1. Using Gender to Examine
Gender Concepts
Using Gender to Examine
Ill-Health
Dr Alpana Sagar
Centre of Social Medicine and Community Health
Jawaharlal Nehru University
New Delhi, India

2. Multifactorial nature of ill-health
Amongst various factors two that are being considered:
1. Sex: Determined by biology
2. Gender: A social and cultural construct that prescribes norms of behaviour for men and women - masculinity for men and femininity for women, and therefrom assigns them social roles
These norms define: dress, attributes behaviour and roles

3. Attributes and Behaviour
1 Gender concepts
Attributes and Behaviour
Women
Emotional
Gentle
Caring
Nurturing
Obedient
Self-sacrificing
Tolerant
Men
Rational
Strong
Competitive
Aggressive
Self confident

4. 1 Gender concepts
Roles
Women
Homemakers Mothers
Wives
Daughters
Daughters-in -law
Nurturers
Subordinate to men
Men
Heads of households
Breadwinners
Professional achievers
Carry on bloodline

5. 2. Gender and Health - Mortality Differentials
While gender is responsible for attributes and norms of behaviour as well as for defining social roles can we say it has any implications for health?

6. 1 Gender concepts
The Implications of Gender for Health
1. Differences in mortality patterns
2. Differences in health seeking behaviour
3. Women’s Reproductive /Maternal Health emphasized more than their overall health
Policy Implications

7. 2. Gender and Health - Mortality Differentials

8. 2. Gender and Health - Mortality Differentials
While women are known to be the biologically stronger sex can biological causes of mortality be overridden by social causes for mortality?
What does a closer look at data on mortality of males and females by infectious and parasitic diseases reveal?

9. Often biological causes are overridden by social causes
2. Gender and Health - Mortality Differentials
Often biological causes are overridden by social causes

10. Often biological causes are overridden by social causes ct.
2. Gender and Health - Mortality Differentials
Often biological causes are overridden by social causes ct.

11. Not only do social causes affect mortality,
3. Gender and Health - Health Seeking Behaviour
Not only do social causes affect mortality,
gender socialization also affects morbidity reporting and health seeking behaviour

12. 3. Gender and Health - Health Seeking Behaviour
While mortality is highest for girls under 14 years of age morbidity reporting and medical care is lowest for this group
For women in the reproductive age group while reported morbidity is more than males of same age, commensurate medical care is not sought

13. 3. Gender and Health - Health Seeking Behaviour
It is also worth noting that morbidity reporting is not the same for all women but differs by income groups
While mortality is known to decrease with increasing income, the reporting of morbidity has increased with increasing income

14. •Women’s own acceptance of illness due to their socialization
3. Gender and Health - Health Seeking Behaviour
What is explanation for this disjunction between women’s morbidity and health seeking behaviour
•Women’s own acceptance of illness due to their socialization
•Social definitions of women’s health by their social figures of authority - husbands and mothers-in -law
•Medical definitions of women’s health by doctors

15. So what is the result of women’s ill health not being legitimized
3. Gender and Health - Health Seeking Behaviour
So what is the result of women’s ill health not being legitimized
Women’s morbidity is thus underreported
Treatment seeking behaviour is affected

16. Is this in consonance with the data on women’s health?
4. Social understanding of women’s health
Not only does women’s state of health get defined socially, a gendered understanding of women also impacts the way in which their problems of ill health are viewed
Most health programs tend to emphasize women’s reproductive or maternal health rather than their over all health
Is this in consonance with the data on women’s health?

17. What is the distribution of causes of mortality in women?
4. Social understanding of women’s health
What is the distribution of causes of mortality in women?

18. 4. Social understanding of women’s health
Additionally percentage of deaths for women is not highest in reproductive age group

19. 4. Social understanding of women’s health
Then why despite evidence to the contrary, is women’s health linked so strongly to their reproductive health?
There are many reasons one of which is the historical understanding of reproduction being woman’s most important function

20. Policy Implications
AN UNDERSTANDING OF THE IMPORTANCE OF THE IMPACT OF LARGER SOCIAL STRUCTURES ON THE HEALTH OF BOTH MEN AND WOMEN.
THE NEED FOR LARGER SOCIAL CHANGES TO IMPROVE THE POSITION OF WOMEN
THIS LEADS TO THE RECOGNITION FOR EMPHASIZING INTERSECTORAL LINKAGES FOR PUBLIC HEALTH
A CHANGE OF EMPHASIS FROM REPRODUCTIVE TO GENERAL HEALTH IN HEALTH PROGRAMS WOULD HELP IMPROVE WOMEN’S OVER ALL HEALTH

21. THANK YOU