This work belongs to Mazza it is provided purely as a guide to
other student nurses. It should in no way be copied or passed off as belonging to a 3rd party.
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This work belongs to Mazza it is provided purely as a guide to
other student nurses. It should in no way be copied or passed off as belonging to a 3rd party.
It is protected under the UK and international law of copyright.
Women’s work and women’s illness
Introduction
This essay makes the points that women’s high morbidity is to some extent caused and reinforced by society rather than simply biology and that women are socialised to fulfil designated roles which make them vulnerable to poverty, emotional and physical illness with limited support.
Discussion
Men and women’s bodies have some distinct biological differences which have been used to explain women’s patterns of health. Views of women’s bodies have been governed in recent times by a medical model of care aimed at fixing the body (Ryan 2000) whose natural functions have been seen as abnormal when compared to the male body. Women’s health has been largely medicalised from menstruation, to childbirth, to menopause (Montgomery 1974, Kaufert 1982) resulting in women being hospitalised more often within their reproductive years. Health care within this time is inclined to be for reproductive reasons more than ‘sickness.’(White 2002) Yet understanding women’s role in society is necessary to understand women’s health.
Social learning theory argues that men and women are socialised from birth into specific gender roles. Females learn the feminine traits expected by society through play, education and role models. (Marsh and Keating, 2006) Girls are given dolls to care for from infancy, while boys are primarily discouraged from such feminine behaviour as they reach school age. This is indicative of society’s expectation of childcare as a woman’s role where childcare remains a woman’s responsibility regardless of her paid employment status (Lorber and Farell 1991, Oakley 1985 cited in Birchenhall 2000). Women theoretically have equal access to further education and employment; however a career is often seen as a secondary pursuit to motherhood which is supposed to be her primary role within the family (Walsh 2004). Adrienne Rich (1976 Cited in Jackson 1994) stated that “No woman is considered ‘special’ because she carries out her responsibilities as a parent; not to do so is considered a social crime.” This sentiment remains true today, despite the illusion of equality. Women combine multiple roles such as mother, unpaid carer, partner, housekeeper and employee which may overburden and lead to ill health. (Lahelma 2001)
Women make up the majority of paid and unpaid carers in Britain, (Birchenhall 2000) with women expected to stay or return home to provide care for dependant family members. Oakley (1988) suggests that this is beneficial to society as a reserve of unpaid nurses. It is assumed that women carers will be supported by men or by the state and while the state may pay to support women who take on the role of carer, it is much more cost efficient than formal nursing care. Opie (1991,1992a cited in White 2002) reports that in 1991 women of working age made up 15% of carers, with similar numbers indicated by Dahlberg (2007). Opie (1991, 1992b cited in White 2002) suggests that this role has a huge influence on women’s high morbidity rate; while Abel and Nelson (1990 cited in White) concur that overrepresentation of women in health statistics reflects this. This corresponds with evidence that women often allow the needs of others close to them to take priority over theirs, caring for them to the detriment of their own well being. (Doyal 1995; Abbot and Wallace 1997 cited in Marsh and Keating 2006). Arber (2001 cited in White 2002) however, states that the family/carer role itself is not unfavourable to health, suggesting that it is poverty which disproportionately affects a high number of women in this role.
The Black Report (DOH 1980) and The Health Divide report by Whitehead (1987) both show overrepresentation of women in disadvantaged groups which suggests that higher rates of ill health in women are poverty related. Material factors and resources are important health determinants evident in the fact that discrepancies in health exist not only between men and women, but between women of different socio-economic groups. Poverty reduces access to resources to cope, both in a demanding family role and with ill health which can lead to more sickness. (Gimenz 1989) Women in society tend to be poorer, less educated and more materially disadvantaged than men. (Arber and Thomas 2001 cited in white 2002)
It could be argued that the roles which women undertake in society explain why women tend to be poorer and therefore more vulnerable to sickness than men. Some groups of women are particularly vulnerable to poverty, such as elderly women and lone mothers (Popay and Jones1990 cited in Ryan 2000). In the case of elderly women, poverty can be related to the roles which they have played in society through their reproductive and working years. Older women are less likely to have a personal income than men, due to sporadic employment and consequently pension contributions over the course of their working life. Women who are reaching retirement age today are more likely to have foregone employment opportunities in favour of raising families. (Nettleton 2006) Society places a low value on domestic work and childcare, therefore there have been few provisions made for women staying at home, raising a family, to adequately provide for pensionable age. Elderly women are more likely to be dependent on a husband or the state for financial provision and affected by poverty related ill health.
