Gender's Impact on Health

Introduction

The constructionist perspective defines gender as a set of socially constructed behaviours, roles and responsibilities, attitudes, personality traits, relative power, values, and influence that a society attributes to the two sexes on a distinction basis (Manandhar et al. 2018). Sex and gender are often used interchangeably in that they are interrelated although they are different. While sex is linked with biological differences between men and women, girls and boys, gender links to social differences between the two sexes. Gender has a significant influence over how people perceive each other and themselves which in turn affects how they interact and behave as well as how resources and power are distributed in the society (López-Alcalde et al. 2019). Sex and gender-based differences between men and women lead to distinctive health risks, health service needs, and disease incidence (O'Neill et al. 2014). In addition, sex and gender interactions considerably affect health and wellbeing in different ways (Heidari et al. 2016). Still, sex and gender affects occupational and environmental risks, risk-taking behaviours, healthcare-seeking behaviour, access to healthcare, healthcare experience perception, and healthcare utilisation, and hence disease prevalence and treatment outcomes (World Health Organization 2011).

The aim of this paper is to discuss the influence of gender on health and wellbeing. The paper is divided into three sections. The first section explains ways in which gender affects health and wellbeing, the second section explores the experience of elderly women in health and wellbeing, and the third section discusses practices that would promote social inclusion for elderly women. The paper makes inference from relevant sociological theories including feminism, conflict theory, and interactionism.

Ways in which gender affect health and wellbeing

Socially, women are to some extent excluded from schooling and from participation in public life, which limits their knowledge about health problems and prevention strategies. According to Deeks et al. (2009), women in most countries have lower educational attainment as compared to men. The degree of low educational attainment is more pronounced in developing countries where women are even forced into early marriages. Dropping out of school implies that these women have little or no knowledge about health problems and how they can prevent themselves from such health problems (Friis et al. 2016). Dropping out of school results to illiteracy which hinders that comprehension capability of health educational materials. This implies that even though these women might have access to health promotional campaigns, they might not understand the content, which hinders them to take relevant actions. Therefore, little or no knowledge about health problems and the prevention strategies predisposes uneducated women to diseases particularly lifestyle illnesses.

The conflict theory holds that men are the dominant gender thus should subordinate women in order to maintain privilege and power in the society. From this perspective, women are assigned roles in domestic spheres while men are assigned roles in public spheres. These gender roles have significant influence on health and wellbeing. A study conducted by Pawar and Adsul (2015) reveals that men end up becoming the breadwinners because they are socially assigned roles in public spheres. As a reward, men are serves greater quantities of nutritious foods while females take small or no portions of these nutritious foods. This gender bias in food allocation inclines women to lifestyle diseases such as obesity. On the other hand, Ek (2013) writes that women are engaged in less physical activity and their roles are within the home, which makes them vulnerable to lifestyle diseases. In the same vein, Grossi et al. (2013) write that women in their domestic assignments are tend to be socially withdrawn thus have little or no access to health information, which further increases their risk of developing lifestyle illnesses. Manandhar et al. (2018) write that women are subordinate to men therefore when they have to work late or away from home for long periods they are more likely to suffer physical and psychological abuse from the husbands, mother-in-laws and the community at large for taking time away from household caretaking roles.

Women have fewer resources to seek healthcare services. Drawing from the interactionism perspective, women are expected to stay at home and take care of their families, which results to inequalities, in money, power, and resources (Langer et al. 2015). On the other hand, Campos-Serna et al. (2013) state that women occupy low positions in occupation as compared to men who tend to even dominate the career world. This implies that men earn more than women thus have more resources to access health services as compared to women. Rosenfield and Mouzon (2013) write that cultural norms and social values have resulted to women’s absence in community cohesion and social groups. Community cohesion and social groups are a significant source of health information as well as a source of support to increased access to healthcare services (Langer et al. 2015). This implies that women are less likely to access healthcare services because they are isolated from social groups and community cohesion. Additionally, it is possible that women are likely to miss out relevant health information such as screening, which lowers the number of women being screen thus making them more susceptible to illnesses as cancer.

The feminist theory is gender distinctive, which significantly affects health behaviours between men and women. From the masculinity perspective, sociocultural norms subject men to risk-taking behaviours, which increases their risk of acquiring some diseases (Griffith et al. 2016). For example, men are more likely to avoid condoms and less likely to seek testing and treatment for HIV, which makes them susceptible to suffering and dying of AIDS among other sexually transmitted infections (Fleming et al. 2016). In addition, men are more likely to misuse alcohol and tobacco among other drugs, which increases the risk of developing lung cancer and obesity among other diseases (Ford et al. 2014). In the same vein, Levant and Wimer (2014) write that alcohol consumption and tobacco smoking significantly contribute to male mortality in that men are socially subjected to risk-taking behaviours.

