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In the United States, a woman age 30 to 70 years of age has a 1 in 8 chance of dying from a noncommunicable disease (NCDs), putting the nation on par with low and middle-income countries, and setting it apart with Iceland among high-income countries, according to a report published Thursday in The Lancet.

The authors write that these differences among Veterans Affairs (VA) populations could reflect variability across the medical centers in terms of quality of care, adherence to evidence-based treatment and screening guidelines, access to urgent care, posthospitalization care protocols, chronic disease management, and access to specialty care, social work services, and behavioral health care.

While cardiovascular disease (CVD) is the leading cause of death among women as well as men, and while both sex and gender differences in CVD and its treatments have been well documented, women continue to be less represented than men in clinical trials of drugs to treat CVD. Among proposed reasons for this phenomenon are the recruitment of younger patients, inclusion criteria that tend to select men, and exclusion criteria that are more common in women.