The health of aging women is a global concern (United Nations, 1995; World Health Organization, 1996). No longer perceived to be the responsibility of more developed countries, the delivery of preventative health care to women at menopause and beyond presents a growing challenge to less developed countries more accustomed to battling infant and maternal mortality than osteoporosis and related conditions of aging (Diszfalusy, 1986). In many nations, the cohort of women now reaching menopause has enjoyed “the lowest mortality rates in human history” (Miles and Brody, 1994:5), resulting in an increase in absolute numbers of older women. By the year 2025, there will be a projected 825 million people 65 years and older, the majority of whom (572 million) will reside in less developed nations (United Nations, 1993), and of them the majority (454 million) will be women (United Nations, 1999). A surprising consequence of these demographic changes is that older women in many less developed countries, particularly in Latin America and Asia, will potentially spend more of their lives in the postmenopausal stage due to an earlier mean age at menopause (Wood, 1994) coupled with an increased life expectancy (United Nations, 1995; United States Bureau of the Census, 1992) compared to women in more developed countries.
The papers in this thematic collection focus on menopause and post-reproductive health of women. They share a biocultural framework, including the co-evolution of anatomic and behavioral changes in hominid evolution, which result in a uniquely long postmenopausal stage of life (Peccei); the potential influence of the social custom of marriage on age at menopause through pheromonal effects (Leidy Sievert et al.); and the impact of biomedical treatment on a study of symptom frequencies (Brown et al.). Other contributions (Lock and Kaufert; Beyene and Martin; Johnston; and Hewner) each explore distinct examples of “local biologies” to better understand the experience of menopause in their respective cultural settings. As these studies demonstrate, biological and sociocultural variables are both cause and effect (Wiley, 1992), intertwined in “a continuous feedback relationship of ongoing exchange” (Lock, 1998:410).
In addition to demonstrating the applicability of the biocultural approach, these papers provide an opportunity to explore another unifying idea: that age and symptom experience at menopause may serve as measures of population health, just as age at menarche (Eveleth and Tanner, 1990), child growth status (Schell, 1986), and infant mortality rates (Swedlund, 1990) have been used as indicators of community well-being. Secular trends and comparisons of median ages at menarche have been used as indices of population health associated with industrialization and urbanization (Eveleth and Tanner, 1990; Pasquet et al., 1999), distribution of social resources (Veronesi and Gueresi, 1994), the effects of pesticide use (Graham et al., 1999), and the social disruption of war (van Noord and Kaaks, 1991; Prebeg and Bralic, 2000). As more attention is given to the health concerns of older women (United Nations, 1995; World Health Organization, 1996) and as more information is collected about diversity and change in median ages at menopause, age at menopause may be similarly used as a measure of population health.
Available at: http://works.bepress.com/lynnette_sievert/36/