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Try out PMC Labs and tell us what you think. Learn More. This paper uses a framework developed for gender and tropical diseases for the analysis of non-communicable diseases and conditions in developing and industrialized countries. The framework illustrates that gender interacts with the social, economic and biological determinants and consequences of tropical diseases to create different health outcomes for males and females.
Whereas the framework was ly limited to developing countries where tropical infectious diseases are more prevalent, the present paper demonstrates that gender has an important effect on the determinants and consequences of health and illness in industrialized countries as well. This paper reviews a large of studies on the interaction between gender and the determinants and consequences of chronic diseases and shows how these interactions result in different approaches to prevention, treatment, and coping with illness.
Specific examples of chronic diseases are discussed in each section with respect to both developing and industrialized countries. Simply put, sex refers to biological differences, whereas gender refers to social differences. In the last decade, a considerable amount of research has been conducted in the area of gender and health, including gender differences in vulnerability to, and the impact of, specific health conditions.
Gender has been shown to influence how health policies are conceived and implemented, how biomedical and contraceptive technologies are developed, and how the health system responds to male and female clients 2. Gender analysis in health has been undertaken mainly by social scientists who observed that biological differences alone cannot adequately explain health behaviour.
Health outcomes also depend upon social and economic factors that, in turn, are influenced by cultural and political conditions in society. To understand health and illness, both sex and gender must be taken into. This paper builds upon a gender framework from the field of tropical diseases 3 by examining to what extent the framework applies equally to non-communicable diseases.
For example, the gender differences in the social determinants of tropical diseases include the different roles of men and women in the household, status within the household and community, and cultural norms affecting risks of infection. These factors influence exposure of women and men to diseases such as malaria because men are more likely to be exposed to mosquitoes in certain work environments such as forestry or mining 3.
The gender differences in the consequences of tropical diseases include how illness is experienced, treatment-seeking behaviour, nature of treatment, and care and support received from the family and care providers. In the case of HIV-associated disease, for instance, the economic consequences may be worse for women who are left with families to support when husbands become infected and die, or they may not be able to earn income or support their families when they themselves are ill.
Whereas this framework ly was limited only to developing countries where tropical diseases are mainly found, this paper expands the analysis to include industrialized countries as well. The paper brings together the findings of various studies to identify how gender interacts with the determinants and consequences of health and illness.
Whereas research based on this framework was limited to developing countries, the present analysis demonstrates that Housewives seeking sex tonight Le Roy West Virginia has an important effect on the determinants and consequences of non-communicable diseases and conditions in both developing and industrialized countries.
In each section of the paper, one example of a chronic disease or condition is provided to illustrate how the gender framework can be equally applied to developing and industrialized societies.
There is no systematic body of knowledge on gender and chronic diseases, although there is a considerable literature emerging on specific diseases such as those discussed in this paper. Based on research findings on gender, several hypotheses have been proposed. Verbrugge, for example, argued that gender differences are more pronounced for prolonged, mild conditions than for acute, life-threatening or severe ones 4. However, further research on specific diseases, including tropical infectious diseases, has added new findings that need to be taken into.
Charmaz notes the importance of examining gender differences in non-communicable diseases and that the experience of illness is strongly related to gender identities 5.
The following analysis, therefore, brings together two areas of investigation—tropical infectious diseases and chronic non-communicable diseases—by showing that the framework from tropical diseases also applies Housewives seeking sex tonight Le Roy West Virginia chronic diseases.
It also draws out conclusions regarding gender and chronic diseases by comparing the of the various studies of different diseases or conditions. This paper is based on a review of published articles in the area of gender and health.
By way of illustration, examples of non-communicable diseases or conditions are highlighted under the headings of social, economic and biological determinants and consequences respectively to demonstrate their interaction with gender variables. The examples are not related to one another but have been selected because they have been studied in both developing- and industrialized-country context and because they demonstrate the interaction of gender variables with social, economic and biological factors and how these produce different outcomes for males and females. This section reviews evidence of gender differences in the social, economic and biological determinants of health and illness, focusing on three non-communic-able diseases or conditions: nutrition for social determinants, mental illness for economic determinants, and longevity for biological determinants.
Social factors, such as the degree to which women are excluded from schooling, or from participation in public life, affect their knowledge about health problems and how to prevent and treat them. The subordination of women by men, a phenomenon found in most countries, in a distinction between roles of men and women and their separate asment to domestic and public spheres. The degree of this subordination varies by country and geographical or cultural patterns within countries, however, in developing areas, it is most pronounced. In this section, the example of nutrition will demonstrate how gender has an important influence on the social determinants of food-consumption patterns and hence on health outcomes.
