Women are drinking more during the pandemic, and it’s probably got a lot to do with their mental health



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Shalini Arunogiri, Monash University; Caroline Gurvich, Monash University, and Jayashri Kulkarni, Monash University

COVID-19 has significantly affected our collective mental health.

For many people, social disconnection, financial strain, increased obligations in the home and ongoing uncertainty have created distress – and with it, a need for new ways of coping.

One way people may choose to cope with stress is through the use of alcohol.

We’re now starting to understand the degree to which alcohol use has increased in Australia during COVID-19. While the data aren’t alarming so far, they suggest women are drinking at higher levels than usual during the pandemic, more so than men.

This trend is likely linked to the levels of stress and anxiety women are feeling at the moment – which, research suggests, are disproportionate to the distress men are experiencing.




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Alcohol consumption and COVID-19

Early reports of increased alcohol purchasing raised the alarm that we might see an increase in alcohol use across the population during lockdown.

However, recent data from the Australian Bureau of Statistics suggests overall, alcohol consumption remained relatively stable during April. Only 14% of Australians reported increased use of alcohol in the previous month.

But women are over-represented in this group. Some 18% of women reported increased alcohol use in the previous month, compared with only 10.8% of men.

14% of Australians reported they were drinking more than usual during April.
Shutterstock

Similarly, preliminary results from our COVID-19 mental health survey of 1,200 Australians in April found a significantly higher proportion of women had increased their alcohol intake: 31.8%, versus 22.5% of men.

Why are we seeing this disparity between women and men? The answers may lie in what we know about why women drink, and in the disproportionate burden of stress women are facing as a result of COVID-19.

Women tend to drink for different reasons to men

In Australia in 2016, 14% of men and 7% of women drank alcohol to risky levels.

Although fewer women than men drink alcohol regularly, alcohol consumption among women has increased in the past decade, particularly in middle-aged and older women. This mirrors international trends that suggest women may be catching up to men in terms of their alcohol consumption.




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Overall, Australia has observed a reduction in risky drinking across the population, with increasing numbers of young people choosing not to drink.

In contrast, women in their 50s are the only subset of the Australian population with rising rates of alcohol use. In 2016, data showed for the first time, they were more likely to drink at risky levels than younger women.

Drinking has become more normalised among women in this middle-to-older age group, potentially contributing to the rise in alcohol use. Alcohol has become a commonly accepted coping mechanism for distress, with women feeling comfortable to say “I just had a bad day. I needed to have a drink”.

This highlights a theme that frequently underpins problematic alcohol use in women: what’s termed a “coping motive”. Many studies have found more women drink alcohol to cope – with difficult emotions or stressful circumstances – as compared to men, who more often drink alcohol in social settings or as a reward.




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Women’s alcohol consumption catching up to men: why this matters


Women seem to be struggling more during the pandemic

With this in mind, it’s unsurprising we’re seeing increased alcohol consumption among women during COVID-19. International data show women have been more likely to experience symptoms of stress, anxiety and depression during the pandemic.

Meanwhile, Australian data show loneliness has been more of a problem for women (28%) than men (16%) during this past month under lockdown.

Caregiver load has also been a source of stress, with women almost three times more likely than men to be looking after children full-time on their own during COVID-19.

Many women have had to work from home while looking after their children.
Shutterstock

While we don’t have enough evidence yet to tell us conclusively whether family violence incidents have increased during the pandemic, this may add to the mental health burden for some women during COVID-19.

Further, younger female workers are disproportionately affected by the economic crisis in the wake of COVID-19. The fact women make up a majority of the casual workforce makes them highly vulnerable at this time.




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Together, it seems COVID-19 is having a different mental health impact on women compared to men. And this is likely to be intertwined with their increased drinking during the coronavirus pandemic.

Whether we’ll see higher rates of problem alcohol use or dependence in women after the pandemic remains unclear. However, we know women who drink at unsafe levels experience complications more quickly, and enter treatment later, with perceived stigma a barrier to help-seeking.

It’s vital we draw our attention to these gender-specific differences in mental health and alcohol consumption as we formulate our mental health pandemic plan.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.The Conversation

Shalini Arunogiri, Addiction Psychiatrist, Senior Lecturer, Monash University; Caroline Gurvich, Senior Research Fellow and Clinical Neuropsychologist, Monash University, and Jayashri Kulkarni, Professor of Psychiatry, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why do more men die from coronavirus than women?



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Jenny Graves, La Trobe University

All over the world – in China, Italy, the United States and Australia – many more men than women are dying from COVID-19.

Why? Is it genes, hormones, the immune system – or behaviour – that makes men more susceptible to the disease?




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I see it as an interaction of all of these factors and it isn’t unique to the SARS-Cov-2 virus – the different response of men and women is typical of many diseases in many mammals.

The grim figures

In Italy and China deaths of men are more than double those of women. In New York city men constitute about 61% of patients who die. Australia is shaping up to have similar results, though here it’s mostly in the 70-79 and 80-89 age groups.

COVID-19 deaths in Australia (last updated April 19, 2020).
Australian Government, Department of Health

One major variable in severity of COVID-19 is age. But this can’t explain the sex bias seen globally because the increased male fatality rate is the same in each age group from 30 to 90+. Women also live on average six years longer than men, so there are more elderly women than men in the vulnerable population.

The other major factor is the presence of chronic diseases, particularly heart disease, diabetes and cancer. These are all more common in men than women, which might account for some of the bias.

But then we must ask why men are more vulnerable to the diseases that put them at greater risk of COVID-19.