From the feminism perspective, gender is associated with response to signs and symptoms of illnesses. Wang et al. (2013) assert that men are socially perceived to be strong and they therefore behave in ways that show they are not weak. Seidler et al. (2016) reveal that men are less likely to respond to signs and symptoms of illnesses by seeking health care in that they perceive themselves to be strong. On the other hand, women are more likely to seek healthcare services for signs and symptoms of illnesses. This implies that early disease detection and treatment is possible in more women than men, which affects healthcare outcomes. Quaife et al. (2014) state that some diseases such as cancer manifest in different and sometimes slight signs until in late stages when major signs are seen. Thus, men are more likely to be treated for cancer in late stages when it is more difficult to manage the disease leading to poor care outcomes. Similarly a report by Department of Health (2015) focus on self-perception of weight and ideal size in both men and women and reveal that women are more likely than men to be aware they are overweight and seek help. The same report reveals that women are more likely to perceive and report themselves as overweight even when they are not while men on the other hand are likely to think of themselves to be lighter than they actually are even when they are overweight. The evaluation of a BBC weight loss campaign established that more women volunteered to participate and more women join private swimming clubs (Department of Health 2015). Similarly, an evaluation of the Counterweight programme in the UK show that only a quarter of the participants are men (Department of Health 2015), which further show that women are more likely to seek consultation and treatment compared to men.

The society is gender biased on how it supports people with illnesses. Williams and Mann (2017) posit that some illnesses such as HIV/AIDS, tuberculosis, leprosy, and mental illness are stigmatising resulting to discrimination of those suffering from these illnesses. However, the authors state that women are more marginalised by these diseases as compared to men. In the same vein, Campbell and Gibbs (2016) state that it is more socially acceptable for a man to suffer HIV/AIDS as compared to women, which means that women with HIV/AIDS will be heavily discriminated leading to even lower quality of life. From a different perspective, Selcuk and Ong (2013) state that culturally, women are known to be more caring than men, which implies that men are more likely to receive assistance and emotional support from their spouses as compared to women. The level of assistance and emotional support a person receives during illness considerably affects his/her quality of life as well as care outcomes. For example, wives with diabetes have more problems in medication and testing blood glucose levels as compared to husbands with diabetes (Manteuffel et al. 2014). This shows that men with diabetes are likely to have better care outcomes as compared to women.

A focus on the experiences of elderly women

Women have fewer resources thus low access to healthcare facilities: old age even exacerbates healthcare access by women. According to López-Alcalde et al. (2019), older women are socially perceived as poorer, which inhibits their access to health services. From the same perspective, Bockting et al. (2016) write that gender bias and the wider stigma and discrimination of older adults deter elderly women from seeking care. On the other hand, Caruso et al. (2013) state that women longer lifespans but often fewer years of paid employment and accrued pension as compared to men. Therefore, women have less access to healthcare services in their old age as a result of smaller contributory pensions.

Older women are more likely to be socially isolated, which reduces the level of assistance and emotional support they receive. Jose and Cherayi (2017) posit that age in itself is not a risk factor for social isolation but income reduces with advancement in age, which leads to social isolation of older persons. Culturally, women are subjected to household caretaking roles which lead to reduced income. Age-related characteristics such as decline in cognitive functioning, widowhood, and economic decline consumes the savings of older women thus disposing them to social exclusion (Walsh et al. 2017). Therefore, advancing age leads to decreasing social relationships, material consumption, and restricted access to service provision. Besides, elderly women are less likely to live with their partners given that women have high life expectancy than men. These factors increase the risk of elderly women developing mental illnesses such as depression. Lack of resources and social exclusion increases the severity of the disease leading to low quality of life at old age.

Deprivation at old age has a significant influence on health and wellbeing of elderly women. Kneale (2012) writes that elderly women lack access to transport and have poor accommodation. Poor accommodation is a risk factor for some illnesses such as cholera and malaria among others. On the other hand, lack of access to transportation implies that elderly women cannot access care facilities. Lack of transportation also implies that elderly persons have restricted access to health information. The chronic poor life experienced by elderly women disposes them to ill-health as well as low quality of life.

Implications for practice

Economic empowerment of women would increase their power and resources resulting to increased access to care services (Sado et al. 2014). Higher educational attainment should be an integral part of women empowerment: through education, women will know their rights, challenge the cultural norms that oppress them, and fit in senior management positions thus be able to afford care services while making healthy choices. Health information should be made more accessible to women such that those remain in domestic roles can learn how to prevent illnesses and shun factors contributing to negative health outcomes (Rosenfield and Mouzon 2013). Social support groups would also be effective to offer assistance and emotional support to women in old age in order to reduce the level of stigma associated with old age (Deeks et al. 2009). Similarly, ways of increasing the lifespan of men should be developed to ensure older women receive assistance and emotional support from spouses at old age. Further, social workers should spearhead in reducing gender inequalities such that women can have equal access to healthcare as men. The government should be concerned with creating decent work for all such that women are able to secure employment opportunities and accumulate pensions to finance their material, health, and wellbeing needs in old age (Caruso et al. 2013). The government should also be concerned with quality education for all such that even though women are not able to secure formal employment, they have the skills to start income generating activities.

Conclusion

Gender has significant influence on health and wellbeing. The paper establishes that in some countries, women have low educational attainment, which limits their understanding of health and illnesses as well as preventive measures leaving them more vulnerable to illnesses. Drawing from the conflict theory, the paper establishes that women are subordinate to men thus have fewer resources which limits the treatment options they can afford. Nonetheless, in the UK there is free treatment under NHS which makes health services more accessible to women. From the feminism perspective, women are more likely to seek consultation compared to men thus receive early treatment. With a focus on elderly women, the paper reveals that older women are more likely to rely on free health services given they have minimal resources. In addition, the paper establishes that elderly women have lower mobility thus require social support to access health services. The paper also reveals that older women are in most cases socially withdrawn, which further affects their psychological wellbeing. Therefore, the paper recommends that the NHS should make free health services more accessible to elderly women by providing transportation services.

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