Single parenthood is also linked with poverty and poorer health for parents and children. (Nettleton 2006) It is suggested by Barley (2004) that this is linked to the socio-economic position of many lone mothers. Women make up the majority of custodial single parents, (Jackson 1997) which is related to the aforementioned idea that the responsibility for children’s primary care is assumed to be the mothers. Low state benefits and often absent support networks available to single parents can have a detrimental affect on their financial circumstances as can inadequate and expensive childcare which limits employment opportunities. Indeed childcare is an issue which affects most women of working age. Across Europe evidence indicates that the availability of affordable childcare and increased benefits for working parents increase the amount of mothers with young children who are able to work. (Marchbank 2000 cited in Marsh and Keating 2006)
Women who go out to work in the 21st century, with the discourse of equality all around, expect a level playing field in terms of earnings and opportunities. However, although childbirth rates have fallen and more women work and have increased social freedom; evidence suggests that women are still not equal. There are still large discrepancies in earnings, and women tend to be paid less and have less security than men’s work. These discrepancies may be related to women’s role as primary carer within the family, as women with young children are most likely to work part time or leave employment to care for children. (Walsh 2004) In the UK in 2002 women earned only 60% of the money that men did. Marsh and Keating (2006) state that this is related to the amount of part time work which women undertake. Nevertheless there is also a large pay gap in full time employment as industries which employ primarily women generally pay less than those which employ men. Stansfield et al (1995 cited in Barley 2004) suggest that gender differences in health are heavily influenced by the high numbers of women in low paid employment. Women are disproportionately represented in the service and care industries which carry lower status than traditionally male industries and are more likely to offer part time employment and flexible shift work (Women and equality unit 2002). However, employment itself has a beneficial effect on self esteem and provides a network of social support promoting better health; it is the multiple roles which women are expected to play in society with limited support which have a negative effect on health (Lahelma 2001) While the dual role of carer and employee can be a disadvantage, paid work may benefit women by helping them to cope with the carer role by providing a break, less social isolation and heightened self esteem (Bird and Fremant 1991 cited in White 2002) This further highlights the implications of affordable, adequate childcare to women and health with self esteem and social networking playing an important role in coping with stress and avoiding physical and mental illness. (Sarafino 2002)
‘Women’s work’ in British society is usually defined as caring and involving the domestic sphere. ‘Men’s work’ is seen as dangerous and woman’s more genteel despite evidence to the contrary in both domestic and paid work. For example, women’s overrepresentation in nursing and social care has been related to a high number of lower back pains in women. Hazardous male orientated work in the construction industry for example, has long been subject to safety procedures and equipment whereas moving and handling techniques in healthcare are more recent and not always implemented. Nursing remains one of the highest risk careers for lower back problems. (Hignett 1996) Secondly, domestic work is characterised by the variety and amount it can entail. The old adage ‘A man can work from sun to sun, but a woman’s work is never done’ has more than an element of truth in it. Domestic work can encompass a huge range of labour, and there are no set working hours, breaks or holiday entitlement, while mothers with young children can be called upon to perform duties day and night. Domestic labour can mean a tiring, physical and mental commitment with low social status and no independent earnings. (Doyal 1995) The European working time directive, European law set up to protect the health and safety of workers, outlines specific hours which may be worked in order to reduce mental distress, stress, depression and anxiety brought on by overwork and pressure. Domestic work dominated by women and without such entitlement can have a negative effect on women’s health where there is limited support and coping resources.
Women are twice as likely to be diagnosed with anxiety or depression as men and some attribute this to women’s multiple roles in society. (Giddens 2006) Stress, anxiety and depression can lead to physical health problems because the immune system is inhibited leading to heart disease, high blood pressure, arthritis, colds and flu. (Bernstein 2006) Some women are more affected than others with working class women appearing to suffer greater negative effects due to less effective support networks and consequently unhealthy coping resources such as smoking, itself a major cause of illness. (Graham 1987, 1994) Working class women are more likely to become unemployed, homeless or suffer the death of a child, yet they are less likely to have effective coping resources. According to the Scottish government (2003): 45% of women in the lowest household income groups were cigarette smokers compared with 13% of women in the highest and smoking prevalence is 29 percentage points higher for women living in the most deprived areas in Scotland than the least. (Scottish health survey 2003) Smoking is a poverty related problem for men and women in Britain, however women are both more likely to live in poverty and more likely to have other health problems combined with the risks of smoking.
Conclusion
In conclusion, women may suffer from more illness than men, but this cannot be explained simply by biology. Women’s health has been medicalised to a point where women’s reproductive functions are seen as sickness. Furthermore the role which women are expected to undertake in society plays a significant role in their health. Women are expected to be the primary carers of children and sick or dependant adults in both the private and public spheres. The value, status, support and financial remuneration for these roles are low, affecting coping resources, self worth, social class and economic status, which each have implications for health. Despite supposed equality in employment there are still discrepancies in income and status within and between many industries which are related to the kind of work which women can combine with socially imposed responsibilities for childcare and the domestic sphere.
While domestic and care work remains the primary role of the women, and while women are expected to undertake multiple roles with limited support and childcare without access to affordable, quality childcare, it is likely that women will remain the sicker sex.
last updated 15/07/08
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