Men and women are biologically different

Men and women differ in their sex chromosomes and the genes that lie on them. Women have two copies of a mid-sized chromosome (called the X). Men have only a single X chromosome and a small Y chromosome that contains few genes.

One of these Y genes (SRY) directs the embryo to become male by kick-starting the development of testes in an XY embryo. The testes make male hormones and the hormones make the baby develop as a boy.

In the absence of SRY an ovary forms and makes female hormones.

It’s the hormones that control most of the obvious visible differences between men and women – genitals and breasts, hair and body type – and have a large influence on behaviour.

The Y chromosome and hormones

The Y chromosome contains hardly any genes other than SRY but it is full of repetitive sequences (“junk DNA”).

Perhaps a “toxic Y” could lose its regulation during ageing. This might hasten ageing in men and render them more susceptible to the virus.

But a bigger problem for men is the male hormones unleashed by SRY action. Testosterone levels are implicated in many diseases, particularly heart disease, and may affect lifespan.

Men are also disadvantaged by their low levels of estrogen, which protects women from many diseases, including heart disease.

Male hormones also influence behaviour. Testosterone levels have been credited with major differences between men and women in risky behaviours such as smoking and drinking too much alcohol, as well as reluctance to heed health advice and to seek medical help.

The extreme differences in smoking rate between men and women in China (almost half the men smoke and only 2% of women) may help to account for their very high ratio of male deaths (more than double female). Not only is smoking a severe risk factor for any respiratory disease, but it also causes lung cancer, a further risk factor.

Smoking rates are lower and not as sex-biased in many other countries, so risky behaviour can’t by itself explain the sex difference in COVID-19 deaths. Maybe sex chromosomes have other effects.

Two X chromosomes are better than one

The X chromosome bears more than 1,000 genes with functions in all sorts of things including routine metabolism, blood clotting and brain development.

The presence of two X chromosomes in XX females provides a buffer if a gene on one X is mutated.

XY males lack this X chromosome backup. That’s why boys suffer from many sex-linked diseases such as haemophilia (poor blood clotting).

The number of X chromosomes also has big effects on many metabolic characters that are separable from sex hormone effects, as studies of mice reveal.

Females not only have a double dose of many X genes, but they may also have the benefit of two different versions of each gene.

This X effect goes far to explain why males die at a higher rate than females at every age from birth.

And another man problem is the immune system.

We’ve known for a long time that women have a stronger immune system than men. This is not all good, because it makes women more susceptible to autoimmune diseases such as lupus and multiple sclerosis.

But it gives women an advantage when it comes to susceptibility to viruses, as many studies in mice and humans show. This helps to explain why men are more susceptible to many viruses, including SARS and MERS.

There are at least 60 immune response genes on the X chromosome, and it seems that a higher dose and having two different versions of these gives women a broader spectrum of defences.

Sex differences in diseases – the big picture

Sex differences in the frequency, severity and treatment efficacy for many diseases were pointed out long ago. COVID-19 is part of a larger pattern in which males lose out – at every age.

This isn’t just humans – it is true of most mammals.

Are sex differences in disease susceptibility simply the by-catch of genetic and hormone differences? Or were they, like many other traits, selected differently in males and females because of differences in life strategy?




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It’s suggested that male mammals spread their genes by winning competitions for mates, hence hormone control of risky behaviour is a plus for men.

It’s also suggested female mammals are selected for traits that enhance their ability to care for young, hence their stronger immune system. This made sense for most mammals through the ages.

So the sex bias in COVID-19 deaths is part of a much larger picture – and a very much older picture – of sex differences in genes, chromosomes and hormones that lead to very different responses to all sorts of disease, including COVID-19.The Conversation

Jenny Graves, Distinguished Professor of Genetics, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Pregnant women should take extra care to minimise their exposure to bushfire smoke



Pregnant women should try to stay inside when the air pollution is high.
From shutterstock.com

Sarah Robertson, University of Adelaide and Louise Hull, University of Adelaide

Smoke haze from Australia’s catastrophic bushfires is continuing to affect many parts of the country.

Although there’s no safe level of air pollution, the health hazards tend to be greatest for vulnerable groups. Alongside people with pre-existing conditions, smoke exposure presents unique risks for pregnant women.

Research shows prolonged exposure to bushfire smoke increases the risk of pregnancy complications including high blood pressure, gestational diabetes, low birth weight and premature birth (before 37 weeks).

These conditions can have short-term and lifelong effects on a baby’s health, with increased risk of conditions including cerebral palsy and visual or hearing impairment. Even babies born only a few weeks early can experience learning difficulties and behavioural problems, and have an elevated risk of heart disease in later life.

So it’s especially important pregnant women protect themselves from exposure to bushfire smoke.




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Why are pregnant women at higher risk?

Pregnant women breathe at an increased rate, and their hearts need to work harder than those of non-pregnant people to transport oxygen to the fetus. This makes them particularly vulnerable to the effects of air pollution, including bushfire smoke.

We often measure poor air quality by the presence of ultra-fine particles called PM2.5 (small particles of less than 2.5 micrometres in size). These particles are concerning because they can penetrate into our lungs, and into blood and tissue to cause inflammation throughout the body.

Importantly in pregnant women, environmental pollutants can cause inflammatory damage to the placenta’s blood supply. This can interfere with the placenta’s development and function, which can in turn compromise the growth of the fetus.

