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Health Care and Gender

Health Care and Gender

Charlotte F. Muller
Copyright Date: 1990
Published by: Russell Sage Foundation
Pages: 272
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  • Book Info
    Health Care and Gender
    Book Description:

    Health and medical services should meet individuals' needs regardless of gender, but in both subtle and overt ways this is very often not the case. Gender biases result not only in flawed access to care but also in insufficient medical research, uninformed diagnoses, and gaps in covering critical needs.

    InHealth Care and Gender,Charlotte Muller provides a contemporary assessment of the forces that sustain gender biases in the health and medical professions. Beginning with an analysis of gender comparisons in health care usage and adequacy of treatment, Muller discusses the experiences of many different women: working women with insurance coverage, the poor dependent on Medicaid, and the elderly. She also focuses on the issues facing women of reproductive age and shows how poverty or extremely volatile political and ethical controversy may impede their search for basic maternity and family planning services.

    Drawing on a large body of evidence from medical, health, and behavioral literature and from national statistics,Health Care and Genderprobes a timely and crucial topic. For scholars, analysts, and policy makers interested in women's studies, health and medical care, gerontology, consumer and labor economics, and social justice. Muller's thorough analysis looks to the future by presenting agendas for reform, research, and evaluation.

    eISBN: 978-1-61044-836-9
    Subjects: Health Sciences, Sociology

Table of Contents

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  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. List of Tables
    (pp. vii-viii)
  4. Acknowledgments
    (pp. ix-x)
  5. Introduction
    (pp. xi-xiv)

    Recognition of gender inequality in the United States as a civil rights issue brought about changes in the law that have affected many lives. Aided by affirmative action and changes in social attitudes, women have gained a footing in many “public sphere” activities previously denied to them. It would be surprising if health care, a major social institution and industry, had been immune from invidious distinctions based on gender before the women’s movement took shape. But such distinctions, once awareness of them develops, do present a challenge to both the humanistic and the scientific values of the health professions. If...


    • CHAPTER ONE Health Care Utilization by Men and Women
      (pp. 3-22)

      Comparison of the relations of the two sexes with the health care system in statistical terms shows that, generally, women have a more active connection with health care providers. Since women also report more illnesses and have extra reproductive needs, study of patterns of use by sex may seem to be unimportant for health care policy or for gender equity. However, this impression does not hold up. First, unmet need (no care) is not precluded; it may exist and should be assessed. Second, although need measured in terms of illness rates may seem to provide a rational base for use...

    • CHAPTER TWO Treatment Issues
      (pp. 23-54)

      Health experiences of women and men have both similarities and differences, according to Verbrugge (1986). In her analysis, based on Detroit data, the two sexes have the same daily symptoms of ill health. Similar conditions cause acute and chronic disability and activity limitation in both sexes, appear in the health care they receive, and become causes of death. With aging, the types of conditions responsible for ill health and use of services become even more alike, as injuries (male) and reproductive disorders (female) give way to chronic illness (both sexes). Sex differences are found, however, in the rates of these...


    • CHAPTER THREE Health Care, the Workplace, and Gender: Health Needs
      (pp. 57-72)

      In the next two chapters the interaction between gender and health needs and health care for the working-age population will be explored. Chapter 3 focuses on health needs of working-age men and women and the relation of work to health. Chapter 4 discusses insurance and financing issues for employed adults and special vulnerabilities that are gender specific.

      Trends in women’s labor force participation, the control of fertility, and the sex wage gap are a background to understanding women’s problems in regard to health care. Sex differences and similarities with respect to acute and chronic illness, mortality risks, and prevention opportunities...

    • CHAPTER FOUR Health Care, the Workplace, and Gender: Insurance and Financing Issues
      (pp. 73-102)

      Many of the health care coverage problems of employed women are aspects of poverty. The employed poor are often uninsured. They do not have employers who are committed to contributing to group health insurance, and they do not have funds to pay for individual insurance, which is more costly. Yet most do not qualify for Medicaid because their earned income is higher than the low standard of eligibility in many states. Their health problems and need for care have been demonstrated, yet they obtain less care than those with coverage.

      A more general, structural problem is related to changes in...

    • CHAPTER FIVE The Elderly
      (pp. 103-146)

      In this chapter several themes recur as to the ways in which gender influences the “careers” of the elderly as users of the health care system. Lifelong adherence to gender-based social roles greatly affects the income, assets, and insurance of older persons and, thus, their ability to gain access to the system. The current economic status of the elderly is affected by their past; for women this includes sex-typed jobs and discontinuous careers, the persistence of wage discrimination in the U.S. economy, and marriages in which the bride was typically younger than the bridegroom (and therefore survived him). Moreover, the...

    • CHAPTER SIX Medicaid: The Lower Tier of Health Care for Women
      (pp. 147-168)

      Being poor, like being old, is a socially defining characteristic that affects one’s potential relationship to the health care system in the United States. If one is poor, Medicaid eligibility and service coverage become crucial for determining whether health care needs will be met. Since women’s social problems place many of them at risk for poverty, the burdens created by certain features of the Medicaid system have become a gender issue. This chapter draws on information contained in various statistical reports and research documents to review Medicaid program elements that affect both younger and older women. Younger women’s access to...


    • CHAPTER SEVEN Reproductive Care
      (pp. 171-216)

      Biology, which determines the technical possibilities of preventing conception and females’ need for care for pregnancy and birth, is a major determinant of gender patterns of reproductive care. However, biology does not stand alone, for social norms, such as whether it is acceptable for a male to take responsibility for contraception, and economic factors, such as the market availability of contraceptive methods for males, are also influential. In addition, when a couple is faced with infertility or risk of genetic defect, decisions as to use of outside sperm donors and other options affect services used by each sex.

      Overall, reproductive...


    • CHAPTER EIGHT How the Issues Have Changed
      (pp. 219-239)

      The health care system figured in sociopolitical models advanced by feminist writers as an arena of expression of male power and inequitable treatment of women, a setting of activities that perpetuated the subordination of women. In the spirited campaign of the women’s movement in the 1970s to reveal, define, and correct sexism in the health care system, a focal theme was that control over one’s own body was part of autonomy dearly valued, captured by others but capable of being regained. Among the issues dissected were medicalization of normal childbirth, resistance of providers to the exercise of reproductive choice, labeling...

  10. Name Index
    (pp. 240-246)
  11. Subject Index
    (pp. 247-258)