Lecture 8: women and men health Flashcards
Sex
-Biological and physiological characteristics that define men or women
• Determined by genetics
• Often two sex categories: male and female
Gender
- Socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for men and women
• Assumed through nurturing, learning and interacting with the socio-cultural environment
• Often falls on a continuum: masculine feminine
Gender Equality
- Means the absence of discrimination on the basis of a person’s sex in opportunities, allocation of resources or benefits, and access to services
Gender Equity
- Means fairness and justice in the distribution of benefits, power, resources and responsibilities between women and men
Self-reported women vs men
- Women tend to report their health as being worse than men
- We know that generally across the globe women live longer than men,
- In the very poor countries we see the trend of lower self-reported health in women more
o More stigma associated with men reporting their health as men
o Differences in defying health between men and women in developing countries
o There are more women in poverty in these regions (more likely to be poor
Life expectancy: women vs men
- Biological
- Social determinants
- Protective factors
- Men tend to live shorter lives than men
Biological reasons: - Female sex hormone estrogen tends to protect women against things like heart disease until they get older
- look up the strength of the male fetus
Social determinants of health - men are more likely to die by suicide, but women are more likely to attempt it
- men are more likely to take part in high risk activities
- men are also at greatest risk of dying during periods of high instability in their country
- men are more likely to die as a result of alcohol consumption, motor vehicle accidents, heart disease
- men are more likely to smoke
- men and stress,
- men are less likely to access health care services, and less likely to partake in preventative medicine and early screenings
protective factors - marriage is a protective factor for men
• prevents men from taking part in high risk activities as well as excessive use of drugs and alcohol
Non-communicable diseases
M v W
- men and women generally suffer from similar non-communicable diseases, but men and women tend to experience them at different rates and different degrees of severity
- men experience non-communicable diseases earlier and more severely
- women are more likely to be diagnosed with non-fatal chronic illnesses such as arthritis, osteoporosis,
Women and NCD
- experience more frequent illnesses and disabilities but these are not typically life-threatening; also face some unique biological risks
Men and NCD
- experience more life-threatening diseases more permanent disabilities, and more earlier deaths
Differences in Diagnosis and treatment
- specific for mental health conditions: women are more likely to be diagnosed with things such as anxiety, depression, panic attacks
- women might be more likely to experience stress however they are also more likely to talk about stress, so it is unknown
SDoH W v M
- in many regions of the world, men and women are not equal in legal, economic and social rights (power dynamic)
SDoH and women
- are more likely to be poor and suffer from poorer health, and be malnourished or undernourished
- gender inequalities may exist before they are even born: preference for male babies
- women tend to have reduced access to paid work
- they tend to have lower wages
- inequalities in how resources are allocated in families
- women have increased care responsibilities
- death in women and girls is often related to their environment
o if there is not enough food, women and girls are last to eat in that particular house hold
SDoH in Men
- men are more likely to be exposed to occupational risks that result in health problems
- men are more likely to take part in high risk jobs
o first responders
o constructions
o emergency related work - men are more likely to take part in jobs that require them to handle hazardous or unsafe materials
- men are more likely to die from homicide or conflict
- women are at risk for sexual and intimate relationship violence, but gay men are also at risk for these types of violence
- experiences these types of violence’s increases your risk of divorce, substance and alcohol use and mental disabilities
Barriers experienced by Women
- Responsible for the caregiving, therefore they are too busy
- Lack of control over resources to pay for healthcare services
- Might need to be accompanied by another individual, mandatory vs safety
- Women are more likely to be on prescription medications
Barriers experienced by Men
- Seen as a sign of weakness
- Taking time of work to access services may be a problem if men are predominant bread winners
Barriers experienced by both
- distance
- poor health literacy
MDG’s and women’s health
- the gender gap in employment persists, with a 24.8% point difference between men and women in the employment-to-population ratio in 2012
- gender gaps in youth literacy rates are also narrowing. Globally 781 million adults, and 126 million youth lack basic reading and writing skills, more than 60% of them are women
- women had reasonable access to well-trained birth attendance
- looked at maternal health first couple months after pregnancies
countries that achieved the 5th MDG (reduce maternal mortality deaths by ¾)
- Bhutan
- Cabo Verde
- Cambodia
SDG’s and Women’s Health
- Focusing a lot of women and paid work, educational and vocational training, higher levels of education
- Looking at things to make schools safer
- Reducing the gender pay gap
- In most countries women are still underrepresented in government and parliament, judicial systems and civil service
Reproductive health
- Concerns the reproductive processes, functions and system at all stages of life
- Aim to assure that people are able to have a responsible and safe sex life, and that they have the capability to reproduce and the freedom to decide when/how
