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The invisible force. Midlife and older women.


 Women over 40 years of age comprise only between 9% and 20% of the population of Latin America and the Caribbean, but their numbers are growing. Life expectancy for women in the region is expected to exceed 71 years by the year 2000. In Costa Rica, women are responsible for more than 36% of urban households headed by persons over 60, according to a report. Many women in developing countries continue to bear children in their forties. In the 1980s the major causes of death for women over 45 in Latin America were heart disease, cerebrovascular diseases, cancer, diabetes mellitus, accidents and pneumonia/influenza. Cancer is the leading cause of death followed by heart disease. In urbanized countries chronic liver disease is a prime cause of death, often as the result of alcohol abuse. Infectious diseases such as influenza, pneumonia, and intestinal infections are more lethal in countries with more rural populations. Beginning at about age 35, cancer ranks first or second as a cause of death. Breast and uterine cervix cancers are the most deadly for both Latin American and Caribbean women. In the less developed and rural countries cancer of the cervix predominates. In more developed countries breast cancer is more prevalent. Lower cervical cancer rates in more developed countries occur because of greater use of PAP smears. Among women aged 65 years and older, heart disease and strokes are the main causes of death in both Latin America and the Caribbean. Diabetes and other chronic degenerative diseases are increasing throughout Latin America and the Caribbean. Diabetes is among the leading causes of death both in midlife and older women in 13 of the 18 Latin American countries and 6 of the 10 Caribbean nations. Among Latin American and Caribbean women at midlife and older chronic undernutrition is common. An estimated 37% of adult women in the Caribbean are anemic, 26% in Central America, 14% in tropical South America, and 12% in temperate South America. Osteoporosis with the potential for fractures is common among older women in the region. Community-based and home health care programs may be the solution for the health care needs of midlife and older women.
