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doi: 10.1080/07399339709516288pmid: 9287560
In this article I address the institutional and personal processes associated with providing and receiving elder care. Although cultural differences abound, it is argued that five conditions currently affect the social response to frail elders all around the world: (a) male dominance of political and economic social institutions; (b) elder care dependent on the “dirty work” of women; (c) limited and ambiguous social recognition for providing elder care; (d) the aging of population as a whole (i.e., the proportion of old people in the world is increasing; and (e) frail old women fare worse than do frail old men. Regardless of which institution (government, economic marketplace, or family) has assumed the responsibility for elder care, the decision‐making role has been dominated by men, and household tasks have been disproportionately provided by women. Women's elder‐care work is physically draining. It tends to be work for which the providers receive, even within cultural boundaries, what is considered to be inadequate compensation. Nevertheless, women continue to provide labors of duty and labors of love. What is truly remarkable is that so many women report that their efforts are emotionally and spiritually satisfying. However, increasingly researchers report that women also experience depression and burnout. I discuss the extent to which the five current conditions of elder care will impede the performance of elder care in the future.
Binson, Diane; Pollack, Lance; Catania, Joseph A.
doi: 10.1080/07399339709516289pmid: 9287561
Women in midlife and older represent over 25% of all women with AIDS and 4% of all reported AIDS cases in the United States. We present prevalence estimates and demographic correlates of AIDS‐related risk behavior and safer sex practices among women in midlife and older from the National AIDS Behavioral Surveys (NABS). Data are of women aged 40 to 75 in the (a) NABS 1 national sample (n = 887), (b) NABS 1 urban sample (n = 2,111), and (c) NABS 2 national sample (n = 624). Data from the baseline survey (NABS 1) revealed that approximately 8% or 4.5 million women aged 40 to 75 engaged in behaviors that might expose them to HIV. Data from the follow‐up survey (NABS 2) indicated that the proportion of women who reported a risk factor remained at about 8%. Overall safer sex practices among older women who reported sexual risk behaviors were minimal. Between 90% and 100% had not used condoms in the previous 6 months. Moreover, almost 90% of the women who reported a risk behavior did not perceive themselves to be at risk.
Douglas, Marilyn K.; Meleis, Afaf Ibrahim; Paul, Steven M.
doi: 10.1080/07399339709516290pmid: 9287562
As more women worldwide enter the labor force, debate has been generated over how this additional work role influences women's health. In this study, we explored the work, maternal, and spousal roles of 59 auxiliary nurses in two university‐affiliated Mexican hospitals. Participants completed questionnaires that included demographics, a women's roles interview protocol, a self‐rating of health status, and the Cornell Medical Index (CMI). No significant correlation was found between the perception of their health status and the number of roles, amount of role involvement, or their perceived levels of stress and satisfaction in any of their three roles. Work stress was significantly correlated with the number of physical symptoms (r = .30, p < .05), longer periods of standing (r = .31, p < .05), more muscle strain (r = .53, p < .01), eye problems (r = .43, p < .01), frequent changes in environmental temperature (r = .30, p < .05), and perceptions of economic inadequacy (r = .37, p < .01). Years of education was not related to any health measure or degree of stress or satisfaction in any of the roles. The greater the degree of role integration, that is, the greater the sum of satisfactions minus stresses of each role, the fewer the physical symptoms (r = .48, p < .05) and the fewer total symptoms (r = .43, p < .05) reported on the CMI. Those with more spousal stress reported more work‐related muscle strain (r = .35, p < .05), and working mothers with three or more children tended to perceive themselves as less healthy (r = .75, p < .01). Thus, analyzing the interrelationship of women's multiple roles is a better predictor of health than examining specific role stresses in isolation.
Nilses, Carin; Lindmark, Gunilla; Munjanja, Stephen; Nyström, Lennarth
doi: 10.1080/07399339709516291pmid: 9287563
To study changes over time in reproductive health and living conditions of women in a rural setting in Zimbabwe, 12 villages were selected at random in the Guru district, Masvingo province. During two study periods in 1992 and 1993, 1,213 women of fertile age (15–44 years) were interviewed and examined. Median age at menarche was 15 years, with a decrease of 0.4 years from the oldest to the youngest age group. There has been no increase in the mean height of women, indicating no change in determinants of nutritional status of girls in childhood and adolescence. Younger women still marry at a median age of 19 years but prefer smaller families. Level of education is the main determinant for age at marriage and preferred family size. A low prevalence of primary (1%) as well as secondary infertility (4%) was found in spite of the currently reported high prevalence of sexually transmitted diseases in Zimbabwe.
doi: 10.1080/07399339709516292pmid: 9287564
At an international conference in 1992 on women and health, an attempt was made to redefine health concerns for women of the English‐speaking Caribbean in the 1990s. Medical practices in developing countries change as advances are made in public health; clinical issues on the islands now resemble those in the United States (e.g., hypertension, cancer, sexually transmitted diseases, domestic violence, and abortion). In the Caribbean, however, these problems exist in a unique socioeconomic context, and women's health there suffers indirectly because of cultural mores. Gender bias in medical education and practice influences treatment of women and obstructs their advancement to policy‐making levels in the design and delivery of programs that bear on maternal and child health, among others. The effect of local cultural beliefs and practices on women's health must be considered when setting goals and direction for health policy if aid or educational programs are to be effective.
Taylor, Diana; Dower, Catherine
doi: 10.1080/07399339709516294pmid: 9287566
In this report we describe the results from 19 focus groups of nearly 250 women held in 1993 and 1994, in which diverse groups of women were asked to respond to a model health care delivery system. This project, sponsored by the Women's Health Advisory Committee of the San Francisco Department of Public Health, solicited focused input from diverse groups of women as they reviewed the draft of an “ideal” women's health care service model. Women's responses to an ideal system revealed some of the problems inherent with the current “nonsystem” of health care delivery. These responses were categorized into general themes and are presented here to demonstrate the range of women's experiences with their current health care, from their perspective and in their voices.
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