Access to reproductive and sexual health services
- Family-planning counselling and education, prenatal care, safe delivery, prevention and management of abortion and miscarriage treatment of reproductive health conditions
Woman’s’ Parity
- Number of births a woman has had, including live births and stillbirths
Sex ratio at birth
- Number of male babies born per 100 female babies born
Natural Fertility
- When women or couples do not vary behaviours that affect their chance of subsequent birth, including birth intervals
Controlled fertility (family planning)
- When woman/couple behaviour influences the interval to the next live birth
Coale’s Preconditions for Fertility Limitation
- Willing: acceptance of the possibility and moral acceptability of control of fertility
- Ready: perception of advantages from reduced fertility
- Able: knowledge and mastery of effective techniques of fertility control
Unmet need for family planning
- Occurs when a woman does not want any more children at all or at this time, but she is not using any method of contraception
Reasons for lack of contraceptive use
- Exposure
- Supply
- Opposition
Contraception
- Prevention of conception/pregnancy through the use of drugs, devices or sexual practices
Modern contraceptive methods
- Have been developed through modern technology or medical research
- Sterilization, the pill, IUDs, condoms, injectable, vaginal barrier methods, implants
Traditional contraceptive methods
- Used to limit fertility historically, often with the use of more natural methods
- Rhythm method, withdrawal, douching, abstinence
Important cause of the decline in female mortality
-Effective birth control
Education and fertility
-Correlation between female literacy rates and birth rates
Bangladesh and Family Planning
- Effective program at limiting children born to women
- Trained local women, to train other women about family planning initiatives
- Worked out really well
- Considered one of the largest and more influential control experiment in the discipline of family planning “Family planning and health services project”
- Started in the late 1970’s in Matlab (rural district in Bangladesh)
- Only a few years after they saw a drastic increase in the use of contraceptive use, and decreases
Birth Interval
-Amount of time between one live birth and the next live birth
WHO’s recommended birth interval
-Answer: 2 years
o Too many pregnancies are often a threat for health outcomes for both the mother and the child
o Rest is very important in the last trimester
How long to wait to attempt pregnancy again after miscarriage or abortion
- 6 months
WHO’s recommendation breast feeding
- women breast feed for a total of 2 years,
- exclusively breast feed for the firs 6 months
- if a mom is HIV positive, be put on ARVs as well as the child and they continue to breast feed
Obstetric Fistula
- a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labour, leaving a woman incontinent or urine or feces or both
- more than 75% of women with these have endured labor that lasted 3 or more days
- Initiatives for access to care, and trained birth attendance
Stigma associated with Obstetric Fistulas
- Lots of literature looks at the consequences of this
- Lost a child
- Men will leave them
Mother’s household wealth, age and child mortality
- Economic and social benefits for young girls to delay marriage and child birth
- Younger people do the worst
Strategies to address unplanned, unintended or unwanted pregnancies
- Abortions
- Sex-selective abortions
- Infanticide: killing of a child under one year of age, which typically occurs very soon after birth
- Fosterage
- Adoption
- Abandonment
Unsafe Abortions
- Access to safe abortion care would reduce maternal mortality rates
- In Africa, about 60% of the unsafe abortions take place among women younger than 25
- Majority of these unsafe abortions in the world take place in low and middle income countries
- 22 million unsafe abortions in the world every year 19 million take place in low and middle income countries
Female Infanticide
- most common in China and India under the form of sex-selective abortions
- has shifted the male to female ratio in some countries quite a bit
- lower income groups are more likely to participate in sex-selection female infanticide
- higher income groups are more likely to take part in sex-selective abortions and in the more educated
-why people who do this
o distorted construction of females as being inferior
o family’s desire to sustain the families name
o avoidance of paying a dowry
o expenditures on females is viewed as a waste because the women will marry and leave the house hold
-in India, ultrasound in the use of sex-selection abortions has been banned in India since 1994 and in China in 1995
Female Genital Mutilation
- comprises all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons
- this is a practice that has been banned globally
-never be performed by a health care provider
ls or women
-can cause complications in pregnancy
types of female genital mutilation
- type1: removal of the clitoris
- type 2: removal of the clitoris and the labia minora with or without excision of the labia majora
-type 3: narrowing the vaginal opening, sewing it up (Infibulation)
o deinfibulation, cutting open the sealed vaginal opening in a women who has been infibulated
-type 4: unclassified
Long term consequences of FGM
- urinary problems
- pain during intercourse
- birth complications
Why is FGM performed
- helping to save the girls virginity in areas where rape is common
- prevent adultery
- to fight against things such as female homosexuality
- prevent masturbation
- make sure the women is a good candidate for marriage
Life-course perspective of violence against women
- prenatal phase: sex selective abortions
- infancy: female infanticide, abuse
- childhood: FGM, sexual abuse, differential access to food and medicine
- Adolescence: dating violence, sexual abuse, rape, forced prostitution
- Reproductive: marital rape and abuse, sexual harassment
- Old age: abuse of widows
