Stroke

Stroke is the third leading cause of death for American women, and it kills more than twice as many women each year as breast cancer [1]. Stroke occurs at a higher rate among African American and Hispanic women compared with white women [1]. Women account for 43 percent (or 240,000) of the 550,000 strokes that occur each year and 61 percent of stroke deaths (97,227 of 159,791 annual deaths) [1]. A stroke is usually caused by a clot that stops the flow of blood to an area of the brain. Stroke can cause paralysis, loss of speech, and poor memory and is the most common cause of adult disability. Taken together, stroke and heart disease kill nearly twice as many American women as do all types of cancer combined. More than one woman in five has some form of major heart or blood vessel (cardiovascular) disease in this country [17]. However, in a 1997 national survey, only 8 percent of American women recognized heart disease and stroke as the leading cause of women's deaths [18].

Chronic obstructive pulmonary disease (COPD)

COPD includes chronic bronchitis, emphysema, and asthmatic bronchitis, all of which obstruct airflow from the lungs. In 1997, COPD was the fourth leading cause of death among women, causing 53,045 deaths, for a rate of 17.7 deaths per 100,000 [1]. While COPD death rates are much higher in men than in women, the rates for women have nearly doubled since 1979, with the most rapid increases occurring in women age 75 and older.

HIV/AIDS

Long considered a man's disease, HIV/AIDS is a public health problem among women, with 10,841 new AIDS cases among adult and adolescent women between July 1998 and June 1999 [19]. From 1985 to 1999, the proportion of AIDS cases reported among women increased from 7 percent to 23 percent. Among 13 to 19 year olds, girls constituted 50 percent of all AIDS cases reported in 1998 [20].

By June of 1999, a total 114,621 women were reported to have AIDS, and 77 percent of women diagnosed with AIDS were African Americans and Latinas [19]. HIV/AIDS is the fifth-leading cause of death among women ages 25 to 44 and the third leading cause of death among African American women in this age group [21]. Fortunately, increased screening for HIV among reproductive age women and more effective therapies to reduce perinatal transmission of HIV, have contributed to the 75% decline in the proportion of infants diagnosed with perinatally acquired AIDS since 1993 [20].

The most common mode of HIV infection among adult and adolescent women is through heterosexual contact, followed by intravenous drug use. Significant gender differences are manifest throughout the course of the illness as well as in the mode of infection, indicating the need for gender-sensitive treatment and prevention strategies to stem the spread of AIDS.