Gender and Health: Some issues to consider

• Gendered nature of social, political economic life–these affect health
  • Women have less access to production factors (land, labor, capital)
  • Women generally have heavier work burdens
  • Not all women are considered equally–class, ethnic, racial, and sexual orientation
  • Women and girls have less education, less autonomy, lower nutrition levels, and lower-paying jobs (in the cash economy)
  • Some causes of death:
    • Underweight (children)
    • contaminated water (dehydration)
    • indoor smoke
    • unsafe sex
    • malnutrition
  • Women face greater risks from HIV infection because of their status (especially at younger ages)
    • Women as unpaid, un- or undertrained caregivers for HIV-positive
    • Possible shift of care to communities (we do this in the States, too, for instance with devolution of mental health treatment away from residential facilities)
    • Obvious questions about quality, standards of care
    • Burdens on girls in household (reducing likelihood of education)
    • Links between HIV/AIDS, poverty, and gender–what are they? Women make up over half of AIDS deaths/HIV infections, many of these through prostitution/sex work, women more likely to be infected during intercourse
    • Rural dimension–shifting of costs
    • Problems of statistical invisibility, low budgets, ‘unseen’ costs at policy level
  • On education:
    • Children of lower-educated women tend to be less healthy, and the girls take on their work burdens in the household earlier
    • Schools are ‘gendered’ in many ways–few female teachers, less expectation of safety for girls, little gender sensitivity, privacy issues (e.g., with toilet facilities)
    • Household budget money for school fees and money for books less likely for girls
  • Work:
    • Mothers in the workforce often mean daughters taking on household burdens (less likely to attend school)
    • Women make up over 80% of care providers in developing world
    • ‘Gendered’ illnesses include schistosomiasis, dengue fever, respiratory, back pain, injuries from violence, malaria (poem no. 4), exposure to toxins in factories, urinary tract problems (factories), STDs + HIV/AIDS
    • in the kitchen: ‘old SARS’
      • poor combustion, unvented cookstoves
      • need for data to understand, need for action
      • women and children bear brunt of poor health (but benefit most from development)
      • in the end: many contributions to lower life expectancy, beyond higher infant mortality rates
  • Globalization:
    • International migration
    • unequal pay, feminization of certain jobs (e.g., garment work)
    • sex work, drug trade, and international demand
    • gendered violence

Health and geography, the life course

• SubSaharan Africa has shortest life expectancy for women
• role of war (women and children most frequent casualties)
• Over the life course: pre-adolescent
  • Young girls and vaccinations (educated mothers more likely to do this)
  • Child mortality can be gendered–where resources are scarce, boys often receive preference
  • Malnutrition–nutrition is so important to physical, mental, brain development
  • Sexual abuse/assault–often before pubescence, girls more likely victims than boys
  • FGC–female genital cutting (invasive procedures ranging from the least invasive–excision of the clitoris–to the most invasive–surgery and partial closing of the vaginal opening)–affects over 2 million girls annually in Africa and the Middle East, causes emotional, psychological and physical problems
  • Adolescence
    • Early marriage, childbirth
    • harassment, violence (often in school settings, again, think of gendered institutions–only in poor countries??)
    • Sex work (STDs, violence, etc.)
    • Unsafe working conditions (on the street, in sweatshops, etc.)
  • Adulthood
    • Pregnancy and childbirth–lack of health care support, complications, nutrition, few birth control options–over 1/2 million women die annually as a result of complications with pregnancy/childbirth, the vast majority in countries of the South
    • Domestic violence (seeing a pattern here?)
    • Women and cooking (see above) in unvented conditions
    • Exhaustion from work loads, poor nutrition
  • Old age
    • Respiratory illness, TB infection (effects of a lifetime of exposure, relationship between the two)

Change

• Human rights–more scrutiny on human rights …. watchdog organizations (issues such as rape, honor killings, forced marriages, domestic violence, etc.)
• Government/Official action
  • agreements, treaties, laws
  • e.g., rights to divorce (‘personal status’ laws, protection from domestic violence)
• Cultural change (remember the discussion of Weber and types of legitimate authority), resistance to ‘rational-legal’ attempts to redress these issues

Conclusions

• Women suffer from  more, different health problems in developing world, problems vary geographically and over the life course–there is a gendered dimension to health
• Women and girls benefit most from development efforts targeting health
• Health affects everything else–poor health causes other problems, and women are the primary caregivers for the unhealthy (often unpaid, undertrained)
• If poor health causes other problems, what causes poor health?
• Violence–women are much more likely to be victims of it