Sex and Gender

WOMEN ARE SICKER BUT MEN DIE QUICKER: A SOCIOLOGICAL APPROACH TO HEALTH AND ILLNESS

DIFFERENCE BETWEEN SEX AND GENDER

Appelbaum and Chamblis 1997, defined sex as “anatomical differences between males and females” and gender as “behavioural differences that are culturally based and sociologically learnt”. Gender role refers to the culturally expected behaviour, thought and feelings of men and women (Fulcher and Scott 2003). Traditionally, in American culture, men are seen as being aggressive, strong, logical, messy and dominant while women the reverse (Appelbaum and Chambliss 1997). The first influence for gender roles is the family. From infancy boys and girls are treated differently. Girls are seen as more fragile and are given toys like dolls and kitchen sets to play with. They are encouraged to behave in a neat, quiet and seemly manner. Boys are given toys like trucks and guns and are encouraged to be more active. Parental influence is great during infancy and early childhood but by 5 to 6 years, peer, school and media influence take over. There are certain ways boys and girls are expected to behave among their peers and deviation from this role can lead to being ostracized. Television and magazines portray gender stereotypes. Movies like ‘Rambo’ and ‘Terminator’ portray the strong, macho alpha male who is aggressive and assertive. While female magazines like ‘seventeen’ emphasize about fashion and makeup. In schools, gender roles are often subtly enforced. Boys are typically expected to excel in sports and women in cooking and needle point. However, nowadays conventional gender stereotypes are less well defined.

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There are broadly two major sociological theories regarding gender. The classical sociological theory was widely accepted in the nineteenth century. It explains that women and men are biologically different and thus have different roles in society. Women’s role was seen to include child rearing and taking care of the home. The men’s role was to provide for the family. Women were seen as being subservient to men.

The second theory is the contemporary feminist theory. It actively seeks to eliminate sexism and patriarchy. Sexism is the belief that one sex is better than the other. Patriarchy was originally used to describe families in which fathers dominate. Now it is used to describe societies in which men dominate. There are several subgroups of feminist thinking. The liberal feminists hold the opinion that the society is imperfect and creates barriers for women preventing them from realising their full potential. The key issue is equal right for women. Societal reforms like legislation can be put in place to remove these barriers and address the issue of inequality. The social feminists also described as Marxists feminists by Fulcher and Scott 2003 hold the opinion that women’s inequality is a result of patriarchy and capitalism being interwoven. They argue that the capitalist male breadwinner benefits from a woman who provides unpaid labour. It is only by addressing both issues: capitalism and patriarchy that inequality can be addressed. Radical feminists say patriarchy is not associated with capitalism but it is seen in all societies. Women are oppressed sexually, politically and economically.

SOCIOLOGICAL VIEW OF HEALTH AND DISEASES

Health cannot just be considered as the absence of symptoms. Sociologists recognise the social factors that affect health and the disruption f social role due to health. Talcott Parson described the ‘sick role’ the rights and obligations of a sick person. In different societies, there are different expectations from men and women regarding health.

GENDER INEQUALITY IN HEALTH

In the early 1970’s gender inequality in health became an area of major sociological research. Inequality in social role of women is seen to have led to inequality in health (Annandale and Hunt 2000). Social change relating to family, education, employment and the relationship between work and home will be briefly looked at. Employment and occupation indicate socioeconomic status and to a less extent health seeking behaviour. There is gender inequality with more men being employed than women. It was shown that in disadvantaged neighbourhood, 1.5 million women wanted to work but were not able to. If they got any jobs, they had low paying jobs. Furthermore, mothers and caregivers had a hard time returning back to work (Grant 2009). A study done in Netherland, Sweden and United States showed gender inequality regarding employment was less with higher educational status (Evertsson, England et al. 2009). It was shown that women in lower social class worked less.

