1. Women’s Health Status

2. 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

3. 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]

4. 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]

5. 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]

7. 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

8. How Do We Measure Health?
 Official Records
 Death
 Birth
 Hospitalizations
 Surveys
 National
 Local
 Community

9. 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?

10. 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

11. 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

12. 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

13. How Do Women Fare?
 Live longer (Mortality) but more chronic disease and
disability (Morbidity)
 Differences exist among women by…
 Class
 Region
 Race/Ethnicity

14. 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

15. 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

16. 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

17. Poverty Among US Women
2008
 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

18. 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

19. Types of Discrimination
 Race/ethnicity
 Age
 Gender
 Sexual Orientation
 Health Status
 Weight
 Behaviors
 SES

20. 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

21. Model of Discrimination & Health
Stress
Discrimination Health
Unequal Treatment

22. Model of Discrimination & Health
Stress
Discrimination Behavior Health
Unequal Treatment