The purpose of this essay is to discuss and attempt to explain why men and women suffer inequalities in health and health care with reference to gender. The main aims of the essay are to discuss the reasons why men and women deal with health and illness differently, how health and illness is viewed by society as a whole and health care providers, to discuss gender socialisations that have arose over time within our society and culture and how these social influences can impact on the type of illnesses experienced by men and women and also how this affects life expectancy.
Firstly, the writer feels it is important to distinguish between sex and gender to gain a better understanding of the theme of the essay. Jones (1994) suggests that “sex is a biological term which refers to peoples ‘biologically given’ state, whereas gender refers to their ‘socially acquired’ psychological and cultural characteristics: their learned masculinity or femininity. ” (p. 249). People are born as biologically male or female but how they act or the roles a person takes on because of their biological state may have more to do with how a person is conditioned by their environment than biological reason.
The Oxford English Reference Dictionary defines gender as “Sex as expressed by social or cultural distinctions”. With regards to health, from an early age boys are told to be “brave” if they hurt themselves but if a girl were to hurt herself and cry they would not be told to be “brave” but would be given attention and concern. This suggests that even from early years women are able to express pain more easily than men. These stereotypes of how a person should act from an early age could suggest why men and women deal with ill health differently in later life.
The above examples give some understanding into how inequalities in health can begin but it is important to look at other aspects such as biological reasons, social expectations, men and women’s status within the labour market (both paid and unpaid) and how this can affect economic status and how this impacts health and the ability to access health care services. Verbrugge in Taylor and Field says that “At its simplest, women live longer but seem to get sick more often than men. ” (1985). There may be biological reasons of why this statement may be correct.
It may be that women can access healthcare more easily and be more “traceable” because they have to use healthcare services during childbirth. In 1927 only 15% of women had their children in hospitals, maternity homes and poor-law institutes but in 1990 that figure had rose to 99% of women having their children in hospitals (Jones, 1994). It could also be said that once a women had a child she may have to make other visits to the doctor due to the child being ill. This point has also been suggested by Graham (1984) in Jones (1994) who argue that “.. omen are more likely to visit their general practitioner with their children, and to be in part-time work which enables them to fit in visits on their own behalf”. Women tend to be more concentrated in part-time work, therefore may have more time than their male partners in full-time work to visit their GP as it may be easier to juggle domestic commitments than trying to arrange time off from work. Although this may seem a positive aspect of being in part-time work it could be said that women are faced with a “double burden” with regards to how they spend their time.
Women may have to juggle unfulfilling part-time work with unpaid caring and domestic labour as suggested by Doyal (1995) in Birchenall and Birchenall (1998) who argues that “It is usually women who continue to be expected to take responsibility for what is regarded as ‘domestic work’. ” (p. 121). Doyal further suggests that “there may be no obvious end to the working day, so that many may find it difficult to separate work from rest or ‘leisure’. ” (p. 121).
This gives a picture that women in this position could become prone to physical and emotional exhaustion. They may suffer from social isolation and a sense of low prestige as unpaid labour is often underestimated and is not appraised in the same way that paid labour is. It may be that women would like to move into full-time paid work which is now made more possible as women can now control their fertility but social attitudes, even now in the 21st century affect this.
Although women are becoming more equal in the division of labour there is still pressure on them to conform to social expectations and to become mothers, therefore “confining them to the ‘private’ spheres of the home”. (Jones, 1994, p. 259. ) These points may help to explain why women suffer more from mental illness, particularly working class women. A point also suggested by Taylor and Field “Working class women are particularly vulnerable to depressive illnesses. ” (1993, p. 73).
Studies carried out in the USA comparing physical and mental health of women in paid and unpaid work show that women in employment have better mental health than women who are outside the labour market (Doyal in Wilkinson et al, 1994). This may be because women in work may be more financially secure therefore, are not reliable on the state or male partners unlike their unemployed or part-time employed counterparts. It is important to state though that statistically women in work are found in lower ranks with regards to status and pay than men.