Women are traditionally saddled with the responsibility of household chores. Nowadays, there has also been a change in this trend. With more women employed, men are helping with the chores. Women of high social class now do fewer chores than their low social class counterparts (Evertsson, England et el. 2009)

Studies have shown that higher employment rate in women has led to increase in single parent families and lower fertility rates. Women in Eastern Mediterranean region have two children less than the previous generation (WHO 2009).Women start giving birth later and have fewer children. There is a higher divorce rate and cohabitation with women more financially stable to support themselves. In the past years, men were likely to be more educated and have more qualifications than women. Nowadays, women are competing with men in sphere of education. In the mid twentieth century, men were more likely to be gainfully employed than women and more likely to be in full time work. Certain occupations like medicine and armed forces were male dominated.

GENDER HEALTH inequalities from cradle to grave

Men and women in higher social class enjoy better health than the lower class. However, in some industrialised countries, it has been shown that women might outlive men for up to ten years (Lober and Moore 2002).This has been attributed to both biological and social factors.

INFANCY

In infancy, female babies are seen to be physiological stronger than, males. There is minimum of 20% more male deaths than female deaths during the first year of life (Stillion 1995). It has also been suggested that the female hormone, oestrogen confers immunity from puberty to menopause (Lober and Moore 2002). Male/ female sex ratio at birth is 1.05 in United /.Kingdom and United States and globally, it is 1.07. The high male to female ratio is possibly to compensate for higher natural death rate in male babies. In certain countries like India and China there is preference for male babies. This resulted in female infanticide and abortion of female babies. The male(s)/female sex ratio is 1.10 in china and 1.12 in India (CIA 2009). This will pose problems when these children reach marriageable age. It will also affect fertility rates.

However, a study carried out by Arber and Cooper 2000, health inequalities in boys and girls are similar what affects health is parents’ economic status. The socio economic state of the mother directly affects the health of the children. A woman with low socio economic status is likely to have high fertility rates, poor access to health care, less likely to use contraceptives and antenatal clinic. Such a woman is also less likely to eat balanced diet and provide the same for her children. She will have less time to take herself and her children to the hospital when they fall ill since she is busy doing the household chores.

ADOLESCENCE AND EARLY ADULTHOOD

Here, there are a lot of social factors that affect health. There is at present increase in teenage pregnancies in the Western World. This can adversely affect health. The infant faces the risk of low birth weight and prematurity. The young mother faces the risk of prolonged labour, cephalo-pelvic disproportion and obstructed labour. Vesicovaginal fistula, which refers to an abnormal communication between the bladder and the vagina, is another complication these young women face. This is due to a combination of small pelvis and prolonged obstructed labour. This in severe cases leads to the young mothers being ostracized and neglected by the fathers.

Teenage pregnancy also increases the mother’s chance of ending in poverty or remaining in poverty if already poor (Lorber and Moore 2002). Teenage mothers are more likely to drop out of school and the teenaged fathers have lower earning potential. There is also increased rate of substance abuse in this group of people (womenshealth channel 2004).

Females are more likely to be victims of domestic violence. This can be physical or emotional abuse. A study conducted by the London School of Hygiene and Tropical Medicine revealed 35% of the women questioned at Accident and Emergency have been victims of domestic violence in their life time (BBC 2004).

Eating disorders like anorexia and bulimia also affect the health status of teenagers. It is commoner in females and is seen to be the result of the obsession that being slim equals beauty. It is estimated that eight million Americans have an eating disorder, seven million females and one million males. About 10 -15% anorexics and bulimics are males (DPH 2006). It is an occupational risk in athletes, gymnasts, and fitness instructors’ both and females. Here, it is done to increase performance and meet weight categories.

African American men have the lowest life expectancy rate in America. The major causes of death are homicide, suicide, Acquired Immunodeficiency Syndrome and alcohol abuse (Staples 1995). They are more likely to suffer from stroke, diabetes prostate and colon cancer than white men. They are also more likely to suffer in silence or go to government hospitals.

CHILDBIRTH AND DELIVERY

Lorber and Moore 2002 stated that an important contribution to increased female life expectancy is improved maternal mortality rates (death due to pregnancy, childbirth or related complications). This has been attributed to attendance at antenatal, antibiotics for puerperal infections, safer blood transfusions, safe abortions and surgical interventions. There is however, a large disparity between maternal mortality rates in different parts of the world. In the European region it is 27 per 100,000 live births and 900 per 100,000 live births in the African region (WHO 2009).

