1. Gender & Health Lecture 4

2. Game Plan Announcements? Introductions Name that Tune! Men & health Women & health Documentaries Take home messages

3. Your Bio! Due next class See examples on Blackboard Don’t spend more than 5mins on it! No marks assigned

4. Gender & Health Focus more on women: greater marginalization (e.g., ) Gender: masculine, feminine; socially/constructed, not biologically given sex : man, woman, male, female: biologically given

5. Robertson (2002) Health practices “cannot be fully understood outside of the social context(s) within which they emerge” (p. 2). Men die sooner (die 1-7 years earlier), kill themselves more often, more likely to binge drink and take illegal drugs, more likely to smoke, less likely to see a doctor Tied to masculinity?

6. Masculinity (Robertson, 2002) Seen as binary to femininity Masculinity linked to lower levels of social support; less help seeking for pschyc problems; lower levels of same-sex intimacy & higher rates of homophobia ; increased drug & alcohol use; less consistent use of condoms; increased cardiovasular stressors; more sexual partners; belief that relations between men and women are inherently adversarial Genetic link?

7. More Masculinity Role theory : Social expectations about status in society produces conformity to a role and its related functions Get rewarded or sanctioned for behavior, but can be difficult to fill/maintain roles (sex role strain from unemployment for man) “being a man” can kill you Role theory challenged by other researchers, challenge binaries: masculinities

8. Differences Between the Health of Men and Women Women have higher life expectancy 19 conditions disproportionately affect females Some specific to women Maternal conditions Cancers that affect females Discrimination: Some related to femalesliving longer Alzheimer’s disease Osteoarthritis Cerebrovascular disease Cardiovascular disease Age-related

9. Key Health Issues for Women Several key health issues are especially important for women: –Nutrition –Sex-selective –Discriminatory health care practices toward young girls –Sexually transmitted infections –Female –Violence

10. Why are Women at Risk? “Being born female is dangerous to your health” Some conditions are biologically determined Other are socially determined Women often have inferior social status Women are disproportionately affected by certain conditions Past focus has been on women “as child bearers”

11. The Importance of Women’s Health Women in many countries face specific and health problems Differences in the health of men and women in a large number of countries Poor health of women has especially negative consequences on families and children Appropriate investments could result in a substantial number of deaths averted at low costs. Yet, in some areas very insufficient progress

12. Determinants of Women’s Health Related to sex and or gender Biological determinants –Unique risks due to menstration and pregnancy –Increased susceptibility to STI’s Social determinants –Gender norms that put females at a disadvantage –Inferior status leading to social, health, and economic problems.

13. The Burden of Health Conditions for Females Sex-selective abortion of females: prevalent in India & china Deaths of young girls due to male sex preference: receive less attention, poorer nutrition, less access to health care Female genital cutting: Increased susceptibility to STI’s

14. Additional Conditions Violence and sexual abuse: rape as a tool of war, within the home Maternal morbidity and mortality: 500 times the risk of dying in Sub-Saharan Africa Unsafe abortion: 13% of maternal deaths obstetric fistula : “an injury in the birth canal that allows leakage from the bladder or rectum into the vagina, leaving a woman permanently incontinent, often leading to isolation and exclusion from the family and community”; lack of emergency care and prolonged labor can contribute Cardiovascular disease:leading cause of death world- wide, increasing in women

15. The Costs and Consequences of Women’s Health Problems Social isolation is a social cost of violence against women Social impacts of maternal mortality during birth: women are primary caregivers for children, young children can die if mothers die Economic costs: i) Direct costs of care for women who experience violence and health problems ii) Indirect costs of lost productivity and contribution to family both inside and outside the home

16. Addressing Future Challenges Improve nutritional status of females Enhance access to education Encourage communities and populations to put greater value on women’s health Put greater emphasis on females as people rather than as childbearers

17. Key Interventions Family planning: only 8% of sterilizations world-wide are in men Behavior change to promote safer sexual practices Measures to reduce intimate partner violence Reduce three delays to cut maternal death: i) Delay in identifying complications and seeking care ii) Delay in transporting women to hospital iii) Delay in emergency obstetric care in hospital Enhance ability to deal with unsafe abortions

18. Take Homes Messages Make a timeline for the book critique Sex vs. gender and how they map onto health: link to earlier class material (MDGs, determinants of health, burden of disease) See me during office hours if you have questions or send me an email!