Overall, women as a whole are treated more for psychiatric illnesses than men. This could be due to medical discrimination, as suggested by Wilkinson et al who say that looking back over older medical literature women were portrayed as “weak, suggestible, emotionally unbalanced, irrational, manipulative, and unable to cope with even relatively minor stresses. ” (p. 8). Doyal (1995) also argues that women’s health is looked at in a purely biological way and social issues are not taken into consideration as much as they should be. in Birchenall & Birchenall 1998). It could be argued that these stereotypical and medical model views are still held by some in the medical profession leading to the diagnosis of mental illness in women. These factors alone can lead to inequalities in health for women as they may be suffering from a genuine medical illness but instead are treated for depressive illnesses, leading them to the belief that they “cant cope” which, in itself can be psychologically damaging to a person and may lead to distrust in the medical profession.
As mentioned earlier, the writer pointed out that men also suffer from inequalities in health and health care, therefore, it is important to discuss the factors that affect men. Physiologically men and women are very similar apart from their reproductive organs so we have to look at why mortality rates of men are much higher than women. Women’s health over the years has been highlighted and much has been done on a preventative scale with regards to women’s health.
From a male pint of view this may be seen to be unfair, but, the question must be asked whether men would access these types of services if they were so widely available as, for instance breast screening services. Part of this may be due to social attitudes towards men’s health which has not changed much over time. The opinion that “real men” do not get sick is still very prevalent in today’s society and this may help us to understand why more men die than women. It may be that men often go to their GP when it is too late. There are also some biological differences between men and women.
Men for instance are more prone to heart disease than women. This is thought to be due to female sex hormones “protecting” them from this type of illness (Sabo et al, 1995). It is also important to look at how men lead their lives in general from the perspective of work and leisure. Men have historically been employed in the industrial sector such as mining, manufacturing and the building trade. These types of occupations can lead to contamination from industrial processes or carcinogenic materials or less life threatening but debilitating conditions such as “creeping deafness” due to excessive noise levels. Jones, 1994). In today’s economic climate these types of jobs are not secure or permanent and to take time off to visit a GP means not being paid. If men have family to support or work commitments to fulfil this may deter them from visiting a GP, this may also be why men make less use of dentistry and other preventative services than women, a point raised in Jones (1994). Men also take part in more risky behaviour than women, which may be due to gender socialisation such as faster driving, extreme sports and higher levels of drinking and smoking.
Jones (1994, p. 253) suggests that this type of behaviour may account for why there are “higher incidences of accidents, cirrhosis of the liver, lung cancer and coronary heart disease” affecting men. But it may possibly be that men partake in these activities to de-stress and deal with daily life whereas “women with ‘problems’ tend to turn instead to (or be prescribed) tranquillisers.. ” (Jones, 1994, p. 253). It could be argued that men also have to deal with almost the same pressures as women with regards to balancing paid and unpaid labour.
One-quarter of carers are men (Jones, 1994). This figure may be surprising to some and will seem out of the “norm” but it had been argued that “Men carers have been invisible to researchers, their experiences ignored or denied because their unpaid caring contradicts gender norms”. (Arber ; Gilbert, 1989 cited in Jones 1994, p. 274). It could be argued that men may feel that they have no-one to talk to and may not be able to or be encouraged to express their feelings and health concerns as easily as women in society.
In conclusion, it is clear that men and women both suffer inequalities in health care. There are similar causes experienced by men and women such as economic status, life stresses and biological differences but they have different experiences with regards to social attitudes, particularly men. It seems they are discriminated against to their detriment, a point also argued by Taylor and Field (1993) who say that “The sick role and illness behaviour may be less stigmatising for women. ” (p. 74).
Men and women are living longer and medical research has succeeded in making some illnesses almost non-existent but health promotion, equality in the provision of health services and prevention initiatives are paramount in continuing to improve the health of our society. For people to access these services they must feel that they will not be discriminated against or stigmatised which means health care providers and society as a whole need to re-evaluate the social norms and attitudes that are used to describe men and women with regards to health care.