Several studies have shown the positive relationship among education of mothers, household autonomy, and the nutritional status of their children 67. During the first 10 years of life, the energy and nutrient needs of girls and boys are the same. Yet, in some countries, especially in South Asia, men and boys often receive greater quantities of higher quality, nutritious food such as dairy products, because they will become the breadwinners 7 — Das Gupta argued that depriving female children of food was an explicit strategy used by parents to achieve a small family size and desired composition Studies from Latin America also found evidence of gender bias in food allocation in childhood 16 — 18 and, correspondingly, in healthcare allocation In developing countries, most studies show preferential food allocation to males over females.
Nonetheless, some studies have found no sex differences in the nutritional status of girls and boys 20 — 22and others have described differences only at certain times of the life-cycle. For example, research in rural Mexico found no nutritional differences between girls and boys in infancy or preschool, but school-going girls consumed less energy than boys.
This was explained by the fact that girls are engaged in less physical activity as a result of culturally-prescribed sex roles rather than by sex bias in food allocation Studies from developing countries of gender differences in nutrition in adulthood argue that household power relations are closely linked to nutritional outcomes.
In Zimbabwe, for example, when husbands had complete control over all decisions, women had ificantly lower nutritional status than men Similarly, female household he had ificantly better nutritional status, suggesting that decision-making power is strongly associated with access to and control over food resources. Access of women to cash-income was a positive determinant of their nutritional status. In rural Haiti, the differences in nutritional status for male and female caregivers were examined for children whose mothers were absent from home during the day.
Those who were looked after by males, such as fathers, uncles, or older brothers, had poorer nutritional status than children who were cared for by females, such as grandmothers or sisters Ethnographic research conducted by the authors revealed, however, that, while mothers told the interviewers that the father stayed home with the children, it is probable that the father was, in fact, absent most of the day working and that the children were cared for by the oldest child, sometimes as young as five years of age.
The involvement of both men and women in nutritional information and interventions is key to their successful implementation. Unfortunately, in most developing countries, women are selected for nutritional education because they are responsible for the preparation of meals. However, they often lack access to nutritional food because men generally make decisions about its production and purchase. Similarly, men may not provide nutritional food for their families because they have not received information about nutrition.
The participation of both men and women is, therefore, fundamental to changing how decisions about food are made and food-consumption patterns and nutrition families The study in rural Haiti referred to above also found positive outcomes through the formation of men's groups which received information on nutrition, health, and childcare.
These men, in turn, were resources for education of the whole community The gender differences are also found in the social determinants of nutrition in industrialized countries, although their manifestations are different.
For example, gender plays an important role in determining risk factors for eating disorders, which influence nutritional outcomes. The most common of these are anorexia nervosa, bulimia nervosa, and binge eating BED 27 — The root causes are only partly understood. Biomedical and psychological theories include hormonal imbalance, malfunctioning of serotonin in the brain, genetic explanations, and emotional problems expressed by abnormal relationships with food.
Experts agree that a key factor is the desire to please others. Dieting and bingeing may be used for improving body image and self-esteem. Concern with body image is particularly strong in adolescence where the differences in calcium intake and a more sedentary lifestyle are pronounced of a study of 1, adolescents in the United States also showed that, during adolescence, intake of fruits and vegetables was generally low for both boys and girls and that their consumption was related to consciousness about controlling their weight Among men, dieting and bingeing seem to be more common among gay men and sports competitors than in heterosexuals Many studies have demonstrated the effect of social support on nutrition in older adults, with a positive impact being seen among those who are married, especially men 32 — This has been explained by several factors—the greater likelihood to skip meals when living alone, or to eat filling but unhealthy products and snacks.
Women who are alone may not be able to afford an adequate diet, or they may be less motivated to cook for themselves when they are accustomed to providing for others 35 — The gender differences in nutritional risk were studied among an older sample of black and white community dwelling residents in Alabama, USA The study took into social support, social isolation, and social capital as possible determinants of nutritional risk.
Social capital was defined to include neighbourhoods, trust people felt in their security, and religion. The study found important gender and racial differences between different groups, black men being the most affected by poor nutrition if lacking in social support and capital.
White men were in the best overall position, with white women in the second best position, and black women in the third. The study found that social isolation and lower income contributed most to nutritional risk for all groups, except black men, for whom lack of social support and capital were the most important determinants of nutritional risk. The studies discussed in this section demonstrate that gender matters in terms of nutritional outcomes, but, at the same time, generalizations as to how gender affects the social determinants of nutrition can be misleading.
