[Previous] [Table of Contents] [Next]

The Social Context of Women's Health

Vivienne Walters, PhD (University of Wales)

This chapter sets a context for the report by highlighting the importance of gender and the links between gender and health. The ways in which we understand the relationship between gender and health have implications for strategies of change and for policy making; as well, they provide a guide for future research, data collection, and health surveillance by pointing to gaps in existing data.

The chapter begins with a consideration of some key dimensions of gender differences and the inequalities that characterize gender relations. These indicate that while "sex" may be used to denote the biological difference between women and men, it is an imperfect measure of "gender". Problematically, such a single measure cannot hope to capture the complexity of gender or the ways in which gender relations change over time and give rise to - or exacerbate - health problems.

The discussion of health emphasizes the importance of analyses of the social determinants of health. Social determinants open up the possibility of targeting policies towards the social factors that impair or improve health. In this regard they can guide health surveillance, even though many of the causes of ill health lie outside the health care sector and the sphere of medicine. This discussion leads to a consideration of two broad questions: (i) What do we know about the social determinants of women's and men's health? and (ii) Are there differences in the health problems women and men experience, and if so, how might we explain them?

The literature on the social determinants of health shows the importance of placing a primary emphasis on the social and economic sources of ill health at national, provincial/territorial, and community levels; this focus has the potential to prevent more deaths and chronic illness than any health care interventions. Poverty, social exclusion, unemployment, poor working conditions, and gender inequalities have a profound influence on patterns of health and illness. Health care policy is very important, but it is only one element of the necessary public policy response, and research attentive to the social structuring of women's health can contribute knowledge relevant to this wider array of policy domains.

Studies of gender differences in health suggest the need to develop an understanding of changing gender relationships, women's and men's differences in power and access to resources, and changing expectations of appropriate gender roles and behaviours. Some material markers of change are suggested that might be used in health surveillance, although with a fuller understanding of how gender shapes people's day- to-day lives these measures could be refined and expanded.

In conclusion, the policy implications of this discussion are emphasized and directions for future research are proposed. In tracing the ways in which women's and men's experiences are "written" on their bodies - the way the social is embodied - social and biological sciences must work alongside each other, showing how women's and men's lives help to create or exacerbate health problems. This collaboration would feed back into policies regarding gender and socio-economic inequalities and would also inform other curative or coping responses.

Download Full Chapter (PDF)

[Previous] [Table of Contents] [Next]