors;
*** Health Canada, Mental Health – Depression, It's Your Health.

Finding Solutions

How men cope with monitoring – not treating – cancer

Men who have early-stage, low-risk prostate cancer but are symptom-free can opt for "active surveillance" of their disease instead of immediate treatment. But what impact does living with an untreated cancer have? CIHR New Investigator Dr. John Oliffe of the University of British Columbia says the uncertainty gets to some. "When they go off active surveillance, it's not because their Prostate Specific Antigen or their biopsy changes, it's because they just can't quite deal with the uncertainty of staying on," he recently told Canwest News Service. A study he co-authored, published in Qualitative Health Research in April, reveals two strategies men adopt. Stoically positioning the cancer as benign was common for men keen on "living a normal life." So was committing to "doing something extra," such as improving their diets.

Teenagers want more emphasis on relationships

A survey of more than 1,200 Toronto-area teenagers has found that many want a better understanding of sexual relationships. Most young people surveyed did not know "sex was supposed to feel good," York University's Dr. Sarah Flicker told Canwest News Service in June when results of the survey were released. The CIHR-funded Dr. Flicker explained that while the majority of respondents knew about HIV, sexually transmitted infections, pregnancy and birth control, only 42% said they had learned about sexual pleasure. "Something is broken in this picture," she said.

Drugging sex victims is common, report finds

Using drugs to facilitate sexual attacks is a common problem and sexual assault services should be tailored to meet the needs of the victims – mostly women – of these crimes, says a CIHR-funded researcher. Dr. Janice Du Mont of the University of Toronto co-authored a report in the Canadian Medical Association Journal in March detailing research she and her colleagues conducted at seven hospital-based sex assault centres over almost two years. In total, 882 victims were eligible for inclusion in the study, of which 184 met the criteria for suspected drug-facilitated sexual assault. The study fills a significant gap: while there are widespread reports of drugging victims to sexually assault them, there has been little done in the way of systemic investigations of the problem.

Female genital cutting impacts the brain

While most scientific investigations into the ancient, but still practiced, tradition of female genital cutting have focused on its impact on women's ability to have children, CIHR-funded researcher Dr. Gillian Einstein of the University of Toronto says the impacts on the brain are also significant. She theorizes that because the vulva is highly innervated, the brain and spinal cord respond to genital cutting the same way they would to the loss of any neural targets or inputs – by rearranging the body's neural networks. This can affect neural signaling and modify sensory perception. Her analysis was published in the Winter 2008 edition of Perspectives in Biology and Medicine.

The Researchers

Dr. Olga Kovalchuk – Sex and Radiation

It was May 1, 1986, in Ivano-Frankivsk, Ukraine, and Olga Kovalchuk's father didn't want his teenage daughter to attend the local May Day parade. Something was terribly wrong, he said. The rain was radioactive.

The world's worst nuclear accident — the Chernobyl nuclear reactor melt-down —  had just occurred 600 kilometres away.

Now a researcher at the University of Lethbridge, Dr. Olga Kovalchuk's CIHR-supported work is bringing new understanding to radiation's health effects, and leading the way towards novel diagnostic and treatment tools.

While Chernobyl opened her eyes to radiation's broad risks, it was a serendipitous discovery in research with mice that revealed surprising gender differences.

"Previously in radiation biology nobody studied females. It was thought to be too complicated to control for their hormonal changes," says Dr. Kovalchuk. "So researchers believed that sex didn't really matter in terms of radiation's health effects."

However, in 2004, Dr. Kovalchuk's lab showed this was wrong — there are significant differences in how male and female body tissues react to ionizing radiation.

"Our findings could have serious repercussions for the development of sex-specific radiation diagnostic and treatment regimes," she says.

Her on-going research to characterize these sex-based molecular differences is now changing thinking about where to look for radiation damage in the body. Radiation researchers have traditionally focused on DNA mutations as the measure of radiation damage.

However, Dr. Kovalchuk's lab group recently discovered that some molecules that regulate gene expression — he epigenetic pathways — are also affected by radiation, and play a crucial role in tumour development.

These epigenetic molecules, such as microRNAs, might also be responsible for one of the key mysteries of radiation medicine: how radiation effects span generations.

"Our lab was the first to find solid evidence to support an epigenetic model of trans-generational mutation and cancer induction in the offspring of exposed parents," she says.

Dr. Kovalchuk's hope is that her molecular research will lead to the identification of molecular markers to indicate radiation exposure. This work brings her full circle to her first major research, published in 1998, on bioindicators of nuclear pollution caused by the Chernobyl accident, work she conducted with her husband Dr. Igor Kovalchuk, now also at the University of Lethbridge.

"If you know you've been exposed to something you can make lifestyle changes to protect your health," says Dr. Kovalchuk. "But it all starts with awareness and understanding."

For More Information

CIHR's Institute of Gender and Health (CIHR-IGH) has identified six strategic research directions: advancing methods and measures; building partnerships; understanding the impacts and implications of violence; improving decision-making in sexual and reproductive health; enhancing the effectiveness of clinical interventions; and putting research into action in work and health. To learn more about these priorities and other CIHR-IGH activities, please visit the Institute's website.

For more information, go to ARCHIVED - Your Health Research Dollars at Work.