Why The Hijab Is A Health Issue

The hijab, worn by millions of Muslim women worldwide is having a negative impact on their health. With limited exposure to sunlight, veiled women are not able to produce adequate vitamin D and have been shown to have an increased risk of developing diseases such as multiple sclerosis.

Multiple sclerosis is a chronic neurological condition, with risk factors that include genetic predisposition, smoking, viruses such as Epstein-Barr and sun exposure. Scientists began to hypothesise a link between solar exposure and MS when they noticed that populations of countries furthest from the equator had a higher prevalence of the disease, and rates differed depending on latitudes within countries, MS presenting itself less in the sunnier regions. Data has shown people moving from sunnier southern European countries to the higher-risk Canada had a higher chance of developing MS than people that hadn’t migrated1)Orton SL et al. Effect of immigration on multiple sclerosis sex ratio in Canada: the Canadian Collaborative Study. J Neurol Neurosurg Psychiatry. 2010 Jan;81(1):31-6.. Subsequently studies have proven vitamin D deficiency to be an MS risk factor2)Sharmila J Dudani et al. Vitamin D and multiple sclerosis: Potential pathophysiological role and clinical implications. Int J Appl Basic Med Res. 2011 Jul-Dec; 1(2): 71–74., and supplementing vitamin D may be an effective way to reduce the chance of relapses in patients3)Summerday NM et al. Vitamin D and multiple sclerosis: review of a possible association. J Pharm Pract. 2012 Feb;25(1):75-84..

Unfortunately greater sunlight hours in a country doesn’t necessarily lead to greater sun exposure for it’s citizens due to lifestyles and cultural pracitces. The hijab is worn generally for the purpose of hiding women from the gaze of unrelated males and has the unintended consequence of shielding the wearer from the sun’s beneficial ultraviolet-b rays. Blood vitamin D levels are an accurate indicator of recent sun exposure, a Turkish study revealed veiled women to be more prone to deficiency4)Guzel R et al. Vitamin D status and bone mineral density of veiled and unveiled Turkish women. J Womens Health Gend Based Med. 2001 Oct;10(8):765-70., more so the longer they’ve been wearing a veil. A study on Iranian school children found girls wearing the hijab were twice as likely to be severely deficient than boys5)Moussavi M et al. Prevalence of vitamin D deficiency in Isfahani high school students in 2004. Horm Res. 2005;64(3):144-8. Epub 2005 Sep 27.. And this isn’t unique to Muslims, the same issue afflicts orthodox Jewish women in Israel6)Mukamel MN et al. Vitamin D deficiency and insufficiency in Orthodox and non-Orthodox Jewish mothers in Israel. Isr Med Assoc J. 2001 Jun;3(6):419-21., who have lower levels of vitamin D than their non-orthodox counterparts.

Students in Tehran pre-1979

Iran’s Muslim revolution provides a unique opportunity to show how the veil can impact women’s health. Prior to the 1979 revolution the people of Iran were encouraged to ditch traditional clothing and embrace more western styles—the hijab was initially banned in 1936, then although the ban was relaxed in the following decades, wearing a hijab was still discouraged and associated with being low class or ‘backward’. The years following the revolution saw these rules flip; it became illegal to not wear a headscarf in public—and research has shown this may be partly responsible for a sharp rise in multiple sclerosis in women since then.

Iran now has the highest rates of MS in Asia and the Middle East7)Etemadifar M et al. Estimated prevalence and incidence of multiple sclerosis in Iran. Eur Neurol. 2014;72(5-6):370-4., prevalence increased seven-fold in Tehran between 1989 and 20058)Sahraian MA et al. Multiple sclerosis in Iran: a demographic study of 8,000 patients and changes over time. Eur Neurol. 2010;64:331–6.—but while it’s important to point out genetic predisposition, advancements in diagnostic tools and lifestyle factors contribute to these figures, they fail to explain Iran’s developing gender disparity. A study MS and women living in Isfahan province, central Iran9)Maghzi AH et al. Increasing female preponderance of multiple sclerosis in Isfahan, Iran: a population-based study. Mult Scler. 2010 Mar;16(3):359-61. confirmed MS cases have risen much like they have in other countries, but more pertinently the study found the ratio of female to male patients changed from 2.13 in those born before 1951 to 5.06 for the patients born between 1977 and 1981.

Nowhere else in the world has MS increased so much in women relative to men over just a few decades.

Incidences of male and female MS by birth year in Isfahan province, Iran. Data source: Increasing female preponderance of multiple sclerosis in Isfahan, Iran: a population-based study.

Research has shown sunlight may be particularly crucial to women. A review on gender and MS concluded that the combination of oestrogen and vitamin D have a protective effect against MS10)Hanne F. Harbo et al. Sex and gender issues in multiple sclerosis. Ther Adv Neurol Disord. 2013 Jul; 6(4): 237–248. Women have different responses than men to sunlight and vitamin D supplements11)Kragt J et al. Higher levels of 25-hydroxyvitamin D are associated with a lower incidence of multiple sclerosis only in women. Mult Scler 15: 9–15 and a study on mice12)Decard B et al. Low vitamin D and elevated immunoreactivity against Epstein–Barr virus before first clinical manifestation of multiple sclerosis. J Neurol Neurosurg Psychiatry 83: 1170–1173 showed only females had a milder form of the disease when fed a vitamin D-enriched diet. Not only that, the amount of UV radiation a pregnant woman is exposed to may impact their child’s chances of developing the disease.13)Staples J et al. Low maternal exposure to ultraviolet radiation in pregnancy, month of birth, and risk of multiple sclerosis in offspring: longitudinal analysis. BMJ 340: c1640.

Just as humans need good nutrition to be healthy, they need sufficient light. If wearing clothing designed to cover sun exposed skin can be a cause of multiple sclerosis, it wouldn’t be unreasonable to expect it to be a causal factor in a host of other health problems.

In Iran and Saudi Arabia wearing a hijab is mandatory but hundreds of millions of women wear them globally, mostly by choice, commonly throughout the Middle East, North Africa and Southeast Asia. Regardless of whether the hijab is seen as a symbol of oppression, a feminist statement, or a sign of modesty and piousness, it will continue to objectively have a negative effect on women’s health. Veiled women should be made aware their health can be improved significantly if they expose their skin to sun in private or at the very least take vitamin D supplements.

Last edit: 23/10/2018

References (click to view)   [ + ]

Leave a Reply

Your email address will not be published. Required fields are marked *