OLD AGE

This presents its specific physiological conditions for both men and women. Men have increased incidence of prostate cancer and women have increased incidence of osteoporosis and bone fragility. With increased life expectancy a women is industrialised countries are more likely to outlive their partners.

DEATHS

Differences in social behaviour and gender roles have led to a difference in mortality rate between the sexes. In the developed countries, there is a higher mortality in men than women across all age groups. The biggest killer in men is ischaemic health disease. other causes of high mortality are lung cancer, chronic obstructive pulmonary diseases, accidents, suicide, homicide, chronic liver disease (Sabo and Gordon 1995). Men smoke cigarettes and drink alcohol more than women. This can explain the higher rate of ischaemic heart disease, lung cancer and chronic obstructive airway disease seen in them. Men are more reckless drivers and are more likely to rive under than influence than women, this can account for their higher accident rates. Due to higher employment rates of men, they have higher rates of occupational diseases.

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THEORIES ON GENDER INEQUALITY

Carpenter 2000 put forward eight propositions on health and gender. First, he stated that the issue to be addressed should be gender, not women in health. Gender is shown to happen as people relate to the members of the same and opposite sex. Health and illness affect both sexes in the course of their lives and each has to struggle to deal with it should be looked at in terms how it affects the two sexes. However, boys and girls are faced by different challenges in different cultures which can affect their health. In some cultures, girl education is not seen as important as that of boys. Secondly, similar factors influence the health of males and females. Males and females are similar biologically and both have increased life expectancy in the present day Britain. However, most sociological researches are done with men as the standard and women as the deviant. Therefore, for women, in the case of cancers, more emphasis is based on the cancers that specifically affect them. This has led to a negligent of other forms of cancers like lung cancer in which an increasing prevalence in being noted in women. Thirdly, Carpenter 2000 discussed the issue of “structured diversity” in health experiences between males and women. Factors like age, race and socioeconomic status are equally important in determining health. Next, Carpenter 2000 discussed the pattern of mortality and morbidity amongst genders. Studies have suggested that men report illness less than women to protect their ‘masculine’ image. It was also suggested that doctors tend to look for diseases in more women than men. However recent studies have shown that the nature of conditions and not gender is more important in determining health seeking behaviour.

Carpenter further listed the role of natural selection in determining gender inequality. Evidence suggests that the female sex confers immunity. There is a higher rate of mortality in male than female infants. However, the influence of biology on mortality cannot be treated in isolation. Social factors play an important role as well. In preindustrial studies, men lived longer. Women had the burden of poor feeding, stress and child bearing. Other issues addressed were ‘social structuration’ and social relation. Social relations have both positive and negative effects on health. Marriage is seen as being protective. However, practices like domestic violence, discrimination have a negative effect. Lastly, he wondered if longer life in women was synonymous to better health. Post menopause, women complain of similar morbidities than men.

ARE WOMEN REALLY SICKER?

Studies have shown that women are more likely to seek medical help than men. The explanations put forward to describe this include that women are sicker as regards non fatal diseases. Conditions like depression are diagnosed more in women. Do they suffer more from it or do doctors look out for it more in women? Adverts for antidepressants usually use women. They have been tagged as being more affected by it. Another view is that women go to hospitals for obstetric conditions which are not technically sickness as childbirth is a natural life progression. Women also take their children to the hospital when they are ill. This could be their gender roles in which they are more at home with the children and for housewives; they are more available to take the children to the hospital since they are not in offices like men. Another view is that it is not ‘macho’ for men to complain, society expects them to grit their teeth and bear pain.

CONCLUSION

Gender and sex are defined differently based on acceptable societal norms. The concept of health and illness cannot be treated in isolation without considering how the social role is affected. Inequality in social role may explain gender inequalities. At different stages of life, social factors affect the health of each gender. Gender roles determine how each gender reacts. Data has shown that more male infants are born and women have a longer life expectancy than men. Women are seen to report more non fatal illnesses. This difference might be due to genetics, social factors or artefact (Pilnick 2009). However, focusing more on differences between the sexes, the difference amongst them is neglected.