Published on March 1, 2008
Lecture 6 : Lecture 6 Gender & Health Slide2: Women get sicker, but men die quicker Anonymous epidemiologist Gender, sex and health: Gender, sex and health What's the difference between gender and sex? Why do sex and gender matter for health? Health warning!: Health warning! Sex difference does not imply difference between all men and all women Statistical artefacts (small differences in large samples lead to statistically significant findings) Many studies finding no differences not reported Many studies show high concordance between men and women‘s health experiences (e.g. rates of hospitalisation, teenage drug use, patterns of caring and knowledge of AIDS) Gender Divisions in Health: Gender Divisions in Health Prevailing stereotype of gender divisions in health (MacIntyre Huntley & Sweeting, 1996) Mortality: Men’s death rates higher at all ages Morbidity: Women report more symptoms, limiting illness, use of medicine & doctor contact Robust findings: Robust findings Men's greater mortality from heart disease Men's shorter than average life expectancy Men's higher rates of injury from accidents Men's & boys higher suicide rates Men's higher rates of alcohol abuse Explanations gender differentials: Explanations gender differentials Biology: Innate superiority of female body/machine Social conditions: Women’s work vs men’s work Gender culture of health: Men & women respond to sickness differently Biology vs History: Biology vs History Annandale (1998) 16-17th Century Male mortality advantage 1st half 19th Century Gender equality 2nd half 19th Century Women begin to achieve greater longevity 1960s 5.8 years extra life expectancy for women 1990s Shrinking differentials Higher male mortality therefore not easily explained biologically Historical patterns of gender mortality rates: Historical patterns of gender mortality rates Historical patterns of gender mortality rates : Historical patterns of gender mortality rates Changes in Mortality Differentials: Changes in Mortality Differentials Decline in female reproductive mortality rates (Kane 1994) Economic scarcity favours the survival of boy children & women’s health improves alongside their economic status. In 43/45 developing countries boys have the advantage over girls Decline of female advantage since 1960s seems to counter explanations based on biological difference and suggests socio-economic/cultural factors may play greater role Changes in Mortality Differentials: Changes in Mortality Differentials Men ‘catching up’ More rapid reduction in smoking amongst men 1950s 38% women smoked vs 68% men 1990s 28% women smoked vs 29% men Stricter drink driving and seatbelt laws produce improved MRs for men Change in nature of ‘male’ work and improved health and safety legislation Gender & Morbidity: Gender & Morbidity Men more likely to report ‘very good’ general health in all age groups Women more likely to report ‘good’ health except in older age groups Annandale (1998) Gender differences in episodes of ill health (GP Reporting): Gender differences in episodes of ill health (GP Reporting) Gendered Patterns of ill-health: Gendered Patterns of ill-health Slide16: Women more likely than men to report slightly higher rates of Limiting longstanding illness Restricted activity But differences in health experiences are subtle and the female excess is not always present where it might be expected and differences vary across the life-span and the type of measurement Summary: Summary Women more likely to admit illness Women more likely to seek medical help Doctors more likely to diagnose women as ‘ill’ Only consistent finding of excess morbidity is in the area of mental health Women seen as ‘over-reporters’ Davis (1981) Osteo-arthritis study: Davis (1981) Osteo-arthritis study Compared radiological evidence in gender blind manner If women ‘over-report’ then controlling for disease and treatment category they should report symptoms at a higher rate Men more likely to report pain 83.95% vs 69.64% for treated group 21.02% vs 15.22% for untreated group No evidence for female over-reporting or men’s under-reporting MacIntyre (1993) Cold study: MacIntyre (1993) Cold study Study of 1,700 participants in the Common Cold Unit Both men and women likely to over-state severity of symptoms Controlling for age and SES, men 1.6 time more likely to over-state than women ‘Whinging male’ vs chauvinist diagnoser hypotheses Social Roles and Health: Social Roles and Health Marriage improves men’s health and worsens women’s (Lorber, 2000) Working women more likely to be ‘double jobbing’ Poorer health for women under 40 with children Paid work outside the home beneficial for All women without children Women over 40 with children Who does what in the Irish Household: Who does what in the Irish Household Who does what in the Irish Household: Who does what in the Irish Household Gender Class and Health: Gender Class and Health Difficult to unpack because of problems of classifying women’s social class Most research now uses ‘asset based’ measures as a surrogate for social class SMRs lower for middle class women when compared to working class women Class differences ‘stronger’ than gender ones Masculinity femininity and health: Masculinity femininity and health Differences in health experience might be explained by different, gendered understandings of what are and aren’t appropriate male/female behaviours which affects both lay people and medical practitioners Medicalisation of women’s bodies Masculinity as a harmful to men’s health Masculinity and risk: Masculinity and risk Masculinizing Practices Doing maleness can lead to risk taking behaviours Driving recklessly Drink Driving Use of alcohol tobacco and drugs At risk sexual behaviours Extreme Sports Media (Jackass, Dirty Sanchez) Occupational health and safety: Occupational health and safety Majority of fatal industrial injury amongst men (the blokes won't wear helmets) But why do men find themselves in dangerous occupations in the first place? Gender division of labour: Men's work is working class work Working class men have one asset: the bodily capacity to labour and bodies are consumed over time Men embrace the processes that consume their bodies as a way of 'doing masculinity' Occupational group merges into the definition of masculinity (e.g. Irish building labourers, soldiers, sportsmen) The 'breadwinner complex'