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Women’s Health Status
Overview
How do we define health?
What is a health disparity and why does it matter?
What causes health disparities?
What is the status of women’s health?
Poverty & women’s health
Race & women’s health
Definitions of Health
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity…The right to health is one of the fundamental rights to which every human being, without distinction of race, sex, language or religion, is entitled.” [WHO, 1946]
Definitions of Health
“….disease can only reasonably be defined as the absence of health…[the author therefore]…feels compelled to accept the consequent proposition that health is indeed the absence of disease…an individual is healthy when his level of function does not impede or determinably threaten to impede the performance of an acceptable social role” [Smith, 1977]
Definitions of Health
“Positive health is a mirage - it is evanescent and unattainable but worth pursuing. If health means anything, it resides in the pursuit, in engaging with these constantly changing and typically unpredictable environmental forces.” [Tones & Green, 2004]
Why Measure Health?
Identify major health problems How common?
When do they occur?
Where do they occur?
Who is affected?
Why do they occur?
Develop a response Prioritize & Meet Goals
Resources
Effectiveness
How Do We Measure Health?
Official Records Death
Birth
Hospitalizations
Surveys National
Local
Community
Representation
Ask yourself, for a given health indicator/measure: How is the data/information obtained?
What types of diseases/events are likely to be well represented?
What populations might not be well represented?
What does this information really represent?
Indicators of Health
Mortality Rates Number of deaths per 100,000 resident population
Death is a clearly defined event
Life Expectancy Based on mortality
Infant Mortality Rates Tells us about health of the mother, which also tells us
about the health of the society
Healthy-Related Quality of Life/Health-Adjusted Life Expectancy
Definition: Health Disparities
"a significant disparity in the overall rate of disease incidence, prevalence, morbidity, mortality, or survival rate" in a specific group of people as compared to the general population.
Health differences between more and less advantaged social groups underlying advantage, position in social hierarchy
Why do health disparities occur?
Biology
Physical environment
Social environment
Cumulative impact (lifecourse)
Cultural differences in behaviors
Access to resources
Differential treatment
Being left out of the dialogue
How Do Women Fare?
Live longer (Mortality) but more chronic disease and disability (Morbidity)
Differences exist among women by…
Class
Region
Race/Ethnicity
Class & Health
One of the strongest & most consistent findings is association between income & health No threshold - not just a question of basic needs
Income inequality associated with health inequalities
Bidirectional effects Poverty can lead to ill health but ill health can also lead to
poverty
Levels of Poverty
World Bank definition
Extreme Poverty = Living on less then $1.25/day
Moderate Poverty=Living on less then $2/day
Over 1 billion people live in extreme poverty worldwide
Majority of these are women
2011 HHS Poverty Guidelines
Persons
in Family or Household 48 Contiguous
States and D.C. Alaska Hawaii
1 10,890 13,600 12,540
2 14,710 18,380 16,930
3 18,530 23,160 21,320
4 22,350 27,940 25,710
5 26,170 32,720 30,100
6 29,990 37,500 34,490
7 33,810 42,280 38,880
8 37,630 47,060 43,270
For each additional
person, add 3,820 4,780 4,390
SOURCE: Federal Register, Vol. 74, No. 14, January 23, 2009, pp. 4199-4201
Poverty Among US Women2008
Nearly 40 million people lived below poverty line.
13% of adult women vs. 9.6% of adult men
9.4% of White women as compared to 22.7% American Indian/Alaska Native; 23.2% Black; and 22.3% Hispanic women
10.1% of women vs 6.9% of men living in families
25.7% of women in families w/o spouses vs. 11.9% of men in families w/o spouses
Racial Disparities
Racial Difference
The rate of AIDS diagnoses for Blacks was nearly 8 times greater than rate among Whites in 2009
Racial Difference Within Gender
Incidence rate among Black women is nearly 15 times the rate among White women
Race by Gender Difference
Black women represent more than a third (34%) of AIDS diagnoses among Blacks while White women represent 14% of AIDS diagnoses among Whites
Kaiser Family Foundation Publication #6089-09
Types of Discrimination
Race/ethnicity
Age
Gender
Sexual Orientation
Health Status
Weight
Behaviors
SES
Stressors of Discrimination
Living with stigma
Living outside the norms of society
Anticipated discrimination Nonevents
Internalized negative perceptions
Diverse Identities Stressor & Resource
Personal/group discrimination Concern for others
Discrimination
Stress
Unequal Treatment
Health
Model of Discrimination & Health
Discrimination
Stress
Unequal Treatment
Health
Model of Discrimination & Health
Behavior
