HLTC02-Readings Week 1.docx

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Department
Health Studies
Course
HLTC02H3
Professor
Joseph Bryant
Semester
Winter

Description
Introduction: Beyond Gender Matters - Canada has been a model for advances in health care generally and women’s health specifically. - The successes, failures, and contradictions related to women’s health in Canada offer lessons for improving health as well as a basis for comparative work in other countries Women’s health in Canada - Canada has the ninth highest life expectancy in the world for both sexes, only 2.1 years behind Japan (81.4). - Although women live longer: o They die prematurely from largely preventable conditions such as cervical cancer and lung cancer. o They die in the prime of life in greater numbers than men, largely because of breast cancer and other cancers o They experience higher levels of disability than men - Life expectancy for high-income women was 1.6 years longer than for low-income women, and five years longer for men. - The income gap between the wealthiest and poorest Canadians is widening, with the proportion of those living in poverty steadily increasing and with people who have recently immigrated, Aboriginal people and single-parent families at the greatest risk of living in poverty - Corporatization and privatization have been touted as both the cause and the answer to problematic health care resource allocation strategies, increasing acuity of health care problems, and the declining ability of the health care system to meet the expectations of Canadians. Women’s Health and the Canadian Health Care System - “Access” for women who migrate to Canada is complex and involves multiple barriers - Among self-employed women, less than half have supplementary health coverage. - Women on average, earn less than men, have lower incomes and are more likely to live in poverty, therefore they face greater financial barriers when health care costs are privatized. Evolving Theoretical Perspectives on Women’s Health - Gendered health inequalities and health problems can only be remedied if they are recognized - The health field requires an understanding in which there is space for a more flexible and elastic understanding of women and one where the intersections of gender with other forms of social and material inequity are better theorized. Sex and Gender - Gender refers not simply to women and men, but to the relationship between them and the way it is socially constructed. Four Approaches to Women’s Health 1. the health of women has often been invisible, and not considered as distinct from the health of people in general. 2. When women HAVE been considered, often women’s health has been associated simply with reproductive function 3. Recognition of the limitations of associating women’s health with reproductive function and the shortcoming of this view within the biomedical paradigm have led to sex and gender analyses that consider how social circumstances and systematic gender inequalities profoundly influence women’s lives and health 4. Recognition of the complex influences of the intersections of multiple social determinants and more sophisticated and complex understanding of concepts such as sex and gender in relation to women’s health have created new bodies of knowledge and shifts in policy and programs Gender Neutral Approaches: Seeing Sex and Gender as Irrelevant - Women shouldn’t be treated the “same as men” because this makes the health of women invisible, overlooking the unique needs of a women, and inappropriately basing women’s health care upon the study of men’s health - The assumption that a disease or condition and the effects of treatment are the same for women and men is wrong. - Especially in CVD, women are still more likely to be misdiagnosed, have greater delay to treatment, have fewer benefits from treatment, and poorer outcomes - Canadian women often think that breast cancer is the greatest risk, but CVD is. Biological and Reproductive Determinism: Seeing Women as Reproductive Beings - pathologizing refers to seeing a normal process as pathological and medicalization means that process under the control of medicine. Ex. Menopause - Women were referred to as fragmented bodies, body parts and diseases, and were depicted as being passive and silent, thus within the health care system the focus on women’s health is often on pathophysiology. Sex and Gender Analysis: Seeing Women as Different from Men - the importance of differences in experiences of illness is highlighted by the example of women’s experiences of HIV/AIDS, only recently women’s experiences have been addressed - Although HIV has been studied in relation to women, such study has been limited, and programs, policies, and prevention tend to be gender neutral. - Analyses that take sex and gender into account highlight how biological and social characteristics and experiences interact to create different effects on women in relation to a range of health issues such as violence, teen pregnancy and smoking; Health Canada reported that 31% of women 15-19 smoke compared to 27% of men of the same age. - Breast cancer risk itself is increased with smoking - Smoking also affects women differently than it does men. Ex. Lower fertility, cancer of the cervix, osteoporosis, and menstrual and menopausal problems - There are differences between how genders experience and interact with the health care system 1. Caregivers are mostly women so they interact more with health care systems 2. When women experience health problems they are often compounded by their caregiving work 3. Gendered assumptions often shape health care interactions. - When gender analyses are used in the absence of an understanding of the differences between sex and gender, and in the absence of attention to the differences among women more widely, the knowledge that is created can be seriously limited in its generalizability. Intersectional Analyses: Seeing Differences Among Women - while one of the areas of greatest difference between women and men is their respective profiles of mental health disorders differences among women profoundly affect women’s mental health - rates and types of mental health problems are influenced most by factors such as racism and poverty o ex. Effects of colonialism and residential schooling of Aboriginals - intersectionality refers to the idea that gender is experienced by women simultaneously with their experiences of class, race, sexual orientation, size, and other forms of social difference; intersection between forms of oppression. - Being subjected to racism compounds poverty. Women’s Health: Current Issues and Challenges 1. the process of healthcare reform continues without adequate attention being paid to the gendered effects of such change 2. Canadian federal government has reduced program spending in all policy areas in ways that are unmatched in any other advanced industrialized nation 3. The commitments and initiatives in the area of women’s health have not been fully supported politically, adequately resourced or implemented wholly or evenly, and there are few comprehensive evaluations of their impact and effectiveness. It’s difficult to determine with any certainty the efficacy of existing health policies 4. The lay public is beginning to think that women’s health has received enough attention and there appears to be growing resistance and even backlash against women’s health as a specific field of research 5. Feminists continue to interrogate the concept of women’s health and critique essentializing tendencies especially the way that feminist health theorizing often has given gender primacy as a determinant of health over other key determinants. 6. Ways of seeing women and women’s health are kept in place by certain ideologies or ways of thinking. Liberal
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