What the evidence says

Many studies have linked poor air quality, particularly high PM2.5 levels, to poor pregnancy outcomes. Data from 183 countries showed in 2010, an estimated 2.7 million premature births, 18% of the total, were associated with PM2.5 pollution.

A 2019 study of more than 500,000 pregnant women from Colorado looked at the effect of bushfire smoke on pregnancy outcomes. The authors analysed data on air quality, fire incidence and pregnancy and birth records from 2007-2015, during which time Colorado was regularly affected by smoke from fires burning in California and the Pacific Northwest.

The study found PM2.5 due to bushfire smoke was linked to spikes in premature birth, especially in women exposed during the second trimester.

In women exposed to smoke during the first trimester, birth weight was lower than average. Further, exposure during any trimester increased the chance of gestational diabetes and high blood pressure.

The effects were detectable even with low exposure to smoke and small increases in PM2.5. For every 1 microgram/m³ increase in average daily exposure to PM2.5 during the second trimester of pregnancy, the risk of premature birth increased by 13%.

To put this into context, in Canberra in the first week of January, PM2.5 levels averaged more than 200 micrograms/m³, compared with the typical background concentration of 5 micrograms/m³. EPA Victoria classifies PM2.5 levels above 25 micrograms/m³ as unsafe for vulnerable people.




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In another large study, a 24% increase in premature birth was seen after 10 micrograms/m³ increase in PM2.5.

As well as PM2.5, bushfire smoke contains larger PM10 particles, nitric oxides, carbon monoxide and other gases and toxic chemicals. These all have potential to impair lung and heart function in the mother, activate inflammation, and directly affect fetal and placental development.

Smoke threatens fertility, too

Air quality is also a factor for couples attempting to conceive or dealing with infertility.

Population studies suggest air pollution compromises human fertility by reducing ovarian reserve (the number of eggs in the ovary) and affecting sperm number and movement.

Direct exposure to fire, burns and fire retardant chemicals can also negatively impact fertility.




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Precautions to take if you’re pregnant

The best strategy is to reduce smoke exposure as much as possible. Recommendations from NSW Health include staying inside on high-risk days, sealing the house to prevent smoke infiltration and using air conditioning to keep cool.

Avoid creating smoke by cigarette smoking, burning candles, or frying and grilling. Use PM2 (N95) masks and air-filtering devices if possible, and avoid exposure to ash, which contains particulate material you can inhale.

Studies have shown when women are exposed to bushfire smoke during pregnancy, the rates of premature birth increase.
From shutterstock.com

Pregnant women in a fire region should carefully follow emergency services’ direction. It’s better to evacuate early, with an emergency supply kit containing clothes, medications, water and food you don’t need to cook.

Make sure your medication and prenatal vitamins are accessible, continue to take them, and stay well hydrated. Inform authorities and shelters you are pregnant and need to maintain your antenatal care.

Be aware of the signs of premature labour including abdominal cramps or contractions, a heavy vaginal discharge, loss of fluid or vaginal bleeding, pelvic pressure and low backache. Seek help if you think you may be going into labour.

Given what we know about the consequences of poor air quality on pregnancy outcomes, it’s critical pregnant women are given top priority when it comes to bushfire relief and health care support.




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The Conversation


Sarah Robertson, Professor and Director, Robinson Research Institute, University of Adelaide and Louise Hull, Associate Professor and Fertility and Conception Theme Leader, The Robinson Research Institute, University of Adelaide

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Endometriosis costs women and society $30,000 a year for every sufferer



It can be difficult to get pain from endometriosis under control.
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Mike Armour, Western Sydney University and Kenny Lawson, Western Sydney University

The average cost for a woman with endometriosis both personally and for society is around A$30,000 a year, according to our research, published today in the journal PLOS ONE.

Most of these costs are not from medication, or doctors’ visits, although these do play a part. Rather, they’re due to lost productivity, as women are unable to work – or work to their usual level of efficiency – while experiencing high levels of pain.

Remind me, what is endometriosis?

Chronic pelvic pain is pain below the belly button that occurs on most days for at least six months. The most common identifiable cause is endometriosis. Endometriosis is the presence and growth of tissue (called lesions) similar to the lining of the uterus that’s found outside the uterus.

Women with the condition have a variety of symptoms, including non-cyclical pelvic pain (which is like period pain but occurs regularly throughout the month), severe period pain, pain during or after sexual intercourse, and severe fatigue. Gastrointestinal problems, such as severe bloating (often called “endo belly” by those who suffer from it) and pain with bowel motions, are also common.




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Currently, surgery (a laparoscopy) is the only way to make a formal diagnosis of endometriosis – this is where a small camera is inserted into the pelvic/abdominal cavity to investigate the presence of endometriosis lesions.

Both medical and surgical treatments are commonly used for women with endometriosis. Medical therapies include non-steroidal anti-inflammatories (such as ibuprofen and naproxen), oral contraceptive pills and other forms of hormonal treatments.

While these medications can be effective for some, many women experience side effects and need to stop using them.

Surgery is the current “gold standard” of treatment, but despite successful surgery many women find their pain and symptoms can return within about five years after surgery.




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How many women have it?

Around 7% of Australian women aged 25–29 and 11% of women aged 40–44 are likely to have endometriosis, which is similar to the worldwide estimate of one in ten women.

Delays in diagnosis are extremely common, and combined with needing surgery for a diagnosis, means many women suffer for years with chronic pelvic pain before being diagnosed with endometriosis later in life. This contributes to the difficulty in getting exact figures for how many women in Australia have endometriosis.

