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Health Status Health Services Health Care Reform Diverse Communities of Women
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Gender,Work and Health: An Analysis of the 1994 National Population Health Survey [1] Peggy McDonough, Department of Sociology, York University & Vivienne Walters, Department of Sociology, McMaster University
The research reported here is an analysis of the 1994 National Population Health Survey (NPHS) data. We used this data set to explore two broad questions:
The NPHS is a longitudinal study of a nationally representative sample of household residents in Canada. In each of just over 20,000 households, limited information was collected from all household members and one individual, aged 12 years and older, was selected for a more in-depth interview. Our analysis uses data collected from a sample of 16,989 individuals whose ages range from 15 to over 80 years. 1. Are there differences in the health of men and women? Our findings show that women and men experience similar types of problems, although the nature of the problems changes with age. Injuries and non-food allergies are most common among younger people, arthritis and rheumatism and back problems increase in frequency in middle age, and high blood pressure, heart problems and cataracts are more frequently experienced in the older groups. Using four general measures of health and several specific measures of mental and physical health, we then investigate the magnitude of gender differences. They do not show a clear excess of ill-health among women. The patterns vary by condition and age, confirming the argument of Macintyre, Hunt and Sweeting (1996)[2] that we need to further explore the nature of gender differences rather than continuing to work with the taken-for-granted assumption that women experience greater ill-health than do men even though they enjoy longer life expectancy. At many ages, the health of women and men is more similar than we have often assumed, though we should not minimize the gender differences that do exist. 2. To what extent do paid and unpaid work conditions and social, personal and material resources affect the health of women and men? Typically, research has examined two hypotheses. The differential exposure hypothesis suggests that women report more ill health than men because of higher levels of demands and obligations in their social roles and lower levels of resources to help them cope with these conditions. The differential vulnerability hypothesis makes reference to women’s greater reactivity or responsiveness to life events and ongoing strains that are experienced in equal measure by men. It is argued that the different reactions of women are a result of women’s general disadvantage in social roles and coping resources that affects the nature and meaning of stressors and, ultimately, the effects of the latter on health. In other words, social roles and resources are related to health in different ways for men and women. We considered each of these approaches to understanding the differences in men’s and women’s health that were observed. Analysis of the distributions of paid work conditions, household circumstances and resources revealed mostly minor differences by gender. Women were more likely to have been formerly married, they were less likely to be in the labour force, and more likely to be working part-time. They were also somewhat more disadvantaged than men when it came to job strain. Given the relatively small gender differences in exposure to these living circumstances, it was not surprising that – with the exception of pain – they contributed very little to accounting for gender differences in health. With few exceptions, we found little support for the notion that comparable paid work experiences and household structure have a greater effect on the health of women than men. In other words, greater vulnerability is not a generalized health response of women to paid and household circumstances. We also found only limited evidence that material, social and psychological resources were involved in pathways linking work circumstances to health in ways that differed between the sexes. In sum, gender differences are less pronounced than is often supposed and paid work, household structure, social support and personal and material resources play a limited role in explaining the differences in men’s and women’s health that do exist. One reason for the variable gender differences in health that we observed may be that changes in women’s and men’s roles have led to a narrowing of differences in health. Yet it is impossible to tell whether this is so until longitudinal studies of health document in much greater detail the changing nature of gender roles. The absence of support for our explanatory model may, in part, be a result of the types of measures which were available in the NPHS data set. It is unfortunate that, despite the detailed data on aspects of paid work, the survey contains so little information on the household itself. There are no data on the division of labour within the household and the time spent on domestic labour, child care, care of dependent adults and other household responsibilities. In this regard it appears to be blind to key features of women’s lives. Even with more comprehensive and sophisticated measures which would permit a fuller exploration of the determinants of gender differences in health, it may still be difficult to grasp the effect of gender on health. Gender permeates all aspects of social relationships and social institutions and it may be an insurmountable task to separate it from the social and material conditions of men’s and women’s lives that we study in order to understand gender differences. Yet this should not deter efforts to understand the links between gender and health. In exploring these it is critical that we draw on both quantitative and qualitative data in order to develop a more textured understanding of men’s and women’s lives. Not only gender, but also women’s health should serve as a focus of research. While it is important to continue to seek to understand the nature and source of gender differences in health, it is also important to focus on women’s health per se. “Women’s health” is more than reproductive health or psychosocial health. A greater range of problems must be included in investigations of the health of women (arthritis, for example) and there must also be a greater recognition of how they vary through the lifespan. Moreover, since data collection institutions have been blind to the realities of women’s lives, a focus on women may serve to identify such ongoing bias. Limited evidence of gender differences in health does not mean that inequalities between men and women are unproblematic. While it is important to document and explain differences in health status, ill-health should not be the sole measure of social disadvantage. For further information contact: NOTES |
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