The complexity of social, economic and cultural contexts and also demographic and epidemiological indicators must be taken into to fully understand the additional impact that gender has. Productive labour is usually defined as labour performed outside the household in income-generating employment; reproductive labour includes work done within the household, such as food preparation, childcare, housework, care of livestock and kitchen gardens.
Reproductive labour, in addition to reproducing the daily conditions of domestic survival, also assures the reproduction of human values, attitudes, and culture. In both industrialized and developing countries, women spend considerably more time than men in reproductive, volunteer and other unpaid labour, whereas men spend ificantly more time in productive, remunerated work 3. In most cultures, productive and reproductive activities are valued differently.
Generally, earning an income brings greater autonomy, decision-making power, and respect in society. Given the greater involvement of men in the paid labour force and their higher earnings even when domestic and other activities of women are costed, they generally enjoy more autonomy and higher social status. The gender differences in economic status and purchasing power affect the health-seeking behaviour and health outcomes of men and women. Recent schools of thought have recognized that many types of non-market or reproductive labour are also productive. For example, gender-aware economics includes unpaid caring work in the home in the concept of productive labour and informal paid work, such as home-based income-generating activities and work in non-profit or non-governmental organizations.
Research on gender and Housewives seeking sex tonight Le Roy West Virginia economic determinants of health and illness is relatively scarce, especially in the area of non-communicable diseases. The example of mental health is used here because there is considerable research on this topic in industrialized countries, and some studies can also be cited from developing countries.
The relative paucity of research on gender and economic aspects of mental health in developing countries reflects the fact that mental health services are less numerous and comprehensive than those in industrialized countries. Nonetheless, interesting studies have been carried out in several countries that demonstrate a clear relationship between economic factors and mental health by gender.
A study of gender and mental health in China that combined historical, epidemiological and qualitative data found ificantly higher rates of schizophrenia among women than among men, a finding contrary to western studies in which men suffer more from schizophrenia Interestingly, however, men occupied more hospital beds than women in psychiatric hospitals, in which at least three-quarters of patients were suffering from schizophrenia, indicating that hospital-bed occupancy did not reflect the male-female ratio of people affected by the disease.
While several possible reasons for this imbalance were cited, ificant gender differences in ability to pay were noted.
Men were much more likely to have health insurance from their employers than women, who tended to be treated more as charity cases. Reports from other parts of the world show that women constitute the large majority of individuals seeking psychological services Given this gender imbalance, services are not positioned to respond adequately to their female clients The gender differences in the economic determinants of mental health were also encountered in South Korea.
A recent study examined the impact on men and women of escalating job insecurity due to increasing s of non-standard workers. The proportion of non-standard workers was considerably higher among women than among men. In general, non-standard workers part-time, temporary, and daily labour were more likely to suffer from mental problems than standard employees, and non-standard female workers suffered more mental illness than men, in terms of self-reported depression and suicidal thoughts Married women reported more psychological problems than single women, and the pattern was reversed for men.
The links among mental health, gender, and economic status were clear in several aspects of the Korean study. Women had about twice the incidence of poor mental health indicators than men, and the mental health problems increased as income declined. This is also true of other studies 42 — The reasons within the Korean context were explained by Kim et al.
Women also had many other family responsibilities which they had to fulfill, in addition to their paid labour. of research in industrialized countries consistently indicate that women have higher rates of anxiety and depression than men, independently of race, time, age, and rural-urban residence. The fact that men have greater control over resources, and decision-making power is one explanation, but there is considerable evidence that even when women have control over resources and income through employment anxiety and depression is not necessarily reduced A national cross-sectional survey of British adults found that people in the most disadvantaged socioeconomic positions reported higher rates of affective disorders and minor physical illnesses than those in higher positions.
The gender differences were found in the other socioeconomic classes. Among healthy older women, for example, those in the skilled occupational class reported the highest rates of affective disorders, whereas among men, the highest rates were found in the clerical class. Generally, in positions occupied by both the sexes, and among men and women with similar income levels, women reported higher rates of both affective disorders and minor physical morbidity The authors concluded that the experience of a particular social or occupational position Housewives seeking sex tonight Le Roy West Virginia be different for men and women, explaining why women consistently experience more affective disorders and minor physical morbidity.
In an analysis of gender, employment, and mental health, Rosenfield compared men and women from the United States using measures of power in work and family, demands on time and personal control, and symptoms of depression and anxiety Men and women with similar demands on their time in family and work situations had similar symptoms of psychological distress. However, women in situations of higher demands, either as unemployed housewives or as working women with ificant familial responsibilities, had higher rates of depression and anxiety than men.
Thus, the gender differences in economic roles strongly influence mental health outcomes.Housewives seeking sex tonight Le Roy West Virginia
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