Worldwide estimates of chronic pelvic pain range from 5% to 26% of women. In New Zealand, it’s around 25% and is likely to be similar in Australia but we are lacking any up-to-date and reliable statistics on this.

What did our study find?

Endometriosis and chronic pelvic pain affect all aspects of women’s lives – social activities, romantic relationships and friendships, education, and work attendance and productivity.

We surveyed more than 400 women aged 18 to 45 who were either diagnosed with endometriosis or experiencing chronic pelvic pain. We asked about health-care costs (both out of pocket and funded), employment-related costs, and other costs related to childcare and household maintenance. We also asked about their pain levels.

Women with endometriosis sometimes have to work when they’re in extreme pain, affecting their productivity.
Flamingo Images/Shutterstock

We found the average cost for a woman with endometriosis was around A$30,000 per year.

Around one-fifth of this cost was in the health sector, for medications, doctors’ visits, hospital visits, assisted reproductive technology such as IVF, and any transport costs to get to these appointments. Of this, A$1,200 were out-of-pocket costs.

The bulk of the costs (over 80%) were due to lost productivity, either because of absenteeism (being off work) or presenteeism (not being as productive as usual because you’re sick). Women with endometriosis often use up all their sick leave and then often have to work when they are in severe pain.

Overall, if one in ten women aged 18 to 45 do have endometriosis, the total economic burden in Australia may be as high as A$9.7bn per year for endometriosis alone.

Pain scores had a very strong link with productivity costs. Women with the most severe pain had a 12-times greater loss of productivity, in terms of working hours lost, than those with minimal pain.

Overall, taking into account all costs (health sector, out-of-pocket, carers and productivity) women with severe pain have six-times greater costs (A$36,000) a year overall compared to those with minimal pain (A$5,700).

Finally, we also looked at the cost of illness not only of those women with a diagnosis of endometriosis, but also of those that had other causes of chronic pelvic pain, such as vulvodynia (pain, burning or discomfort in the vulva) and adenomyosis (growths in the muscular wall of the uterus).

We found the overall costs between the two groups – those with endometriosis and those with other types of pelvic pain – were very similar.




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The more pain a woman has, the bigger the impact on her productivity and out-of-pocket costs.
Iryna Inshyna/Shutterstock

So what should we be doing?

The economic burden of endometriosis is at least as high as other chronic disease burdens such as diabetes. However, many women are not receiving the support they need.




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We also need to prioritise funding for endometriosis research, which until recentlyhas attracted comparatively little research funding.

Plans are underway to increase awareness and education, and improve diagnosis and pain management. Unfortunately, there is no such plan for women with other forms of chronic pelvic pain.

Reducing pain, by even a modest 10-20%, could improve women’s quality of life and potentially save billions of dollars each year.The Conversation

Mike Armour, Post-doctoral research fellow, Western Sydney University and Kenny Lawson, Adjunct Principal Health Economis, Translational Health Research Institute, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Diplomacy and defence remain a boys’ club, but women are making inroads



Julie Bishop and Marise Payne have risen to the top in foreign affairs, but their successes may be masking more systemic issues preventing women from advancement.
William West/AAP

Susan Harris Rimmer, Griffith University and Elise Stephenson, Griffith University

The Lowy Institute has launched a three-year study on gender representation in Australia’s diplomatic, defence and intelligence services, and the findings are critical: gender diversity lags significantly behind Australia’s public service and corporate sector, as well as other countries’ foreign services.

In a field which has long ignored research on gender or feminist approaches to understanding international relations, this report is welcome and sets forth an important research agenda within Australia.

Gender diversity is an important issue for all who value the pursuit of Australia’s national interests overseas. Attracting and retaining the best talent is more important now than ever before.

As then-Prime Minister Malcolm Turnbull said in June 2017:

The economic, political and strategic currents that have carried us for generations are increasingly difficult to navigate.

The report’s most significant findings

The Lowy Institute found that of all the fields in international relations, women are least represented in Australia’s intelligence communities.

As the funding and resources of the intelligence sector continue to grow, this is a serious problem with little transparency. The sector appears to be struggling with a “pipeline” and “ladder” problem: women are both joining at lower rates and progressing at far slower rates than their male counterparts.

Another important finding is that the presence of female trailblazers in these fields, such as foreign ministers Julie Bishop and Marise Payne and Labor’s shadow foreign minister, Penny Wong, may be masking more systemic issues. This may be leading some agencies to becoming complacent, rather than proactive, on gender diversity.




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Women’s pathways to leadership continue to be impeded by institutional obstacles, such as unconscious bias and discrimination built into the cultures of these sectors, as well as difficulties in supporting staff on overseas postings. For instance, the report notes that in 2017 the government cut assistance packages for overseas officers, including government childcare subsidies. This has gendered ramifications given that women continue to do the bulk of domestic labour.

As such, the most important and high-prestige international postings are still largely dominated by men. DFAT’s Women in Leadership Strategy has proved successful in meeting initial targets for improving women’s representation, however the industry as a whole has not yet followed suit.

Further, it is not enough to just consider how many women there are, but what roles they occupy, given that women have often been siloed into “soft policy” or corporate areas and out of key operational roles needed for career progression.

The report also draws attention to the marginalisation of women from key policy-shaping activities.

From the study’s research on declared authorship, a woman is yet to be selected to lead on any major foreign policy, defence, intelligence, or trade white paper, inquiry or independent review.




