Gender and asthma

The evidence reviewed brings to light the complexity of the interactions that exist between the varied manifestations of sex and gender with the development of and morbidity associated with asthma. The effects of sex are manifest throughout life, beginning during pregnancy. Although the effects of sex on asthma include hormonal differences between females and males, diverse effects have been noted, including influence on immune maturation, the balance of the immunologic response, amplification of the inflammatory state associated with obesity, and modification of the response to therapy through effects on the β₂ AR. The complex interactions that occur between the effects of sex and gender (the socio-cultural effect of being female or male) are discussed. Th influence of psychosocial factors (eg, stress, cognitive factors, emotion, coping, identity) on the course and presentation of obstructive lung disease is examined compared between girls and women and boys and men. To understand the disparities in asthma risk, the potential role of the complex interactions between various determinants of health should be understood. Understanding these interactions promises to lead to more effective therapies, including interventions aimed at educating individuals with asthma and their social supports and at helping individuals make behavioral changes. Documenting these multilevel determinants of health can shape changes at the institutional level, including policies that influence environmental exposures, and can remediate social inequities in resources.