Health & Gender wk 3:2 Summer 08 1 Understanding Gender & Health Wk 3: 2.

Health & Gender wk 3:2 Summer 08

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Understanding Gender & Health

Wk 3: 2


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How Does Gender Perceives Fitness, Body Weight,

Height (Body Mass Index)• What is to men & women

fitness mean?• How do you see your own

body weight, height?• What types of clothing would

women & men choose for casual, special events: dinners, weddings ---Funerals?

• How do see your diet and lifestyle? Are they connected?

• How do media portray body image? What is it to the girls & boys?

Lifestyle Being Poor?

Diet

Health


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Sex & Gender Relations – health status

• Interaction with social class, race, ethnicity, age sexual orientation to shape health

status & physician-patient relationship & treatment by health care system• Health as to WHO (1960) is

multidimensional.” a complete state of physical, mental, & social well-being.”

Hierarchical * Power Relations

*Ability to make decisionswith regards to own body.

-Unwanted pregnancies-Unsafe abortions-Maternal deaths

-STDSHealth & Gender wk 3:2 Summer

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Premise

“Inequity in the relations between men and women places one or the

other sex at a disadvantage in terms of access to and control of

resources, e.g. needs to protect health.”


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Patterns of ill health

Factors affecting who gets ill

Factors affecting responses to ill health


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Environment HouseholdsBargaining Communitiespositions Influence of

States?Markets?Int. RelationsResourcesActivitiesGender norms


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Gender & Mortality

• Do women live longer than men on average? • What is live expectancy of females & males in

Canada? What does statistics say?• For Malaysia, women live longer than men:

average 82 vs 73


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Life Expectancy at Birth by Sex for Selected Countries

Country Female Life Expectancy (in years

Male Life Expectancy (in years)

Japan 82.9 76.4

France 82.6 74.2

Switzerland 81.9 75.1

Sweden 81.6 76.2

Spain 81.5 74.2

Canada 81.2 75.2

Australia 80.9 75.0

Italy 80.8 74.4

Norway 80.7 74.9


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Netherlands 80.4 74.6

Greece 80.3 75.1

Austria 80.1 73.5

Germany 79.8 73.3

Belgium 79.8 73.0

England & Wales 79.6 74.3

Israel 79.3 75.3

Singapore 79.0 73.4

USA 78.9 72.5


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Life Expectancy at Birth by Sex for Selected Countries



Finland 80.3 72.8

New Zealand 78.9 73.3

Puerto Rico 78.9 69.6

Portugal 78.6 71.2

Northern Island 78.5 73.1

Ireland 78.1 72.5

Denmark 77.9 72.8Source: National Center for Health Statistics, 2000. in

Renzetti & Curan. Most data from 1995

Gender-focused health programs recognize that gender

is an organizing principle that affects women and men

in all aspects of their lives, and consequently influences

the outcomes of health programs and interventions.Health & Gender wk 3:2 Summer

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Gender -a social construct because it is defined,

supported and reinforced by societal structures

and institutions. It is also a psycho-social construct


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Gender inequities in access toand influence upon health programs, resources, and

services suggest that a common plan is unlikely to servemen’s and women’s distinct needs. Gender-differentiated

priorities and processes are needed to guide healthpolicies. Governments exert a powerful impact—bothpositive and negative—on funding for health programs

through, for example, requirements that programsmust include an evaluation component. If evaluation

and other processes do not reflect gender differentiation,they perpetuate old models that overlook gender

needs and differences, and fail to support the empowermentof women.


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*Many women-centred organizations recognize the need to develop gender-specific and woman-centred programmingand evaluation. *The Prairie Women’s Health Centre of Excellence (PWHCE), one of five Centresof Excellence for Women’s Health is dedicated toconducting policy-oriented research to improve the health status of Canadian women by making the health system more aware of and responsive to women’s health needs


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social bases of women’s health,. . . the evidence in many studies in several

countries is consistent. Ill health is associated withdisadvantage. As income declines, so does health;

each increment in income is associated withan improvement in women’s health status. Social

class, as measured by occupation, housingtenure and access to a car is similarly associated

with health.


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Women in the labour force havebetter health than homemakers, though their

health is associated with their occupational status,with women in the higher status occupa

occupationsexperiencing better health. Women with

higher levels of education are more likely to enjoygood health. Studies

also indicate that racial minorities experiencepoorer health . . . Such patterns are . . .

compelling evidence of the importance of understandingthe social bases of health and illness


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A new health determinants model has been developedby Davidson et al,7

P Income and socioeconomicstatusP EducationP Social environmentP Cultural affiliationP Physical environmentP Personal healthpracticesP Coping skills multidimensional constructs

P Employment andworking conditionsP Healthy childdevelopmentP Biology and geneticendowmentP Health servicesP Social support and networks


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GENDER EQUITY MODELS Practical vs. Strategic Needs Model

The concepts of “practical needs” …the needs that arise from imbalances of

power between men and women in most societies. Strategic interests may include increasing

women’s access to education; reducing the amountof domestic labour that falls to women; enhancing

women’s legal rights; ending family violence; providingopportunities for women to develop leadershipskills; and increasing access to family planning


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practical needsp tend to be immediate,

short-termp are unique to particular

womenp are related to daily needs:

food, housing, income,healthy children, etc.

p easily identifiable bywomen

p can be addressed by provisionof specific inputs: food, clinics etc.