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We would mention a few exceptions of women in other high-profile foreign policy roles – Heather Smith’s stewardship of the G20 during Australia’s presidency and Harinder Sidhu’s leadership in the crucial India High Commission. We would also note the contribution of Jane Duke to the ASEAN Summit in Sydney.

Rebecca Skinner has served as associate defence secretary since 2017 and Justine Grieg was appointed deputy secretary defence people in 2018. Major General Cheryl Pearce was also appointed commander of the UN peacekeeping force in Cyprus – the first Australian woman to command a UN peacekeeping mission.

Cheryl Pearce was commander of the Australian joint task force group in Afghanistan before taking up her current role.
Paul Miller/AAP

While the under-representation of women in international affairs remains a core concern, we would argue the report could have taken a broader look at gender representation in foreign affairs-focused academic communities, think tanks and publishing industries, as well.

Many of these organisations have similarly woeful records when it comes to gender diversity. For instance, Australian Foreign Affairs magazine has been criticised for the lack of women authors it publishes. We know that it is not for lack of credible voices, but rather seems indicative of a systematic form of marginalisation of women within the wider foreign affairs community.

Bright spots for gender diversity

However, there is some cause for optimism. For instance, our current PhD project is documenting the gender make-up of leaders and internationally deployed representatives in the departments of foreign affairs and trade, defence and home affairs, as well as the Australian Federal Police. As of this January, women represented 39.5% of those in the senior executive service in DFAT, and 41.4% of those employed as heads of Australian embassies and high commissions globally.

Further, we’ve found an increase recently in the number of women who work in diplomatic defence roles. While the Lowy report notes that women held just 11% of international roles in defence in 2016 (it is unclear exactly what international roles they are talking about), we found a slightly higher percentage of women (19%) currently employed in defence attaché roles.




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The achievements made in this sphere are not just limited to gender either, with women from culturally and linguistically diverse backgrounds forming an important and growing part of representation.

In fact, a more in-depth analysis of the Lowy report’s data would have produced some very interesting, and more nuanced, findings. For instance, foreign affairs has long been the preserve of men, however it has also been the preserve of certain types of men. Diplomacy remains a bastion of prestige, social class, heteronormativity, and in Australia, Anglo-Saxon privilege. It was only last year, for example, that Australia’s first Indigenous woman, Julie-Ann Guivarra, was appointed ambassador (to Spain).

Overall, as the report outlines, gender equality is not just nice to have, nor is it a marginal issue in foreign policy. Rather, the findings are clear: addressing the continued gender gaps are imperative to Australian foreign policy, national security and stability.

We can, and must, do better. Australian foreign policy needs good ideas, and it needs a lot of them. We cannot assume they will all come from the same place.The Conversation

Susan Harris Rimmer, Australian Research Council Future Fellow, Griffith Law School, Griffith University and Elise Stephenson, PhD Candidate, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Health Check: why do women live longer than men?


Biology and behaviour can explain why men tend to die younger than women.
From shutterstock.com

Melinda Martin-Khan, The University of Queensland

In Australia, an average baby boy born in 2016 could expect to live to 80, while a baby girl born at the same time could expect to live until closer to 85. A similar gap in life expectancy between men and women is seen around the world.

As we better understand why people die, we’re learning how biological and behavioural factors may partly explain why women live longer than men.

Scientific advancements also impact the health of women and men differently.




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Biology and behaviour

While women may live longer than men, they report more illnesses, more doctor visits and more hospital stays than men. This is known as the morbidity-mortality paradox (that is, women are sicker but live longer).

One explanation is that women suffer from illnesses less likely to kill them. Examples of chronic non-fatal illnesses more common in women include migraines, arthritis and asthma. These conditions may lead to poorer health, but don’t increase a woman’s risk of premature or early death.

But men are more susceptible to health conditions that can kill them. For example, men tend to have more fat surrounding their organs (called visceral fat) and women tend to have more fat under their skin (called subcutaneous fat). Visceral fat is a risk factor for coronary heart disease, the leading underlying cause of death for Australian men.

Coronary heart disease, which results from a combination of biological factors and lifestyle habits, is a major reason for the difference in mortality between men and women.

Other biological factors may contribute to men ageing faster than women, but these remain to be fully understood. For example, testosterone in men contributes to their generally larger bodies and deeper voices. In turn, this may accelerate the age-related changes in their bodies compared to women.

On the flip side, women may have a slight advantage from protective factors connected with oestrogen. Coronary heart disease has been observed as three times lower in women than in men before menopause, but not after, indicating that endogenous oestrogens could have a protective effect in women.




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Some behaviours that can lead to an earlier death are more common in men. Accidental deaths, including those caused by assault, poisoning, transport accidents, falls and drownings, are particularly high among young males aged 15-24.

Men also have a greater tendency to smoke, eat poorly and avoid exercise. These habits lead to often fatal chronic illnesses, including stroke and type 2 diabetes, and are also risk factors for dementia.

Developments in science and public health

Many scientific discoveries have led to improved clinical practice or changes in government health policies that have benefited the lives of women.

For example, innovations in birth control have enabled greater choice and control over family size and timing. This has resulted in fewer pregnancies that may have led to dangerous births, and improved general physical and mental health for women. Improved clinical care has resulted in fewer women dying during childbirth.

As people reach an older age, the gap in life expectancy narrows.
From shutterstock.com

Public health programs such as screening for breast cancer have had impacts on life expectancy over time. Similarly, vaccines to prevent cervical cancer have now been distributed in 130 countries.

Of course, there have been similar public health policies and clinical innovations that have benefited men too, like screening for bowel caner.

