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Women & Minority Health

Women & Minority Health. Dr. Dawn M. Upchurch PH 150 Fall ‘04. Overview of Lecture. Short review of HP 2010 Concept of Social Stratification Social stratification and health Women’s health Gender paradox Key issues in women’s health “Minority” health Key issues

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Women & Minority Health

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  1. Women & Minority Health Dr. Dawn M. Upchurch PH 150 Fall ‘04

  2. Overview of Lecture • Short review of HP 2010 • Concept of Social Stratification • Social stratification and health • Women’s health • Gender paradox • Key issues in women’s health • “Minority” health • Key issues • Ways of ameliorating health disparities

  3. Healthy People 2010 • Two overarching goals: • Eliminate health disparities • Increase quality & years of healthy life • Objectives organized into 28 “Focus Areas” • Each objective has “Leading Health Indicators” • Importance of health promotion & disease prevention

  4. What are “health disparities”? • Mortality • Varies by gender • Varies by race/ethnicity • Varies by other sociodemographic factors • Morbidity • Varies by gender • Varies by race/ethnicity • Varies by other sociodemographc factors

  5. Explanations for Health Disparities • Theory of “Social Stratification” • Society “stratified” by several sociodemographic characteristics • Gender • Age • Race/ethnicity • SES • Others? • Stratification: Differential access to resources

  6. Theory of Social Stratification • All known societies have inequalities • What are social “resources”? • Wealth • Power • Prestige • Rules of allocation: • Variable distribution of goods/resources across various positions in social structure • Most privileged enjoy disproportionately • What is “social structure”?

  7. Types of Social Stratification • Degree of inequality of resources • Dispersion • Concentration • Degree of rigidity • High: “social closure” • Low: “social mobility” • Ascriptive vs. Achieved • Ascriptive: Traits present at birth influence subsequent social standing • Achieved: Traits acquired over lifetime influences subsequent social standing

  8. How is U.S. Society Stratified? • Both ascriptive & achieved stratification processes • Ascriptive • Gender • Race/ethnicity • Nativity, culture • SES of family • Achievement • Education, etc.

  9. Concept of Status Attainment • Social status individuals achieve over their lives • Key Indicator: Educational attainment • Concept of “human capital” • Examples of status attainment process • “Intergenerational transfer” of status • Individual status attainment over life course

  10. Key Sociodemographic Characteristics Associated with Stratification & Health • Age • Biological & social components • Gender (Sex) • Biological & social components • Race & ethnicity • Biological & social components • Social meaning of race & ethnicity changes • Socioeconomic status (SES) • Contingent effects of age, gender, race/ethnicity & SES on health

  11. Women’s Health – Gender Paradox “Women get sicker, men die quicker.” • What does this mean? • Women • Higher morbidity rates than men • Lower mortality rates than men • Men • Lower morbidity rates than women • Higher mortality rates than women • But, higher morbidity should predict higher mortality – What’s happening?

  12. Gender Paradox • Gender differences in health care seeking behaviors • Women more likely to go to HCP early & often vs. men • Visits are “counted” in morbidity rates • Men more likely to wait and/or not go to HCP • So, lower morbidity rates • But, wait until conditions more severe  increased risk of mortality • So, both “true” & “artifact” differences

  13. Race/ethnicity, SES, & Health • Gender, race/ethnicity, & SES associated with one another • Distribution of risk factors & resources are shaped by the conditions under which people live & work. • What are some of the explanations for the observed race/ethnic & SES differences in health?

  14. Factors Associated with Race/ethnic & SES Differences in Health • Medical care • Differential use of preventive care • Health behaviors • Unhealthy behaviors account for 50% of deaths in US • Environmental conditions • Working conditions, environmental exposures • Personality • Self esteem; mastery; fatalism • Early life conditions

  15. Reducing Health Disparities • Intersection of Research, Policy, & Program Policy Research Program

  16. Reducing Health Disparities • National Public Health Agenda • National Health Policies & Programs • Healthy People 2010 • State & Local • Policies & Programs • Targeted Populations • Policies & Programs • Program Development & Evaluation

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