48 J Health Popul Nutr Mar 2007 from the family and care providers. In the case of HIV- associated disease, for instance, the economic conse- quences may be worse for women who are left with families to support when husbands become infected and die, or they may not be able to earn income or support their families when they themselves are ill. Whereas this framework previously was limited only to developing countries where tropical diseases are mainly found, this paper expands the analysis to include industrialized countries as well. The paper brings together the findings of various studies to iden- tify how gender interacts with the determinants and consequences of health and illness. Whereas previous research based on this framework was limited to devel- oping countries, the present analysis demonstrates that gender has an important effect on the determinants and consequences of non-communicable diseases and con- ditions in both developing and industrialized countries. In each section of the paper, one example of a chronic disease or condition is provided to illustrate how the gender framework can be equally applied to develop- ing and industrialized societies. There is no systematic body of knowledge on gender and chronic diseases, although there is a considerable literature emerging on specific diseases such as those discussed in this paper. Based on research findings on gender, several hypotheses have been proposed. Ver- brugge, for example, argued that gender differences are more pronounced for prolonged, mild conditions than for acute, life-threatening or severe ones (4). However, further research on specific diseases, including tropical infectious diseases, has added new findings that need to be taken into account. Charmaz notes the importance of examining gender differences in non-communicable diseases and that the experience of illness is strongly related to gender identities (5). The following analysis, therefore, brings together two areas of investigation—tropical infectious diseases and chronic non-communicable diseases—by showing that the framework from tropical diseases also applies to chronic diseases. It also draws out conclusions re- garding gender and chronic diseases by comparing the results of the various studies of different diseases or conditions. MATERIALS AND METHODS This paper is based on a review of published articles in the area of gender and health. By way of illustration, examples of non-communicable diseases or conditions are highlighted under the headings of social, economic Vlassoff C and biological determinants and consequences respec- tively to demonstrate their interaction with gender vari- ables. The examples are not related to one another but have been selected because they have been studied in both developing- and industrialized-country context and because they demonstrate the interaction of gender variables with social, economic and biological factors and how these produce different outcomes for males and females. RESULTS Gender differences in determinants of health and illness This section reviews evidence of gender differences in the social, economic and biological determinants of health and illness, focusing on three non-communic- able diseases or conditions: nutrition for social determi- nants, mental illness for economic determinants, and longevity for biological determinants. Gender differences in social determinants of health and illness Social factors, such as the degree to which women are excluded from schooling, or from participation in pub- lic life, affect their knowledge about health problems and how to prevent and treat them. The subordina- tion of women by men, a phenomenon found in most countries, results in a distinction between roles of men and women and their separate assignment to domestic and public spheres. The degree of this subordination varies by country and geographical or cultural pat- terns within countries, however, in developing areas, it is most pronounced. In this section, the example of nutrition will demonstrate how gender has an impor- tant influence on the social determinants of food-con- sumption patterns and hence on health outcomes. Several studies have shown the positive relation- ship among education of mothers, household autono- my, and the nutritional status of their children (6,7). During the first 10 years of life, the energy and nutri- ent needs of girls and boys are the same. Yet, in some countries, especially in South Asia, men and boys often receive greater quantities of higher quality, nutritious food such as dairy products, because they will become the breadwinners (7-15). Das Gupta argued that depriv- ing female children of food was an explicit strategy used by parents to achieve a small family size and de- sired composition (13). Studies from Latin America also found evidence of gender bias in food allocation in childhood (16-18) and, correspondingly, in healthcare allocation (19).