So although we may have some insights, we can’t conclusively answer why women continue to live longer than men.

Mind the gap

The gap between men and women decreases the longer they live. In 2016, at birth in Australia, the gap was 4.2 years, with a male expected to die at 80 on average. But as that male gets older, the gap decreases to 2.7 years at age 65, to one year at age 85 and to just 0.3 years at age 95.

This suggests men who live to an older age have been able to avoid certain health risks, giving them a greater prospect of a longer life.




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Ultimately, none of us have control of when or how we’re going to die. But paying attention to factors that we can change (such as maintaining a healthy diet, doing exercise and avoiding smoking) can reduce the risk of dying earlier from a preventable chronic disease.

While women may always live longer than men, by a year or two, men can try to make some lifestyle changes to reduce this gap. That being said, women should work towards these goals for a long and healthy life, too.The Conversation

Melinda Martin-Khan, Senior research fellow, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Rugby league may finally have reached its tipping point on player behaviour and violence



File 20190221 120329 1no56ia.jpg?ixlib=rb 1.1
The Sharks’ Ben Barba (centre) was sacked by his club after allegations he assaulted his partner.
AAP/Dan Himbrechts

Jessica Richards, Western Sydney University; Eric Anderson, University of Winchester, and Keith D. Parry, University of Winchester

St George Illawarra and NSW State of Origin player Jack de Belin has become the first player to be banned under a new “no fault stand down” policy introduced by the National Rugby League (NRL).

This policy allows the NRL to stand down players facing criminal charges that carry a jail term of 11 years or more, pending the outcome. Players will remain on full pay and will be allowed to continue to train with their teams until the matter is resolved.

In December 2018, the NRL was urged to take “urgent action” after a spate of allegations of domestic violence and assault by players. The sport’s governing body was accused of failing to adequately condemn these acts of violence against women.

Could it be that finally rugby league is listening to the criticism?

Just a few weeks ago, Ben Barba was sacked by his NRL club following allegations he physically assaulted his partner and mother of his four children. After a history of off-field incidents, he was deregistered by the NRL. Despite one former player speaking out in support of Barba, he has been widely condemned by the NRL community.

Violence on the field too often translates to violence off the field. Barba’s sacking should herald a culture shift in the NRL away from versions of masculinity that are exclusive and threatening to women. The sport must move towards a culture that is better aligned with the values of society.

Rugby League – a bastion of masculinity

For many years, rugby league has provided an outlet for violence that allows masculinity to be performed.

Throughout the 1980s and into the 1990s, league epitomised orthodox masculine characteristics such as aggressive competition and toughness. Fighting, confrontation and belligerence has been revered in media coverage and by the wider public. For example, The Footy Show valorised versions of masculinity that portrayed men as hyper-heterosexual, stoic and aggressive. The hosts repeatedly demonstrated disrespect for women.

But in recent years, social customs, gender relations and the expectations of even hyper-masculine warrior athletes began to change. The Footy Show has been cancelled; and evidence from America’s most similar sport, American football (NFL), suggests that since 2006, there has been a slight decrease in players arrested for domestic violence.

Barba’s sacking appears to provide evidence of an emerging social contract with masculinity. No longer is men’s violence acceptable to the public. Rugby League — finally now — is taking action.

While player welfare is important, so is the welfare of women. The “boys will be boys” excuse no longer stands. NRL endorsed campaigns, such as Power For Change, an initiative described as “empowering young people to be leaders of change against domestic violence”, appeared hypocritical in the face of five sexual assault charges in the most recent off-season. On the sixth, the NRL took action.

It appeared the Australian sporting community had had enough. NRL fans, particularly, were fed up with misbehaving players and seeking significant change. Sanctioning players with bans and fines has proven ineffective.

In addition to introducing their “no fault stand down policy”, NRL chief executive Todd Greenberg has called on other codes to honour the NRL-imposed ban. The Northern Hemisphere Super League has closed the door on Barba and Rugby Australia boss, Raelene Castle, said they would also respect the NRL’s wishes.

Inclusive masculinities

The NRL is today at a crossroads.

There has been a highly visible, and extensively documented phenomenon that millennial men reject orthodox notions of masculinity. They instead value intimacy among friends, tactility, respect for women, and disregard for violence. Much of the reason for this is considered to be related to changing mores surrounding male homosexuality. When this changes, so does everything about masculinity.

The sociological work on this suggests that when heterosexual men exist in a culture that maintains high antipathy toward gay men (as existed in the 1980s), they will try to distance themselves from anything associated with gay men. Thus, men revere violence and stoicism, and hyper-sexualise women. They are thought weak for showing emotions concerning care for other men, or fear of confrontation.

However, as cultural attitudes have shifted, making homophobia and not homosexuality stigmatised, heterosexual men have more social freedom to express gender in ways that were once taboo. So it becomes permissible to talk your way through a problem with another male instead of fighting.

Scholars call this inclusive masculinity, but more colloquially it might be understood as a highly revered, feminised masculinity. In the last few decades, we have seen wholesale shifts to adolescent masculinities, something epitomised by the burgeoning of the “bromance”.




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The NRL has divided fans with its recent rule change. Although the rule change sends a strong message to players and clubs that violence will not be tolerated within the code, until the wider culture of Rugby League begins embracing alternative forms of masculinity, the cause of the problem will still remain.The Conversation

Jessica Richards, Lecturer Sport Business Management, Western Sydney University; Eric Anderson, Professor of Masculinities, Sexualities and Sport, University of Winchester, and Keith D. Parry, Senior Lecturer in Sport Management, University of Winchester

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A peace agreement in Afghanistan won’t last if there are no women at the table


Susan Hutchinson, Australian National University

Over the past weeks, the US government has been in peace negotiations with the Taliban. It has been 17 years since US and allied troops first deployed to Afghanistan to overthrow the Taliban and support a democratically elected government.

