Health & Gender
Dr Anthony Pryce
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aims
To explore the social construction of gender and health
To consider different health behaviours and expectations of men and women
To identify how these issues may impact on access to health care
‘women get sick - .men die’
Why?
Mortality figures change in late 19thC. Women were more prone to TB but this was due to malnutrition, but tight corsets were blamed because poor nutrition was a negative comment on society. Also the healthier men died in First World War whilst the more vulnerable, less healthy men died in the ensuing flu epidemic
Reduced family size between mid 19th C and mid 20th C improved women’s health.
Patriarchy and the shifting balance of advantage - .girls and women suffer adverse social conditions. In 19th C. baby boys 20% more likely to die but girls more likely to die in infancy
social construction of gender
social and biological notions of gender
inequalities
patriarchy
religion
sexualities
science
education
power
law
domestic ideology
Gender roles
Masculinities
Provider ˆ kill or be killed
White, heterosexual, male as ‘normal’ ungendered and universal
Problematic notions of health (Annandale p.139)
‘Bad’ health practices often central to notions of masculinity
Men less tolerant of differences and variation
Femininities
Women historically, culturally subordinated
Women work double shift of work/domestic labour
Registrar general classifications are based on men’s labour/work categories not female
Social class is defined by male status
Women’s bodies/health determined far more by reproductive cycle and childbirth, women’s bodies/physical and mental health to be pathologised than men’s.
Women more likely to given psychiatric label.
Gender differences in morbidity and mortality rates
Four sociological explanations:
Genetic/biological
Cultural/behavioural
Material/structural
Inequalities in access/treatment by health services
Genetic/biological
Pregnancy and childbirth
Contraception & Abortion
Menstruation and menopause
Cervical, ovarian and breast cancer
Problem with focusing entirely on these issues is that is limited, focusing on relatively few diseases/conditions and ignores the cultural influences
Cultural/behavioural explanations
Aspects of women’s role have adverse effects
Pahl (1983) suggested that even in same household there is unequal standard of living. Graham(1986) found that after divorce although women may be single parents they might experience better standards because there was no inequality of distribution.
Bernard suggests that marriage might make women ill ˆ giving up work may make housewives isolated and depressed.
Gendered division of labour & health
‘Men, they are like babies. You don’t know what I put up with from him. Women they get on with it - I’d say women have more aches and pains than men, but, as I say, when you’ve got a family, you will find a woman will work till she’s dropping. But she’ll do what’s she’s got to do and then she’ll say "Right, I’m off to bed" whereas it’s alright for a man. If he’s ill he’s got nothing to do, he just lies there doesn’t he?’ (Cornwell, 1984)
other contributory factors
Women more likely to see doctor but if reproductive issues are excluded, visits are less often than men
Women’s bodies more under medical/ patriarchal scrutiny about reproduction and sexuality
Men less likely to visit doctor later in disease process
Men’s bodies less under scrutiny than women, and men less educated/vocal about bodily functions
Women’s work, historically confined to home setting and disadvantaged in work market.
Women less prone to competitive sports injuries
Women more likely to change behaviour through education
Men more likely to work in ‘risky’ occupation ˆ more accidents.
Men more likely to acquire disease through occupation e.g. mining, farming
Men engage more in competitive work/sport activities and more ‘stressed’
inequalities of access
Only 15% of hospital consultants are women whilst 90 of nurses and 75% of ancillary staff were female.
Most care given by women but they are less well paid.
Women more at risk from clinical iatrogenesis e.g. side effects of oral contraception
Women feel they have less control in childbirth: doctors see it as medical problem, women see it as natural.
Because some diseases e.g. heart disease is constructed primarily as a male problem, women are less likely to get appropriate investigations.
Women more likely to be psychiatrised e.g. hysterical
Men may appear to benefit but women’s life expectancy remains higher. Some diseases such as breast or cervical cancers receive high profile campaigns, screening programmes: prostate and testicular cancer much less so. However, men can and do die of breast cancer!
Men have had greater economic power therefore more access to private care
Women have had less economic and social power: suicide rate is higher amongst young Asian women than white or AfroCaribbean women
Male role more defined by public domain
narrowing the gap?
Changing patterns of employment ˆ fewer traditional male jobs
Women's behaviour changing increased smoking and drinking
Women undertaking more risks
Men becoming more aware of healthy diet and exercise
Greater availability of health care information and social pressure on men to regard their own bodies..increase in anorexia/bulimia in males.
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