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strategic needsp tend to be long-term p common to almost all

womenp relate to disadvantagedposition: subordination,

lack of resourcesand education, vulnerability

to poverty and violence,etc.

p basis of disadvantageand potential for change

not always identifiable bywomen


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..Strategic Needs p can be addressed by:

consciousness-raising, increasingself-confidence,

education, strengtheningwomen’s organizations,

political mobilization


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ADDRESSING PRACTICAL NEEDS

P Tends to involve womenas beneficiaries and perhaps

as participantsP Can improve the condition

of women’s livesP Generally does not alter

traditional roles and relationshipsHealth & Gender wk 3:2 Summer

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Addressing Strategic NeedsP Involves women as

agents or enableswomen to become agents

P Can improve the positionof women in

societyP Can empower women

and transform relationshipsHealth & Gender wk 3:2 Summer

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WELFARE APPROACH: Womenseen as passive beneficiaries

P Helps the most vulnerable groups, includingwomen;

P Sees women as passive recipients of development;

P Centres its perspective on the family as a unit,emphasizing the reproductive role of women;

P Views better child rearing as the principal contribution

of the program;P Uses a practical gender approach to gender equity


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ECONOMIC SELF-RELIANCE APPROACH:Gender inequities reflect

poverty, not gender subordinationP Attempts to ensure increased productivity of

poor women;P Sees women as poor because of economic

limitations, not gender-structured constraints; P Recognizes the productive role of women;

P Emphasizes small, income-generating projects;provides productive skills;

P Uses a practical gender approach.


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EFFICIENCY APPROACH: Womenas under-developed human capital

P Sees women in terms of their ability to compensatefor deteriorating public services;

P Relies on women’s reproductive, productive, andcommunity roles and their supposed free or flexible

time; recognizes the gender division of labour;P Sees women entirely in terms of their deliverycapacity and supposed ability to extend working

day;P Increases women’s access to skills training, technology

and resources;P Uses a practical gender approach.


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EQUALITY APPROACH: Affirmativeaction to ensure women havean active role in development

P Identifies women as the target population of programsor projects;

P Designs programs to reduce inequality betweenmen and women, especially with regard to the

division of labour by gender, and to increase thepolitical and economic autonomy of women;

P Is directed to any of the three roles (reproductive,productive, community);

P Uses a strategic gender approach through top downgovernment interventions giving political

and economic autonomy to women in order todecrease their inequality. Health & Gender

wk 3:2 Summer 08

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EMPOWERMENT APPROACH: Definesempowerment as access to

and control of the use of material,economic, political, educationalinformation and time resources

P Has its origins in women’s grassroots organizations;P Proposes a new relationship in health of shared

power between the health sector and differentgroups of a population;

P Sees women’s subordination not only in relationto men at the individual level, but as part of predominant

political, economic, psychological andsocial models;

P Uses bottom-up mobilization around concretehealth needs in a manner that incorporates strategic

gender approaches—can use both practicaland strategic gender approaches.

Programs may reflect a combination of approaches. 29

Health & Gender wk

3:2 Summer 08


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• Which countries have a bigger sex differentials in life expectancy?

• Would race matter in terms of significant sex difference in life expectancy?

• Theories supporting the differentials:1. Biological – genetics partly • Chromosomes: 23 pairs in human. One determines

sex.• Male: XY; Female: XX• XX according to science carries more genetic info than

Y including some defects.• But, XX has a genetic advantage over YY.


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• 2 defective X Chromosomes for most genetically linked disorders

• One healthy Chromosome overrides the abnormal one.

• For male, if X is defective, he has the genetically linked disease. Higher number of miscarriages of male fetuses

2. Hormonal Differences bet the sexes.Female sex hormones, the estrogens appear to give

women some protection against heart disease.


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Mortality Rate: the number of deaths in proportion to a

given population. • Heart diseases: causes. Smoking, personality traits:

types A, B & D• Cancer• Occupational Hazards to Male & Female Workers• AIDS• Women, Men & Morbidity Rates• Women’s morbidity rates higher than men: higher

rates of illness from acute conditions & non-fatal conditions. Women are slightly more likely to report their health as fair to poor.


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Sexism in Health care


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3. Marital Status at least for men• Research found men bet 45-65, lived alone or with

someone other than a spouse were 2 times likely to die within 10 years of men of the same age but lived with spouse

• For women more of low income than by lack of spouse.

• Studies showed that men rely almost totally on their spouses for social support.

• Married men express a higher level of well-being than their non-married peers. Women: married and non-married - no difference in their level of contentment.


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• When a woman’s husband dies, she typically retains the social support of relatives & friends (Helgeson, 95)

• When spouses become seriously ill, wives are more likely than husbands to nurture their spouses through illness, whereas men are significantly more likely than women to divorce seriously ill spouses (M.S. James, 2001)

• Do you see a relationship between life expectancy and conformity to traditional gender stereotypes?

• Examine male & female mortality rates for particular causes.


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Health & Gender wk 3:2 Summer 08 1 Understanding Gender & Health Wk 3: 2.

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Transcript of Health & Gender wk 3:2 Summer 08 1 Understanding Gender & Health Wk 3: 2.