The current peace negotiations have progressed further than any other attempted during the conflict. But they have two serious problems. Firstly, they have have not included the democratically elected government of Afghanistan, led by President Ashraf Ghani. Secondly, they have failed to include a single woman.

The situation so far

Peace negotiations can take many forms. At their most basic, they cover ceasefires and division of territory. But they often go further to address underlying causes of conflict and pave the way for durable solutions. They include extensive informal discussions before any formal agreement is signed.

In 1996, the Taliban took control of Afghanistan. It banned women from attending school and denied them their most basic rights. The Taliban provided safe haven for those responsible for the attacks against the US on September 11, 2001.

The US is keen to withdraw its remaining troops. But they want to secure a commitment from the Taliban that Afghanistan will not be home to terrorist groups planning attacks against the United States.

The most recent reports show the Afghan government controls 56% of Afghan districts, or 65% of the population. The Taliban controls 15% of the districts, with 29% remaining contested.

Peace negotiations are often fraught with tension about who is allowed at the table. So far, the Taliban has refused to allow the government of Afghanistan to participate in the current negotiations. The chief US negotiator, Zalmay Khalilzad, has been briefing the Afghan government on the progress of negotiations taking place in various Gulf States.




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Khalilzad is under pressure from US President Donald Trump to move the negotiations forward. But excluding the government is problematic. It could indicate the likely failure of negotiations, end up making the government look even weaker than it is and/or pave the way for a return to deeply conservative religious rule for Afghanistan.

It is often tempting for power brokers to prioritise the participation of armed groups in peace negotiations. But it’s important to ensure broader participation of civil society.

Research examining every peace agreement since the Cold War shows the participation of civil society makes a peace agreement 64% less likely to fail. The key reason is the peace process is perceived as more legitimate if civil society is included. But including civil society also ensures the concerns of the broader community are accounted for and that those who carried arms do not receive positive reinforcement by monopolising the benefits negotiated in the agreement.

What about the women?

Afghan women are angry about being excluded from the peace negotiations. The country’s leading women’s rights group, the Afghan Women’s Network, released a statement calling for “the full, equal and meaningful participation of women” in the negotiations.

Life for women in Afghanistan remains hard. The latest Reuters Poll said Afghanistan was the second most dangerous country to be a woman, down from the most dangerous five years earlier. The country still makes the top of the list for violence against women, discrimination, and lack of access to health care.

But significant progress has been made in the past 17 years.
Data from the UN Development Program show gender inequality dropped by ten percentage points between 2005 and 2017.

Women have strengthened their political, economic and social presence through efforts to advance their status and respect for their rights. Girls have been able to go to school. Women have become members of parliament, governors and police.




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Afghanistan’s 2004 constitution includes a hard won provision that enshrines the equality of men and women. But the Taliban is calling for a new constitution and it is highly unlikely if this was agreed, such a provision would survive.

Research drawing on extensive quantitative and qualitative data has shown that the way a country treats its women is the best indicator of its peacefulness. This is a better indicator than wealth, ethnic and religious identity or democracy.

We also know that women’s participation in peace processes makes for a more effective outcome. A peace processes is 35% more likley to last at least 15 years if women are at the negotiating table, have observer status, or participate in consultations, inclusive commissions or problem-solving workshops.

Women can negotiate with the Taliban

Even so, men and people from the international community often believe the struggles faced by Afghan women mean they are not in a position to negotiate with the patriarchal Taliban.

But Afghan women like Palwasha Hassan have been working for years to pursue peace with the Taliban. Hassan sits on the country’s High Peace Council and has seen how women across the country have already negotiated with local Taliban leaders. She says “the international community is failing to value what we have achieved together and the progress we have made so far.”

She conducted a workshop in 2010 with women across local communities. Stories included one woman who had negotiated to keep a local girls’ school open by arguing that educated girls could do better in Islamic studies, including learning to read the Quran. She also guaranteed to her Taliban interlocutors that a prayer space in the school would be reserved strictly for women and girls only.

Another woman explained how she and others negotiated the release of hostages being held by the local Taliban commander. She appealed to Islamic values of life and justice, and persuaded the captors that the hostage was being held unjustly.

International agreements

The importance of women’s participation in international peace and security was codified by UN Security Council resolution 1325 nearly 20 years ago.




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Seventy-nine countries, including Afghanistan, have National Action Plans to guide the resolution’s implementation and the subsequent seven Security Council resolutions on Women, Peace and Security.

In October 2017, the US became the first country in the world to pass a Women, Peace and Security Act, signed off by President Trump himself. It was passed explicitly to

ensure that the United States promotes the meaningful participation of women in mediation and negotiation processes seeking to prevent, mitigate, or resolve violent conflict” across the world.

Democratic Senators have urged the Trump administration to ensure Afghan women’s involvement in the peace negotiations. But so far no one has invoked the new law.

There are few who wouldn’t hope for peace for Afghanistan, but as Palwasha Hassan says, the negotiations “have to include women, both to protect our rights and also to ensure the durability of the peace that follows.”The Conversation

Susan Hutchinson, PhD Candidate, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Australia can do more to attract and keep women in parliament – here are some ideas


Brendan Churchill, University of Melbourne

The resignation of Kelly O’Dwyer, Federal Minister for Women, Jobs and Industrial Relations, tells us what we have known for some time: Australia’s parliament is a hostile workplace for women and working mothers.

