I have written quite a bit about social class and health, but relatively little about gender and health. The logic behind this resides in my thesis that the paramount explanatory mechanism in post-1970s financial capital is the ‘class/command dynamic’. This does not of course mean that I think gender (or ethnicity, age and so on) insignificant. The few paragraphs comprising this blog on linkages between gender and health, needless to say, draw on the work of more knowledgeable colleagues.
What the data suggest is that women tend to live longer than men in most societies, which on the face of it seems to run counter to sociological diagnoses of enduring systems of patriarchy. There are issues of measurement: until recently in developed countries like Britain, for example, women’s ‘occupational status’, whether they were in paid work or not, was routinely determined by that of their (male) partner. At the turn of the century Arber and Thomas (2001) culled the available data and judged that there is nothing inevitable about the gendering of patterns of mortality: the social plays its variable part, as does contingency. There are certainly societies in which there is no obvious gender difference and some in which men outlive women. While global figures show that boy’s infant mortality generally exceeds that of girls, this can be reversed in countries where, in Nettleton’s (2013: 167) felicitous phrasing, ‘gender-based discrimination outweighs biological advantage’. There are countries too in which women outlive men by eight or more years. This applies to a number of countries comprising the former Soviet bloc, Russia, Ukraine and Lithuania for example, countries that have experienced major socio-economic upheavals.
The conventional wisdom that women tend to live longer than men but nevertheless have higher rates of morbidity, at least in developed societies, has also been thrown into doubt. Episodes of sickness are more open to alternate and rival interpretations and measurements than deaths. It seems clear too that gendered levels of sickness are linked to the social dynamics of time and place: countries, regions, localities and generations and cohorts are not easy to compare.
As with standard of living and facets of occupational position, there exist numerous competing explanations of gendered patterns of mortality and morbidity. Arber and Thomas (2001) discern and comment on seven. They pay scant attention to (a) biological explanations that cite genetic and physiological differences (because these cannot account for the wide and shifting mortality gaps between men and women. Nor are they convinced by (b) psychosocial models (due to their typically restricted and restricting focus on individual traits or attributes). They assign a touch more plausibility to (c) risk behaviours (noting in the process that more women are adopting traditionally ‘masculine’ pastimes like driving fast and binge drinking).
More detailed attention is accorded (d) occupational and work-related factors (in recognition that women ‘earn’ less than men in paid work, which impacts on their later life resources, and engage in much more unpaid domestic labour). They next consider (e) social roles and relationships (noting for example that older men living alone show elevated risks of social isolation and loneliness). Of significance too are (f) power and resources within the home (with intra-household distributions of power and money as well as labour disadvantaging women ‘throughout the world’). Most of Arber and Thomas’ eggs, however, go into the basket of (g) social structural differences in society (referring to the ubiquitous and heavily gendered access to material resources, which resonates of course with the earlier paragraphs on inequality). Elaborating on (g), they write:
women in most societies are more likely than men to be poor, have less education, and live in disadvantaged material circumstances. The feminization of poverty in the US and the UK has been widely acknowledged, and is particularly associated with lone motherhood and older women (Arber & Thomas, 2001: 108).
Annendale (2009) contends that in the era I call financial capitalism there is some evidence of a shrinking of the gap between men and women in life expectancy. She links this to a weakening of the sex/gender binary, the subsequent complication and diversification of gendered patterns, and novel and unstable gendered identities. Divisions between men and women are blurring, she claims.
The literature on gender and health is certainly less socio-epidemiological than that on links between absolute and relative poverty, occupational status, income and so on and health and longevity. My brief expositions of Arber and Thomas and, more obviously, Annendale, illustrate this.
Annendale, E (2009) Women’s Health and Social Change. London; Routledge.
Arber,S & Thomas,H (2001) From women’s health to gender analysis of health. In Ed Cockerham,W: The Blackwell Companion to Medical Sociology. Oxford; Blackwell.
Nettleton,S (2013) The Sociology of Health and Illness. Cambridge; Polity Press.