O’Dwyer’s desire for a bigger family and more quality time with her young children reflects, in some respects, the challenges ordinary working mothers in Australia face everyday. It also highlights yet another example of the difficulties faced by women in politics.

As Liberal senator Linda Reynolds wrote in an opinion piece: O’Dwyer’s resignation “ …is not simply a gender issue. It is a parent issue”.

But for every Tim Hammond (the federal Labor Member for Perth who quit politics last year for family reasons) there is a Kelly O’Dwyer or a Kate Ellis .

Women by and large are still the primary caregivers in this country regardless of whether they are an MP or senator.




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Institutionally, Australia’s parliament has made significant progress over the past decade to accommodate parents. Parliament House now has childcare services and a breastfeeding room off to the side of both chambers for new mothers.

Breastfeeding mothers can vote by proxy in the House of Representations. And in 2017, former Greens Senator Larissa Waters became the first federal MP to breastfeed in parliament.

But there is still progress to be made. Parliament remains family-unfriendly. Sitting hours often extend well beyond childcare hours and sitting weeks are often scheduled during school holidays.

Fewer options than other working women

These issues affect all working parents but must surely impact heavily on parliamentarians who have to travel from their electorates to Canberra. Ordinary working mothers often opt for part-time work to manage the demands of work and family. This is because we haven’t quite figured out how to help women and families best manage their competing workloads.

An MP or senator does not have the option of working part-time. While women politicians do take maternity leave, a part-time MP or senator might not meet community expectations about politicians and service. We also know women in part-time work often end up feeling more stressed as they take on more domestic work or end up working outside of their set part-time hours.

But the idea of job sharing seems less remote. Historically, job sharing, which involves two people sharing what is normally a full-time role, has been seen as an alternative way for women to stay in the workforce. Some preliminary research in the UK suggests that might be a viable option for politicians. And evidence shows it works at the highest level of business, so this is perhaps one way parliaments can learn from the business community.

However, like all flexible working arrangements, job sharing cannot be seen as a solution or alternative for women alone – swapping the political sphere for the private. Male politicians with children would need to be encouraged to adopt these arrangements should they ever eventuate. And getting men to take up flexible working arrangements is not always successful as evidenced by policymakers’ attempts to get new dads to take up parental leave.




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As we enter the next decade, politicians, political parties and the parliament should consider how best to support working mothers (and fathers).

This must begin with a shift in culture. In her resignation speech, former Liberal now Independent, Julia Banks, stated:

equal representation of men and women in this parliament is an urgent imperative which will create a culture change.

Advances towards equal representation are lopsided in the parliament. While Labor is on track to reach equal representation with almost half of its parliamentarians women, the Coalition’s ratio is only one in five. It’s expected with O’Dwyer’s resignation along with recent announcements by other women, female representation in the Liberal and National parties will be proportionally lower than when John Howard left office in 2007.

Regardless of political persuasion, fewer female MPs can only slow progress towards gender equality.

Tim Hammond’s experience is an example of the toll experienced by fathers in federal parliament, but this is still the exception rather than the rule. Greater female representation will help shift cultural ideas about women and working mothers.

But shifts in ideas about working fathers in parliament are needed too. Images of male politicians working with their children at their side is a rarity saved only for election campaigns.

Like ordinary working women, female politicians need not only supportive workplaces but supportive families. Former Queensland premier Anna Bligh relied on her partner and mother for support during her time in office. However, not every female politician has a Greg Withers or a Clarke Gayford, partner of New Zealand prime minster Jacinda Arden, to care for their children while their partner gives a speech to the United Nations.

Ideas from other nations

Jacinda Arden provides one example of greater flexibility for mothers who are parliamentarians. She has broken up her schedule into three-hour slots so she can breastfeed. But not every woman in parliament has as much control over her schedule as a prime minister.

New Zealand is perhaps leading the pack in making parliaments work for parents. Recently, the Speaker of the New Zealand parliament has sought to make it even more family-friendly with a raft of measures, including the installation of highchairs in the cafe and a playground.




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In Europe, things are also progressive with women politicians in the European Parliament – including most famously Italian MEP Licia Ronzulli – taking their children to parliamentary debates and meetings.

In the US, the number of mothers in congress has doubled following the mid-term elections in 2018, which saw a record number of women run for office. Last year, Tammy Duckworth of Illinois became the first senator to have a baby in office, which necessitated changes to allow a baby on the senate floor.

Only ten women have given birth while in Congress and of those, six in the last 11 years.

The presence of children, especially mothers breastfeeding in parliamentary chambers, continues to be worldwide news, suggesting it’s still a novelty. Japanese local government member, Yuka Ogata, has a number of times been forced to leave the assembly as irritation grows around her demanding more family-friendly policies.

At the press conference announcing O’Dwyer’s resignation, the prime minister said he supported:

[…] all women’s choices. I want women to have more choices and all the independence that comes with that.

But choices are always made in the context of individuals’ lives. This is especially true for women who are working mothers. To ensure they make the choice to enter and stay in parliament we must ensure these issues are addressed.

It’s important parliament be made up of working mothers so policies and laws that affect families and in particular working women are informed by those who experience these challenges.The Conversation

Brendan Churchill, Research Fellow in Sociology, University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.