The women's movement and older women's health: issues and policy implications

Since women are an increasing proportion of the older population, the health issues that affect older Americans must be regarded in large part as women's issues. Women experience aging differently from men. The advantage in life expectancy of women over men is not always a boon. Older women have substantially lower incomes and higher poverty rates, are more likely to be widowed and living alone, and depend more on entitlement and social service programs. This paper traces the evolution of the women's movement and identifies some of the health care problems of older women in terms of psychological, socio-cultural, and economic factors. The role of the medical establishment and federal regulations that affect older women are examined. The White House Conference on Aging (1981) is seen as a prelude to the current policies of the Administration that affect older women. Necessary policy changes on the Federal and local levels are discussed as well as the need for redirection in the women's health movement.     

Cross-border movement and women's health: how to capture the data

Introduction  

The movement of women across international borders is occurring at greater rates than ever before, yet the relationship between migration and women's health has been under-explored. One reason may be difficulty measuring migration variables including country of birth, length of time in country, immigration status, language ability, and ethnicity. A range of social, environmental, cultural, and medical characteristics associated with the pre-, during- and post-migration phases are also important to consider. The objective of this paper is to present challenges and solutions in measuring migration and related variables via survey-like questionnaires administered to international migrant women.     

Rethinking literacy and women's health: a Bangladesh case study

Health and literacy are two major areas of women's development in the Third World. Although health and literacy have been recognized as essential elements for improving the quality of women's lives, questions emerge from Eurocentric and colonial assumptions about development, including the following: Does literacy have an impact on women's health? If it does, what are the mechanisms whereby literacy could have an impact on women's health? Using Bangladesh as a case study, I question the Eurocentric and colonial nature of dominant discourses in the answers to questions about literacy and women's health. I argue that literacy and women's health need to be reconsidered from the local women's standpoint since dominant discourses fail to take into consideration local women's worldviews, indigenous knowledge, and oral traditions. Finally, I make some recommendations for future research and programming in literacy and women's health in Bangladesh and in health care in Third World contexts.     

Creating Europe-wide health policies: a case study

Many local-level issues have direct parallels within broader transnational and global trends. Using practical examples, this article will share the learning from policy development for England within the broader European context, focusing particularly on the changing partnership dynamics and the opportunities afforded for policy development by the new communications technologies.     

The women's health movement: making policy, 1970-1995

With the advent of second-wave feminism during the 1970s, a significant body of literature emerged describing sexist practices in women's health care. Gender-bias and gender disparities found in women's health care became concerns that garnered considerable attention in the United States because of the increased health risks posed for women. This article describes key historical challenges and accomplishments made in U.S. women's health care policy during the quarter century spanning 1970-1995 that influence contemporary health care social work practice and social work education.     

Unhappy endings: a feminist reappraisal of the women's health movement from the vantage of pregnancy loss

This essay contrasts the rosy birth scenarios of the natural childbirth movement with reproductive disaster stories of members of pregnancy loss support groups and women from toxically assaulted communities in the US who have suffered pregnancy loss. I argue that both biomedical obstetrics and the women's health movement critique of it share a belief in the ability to control reproduction so that there will be a positive outcome. I show that this emphasis on happy endings (whether believed to be the result of medical intervention, or women's natural inborn powers to reproduce) exacerbates the experience of those whose pregnancies do not end happily. I show how the women's health movement's emphasis on the importance of women being in control of their own bodies is related to a broader "culture of meritocracy" which contributes to maternal blame (and self-blame) when pregnancies are not perfect.     

The evolution of women's health education: the Cleveland Clinic's women's health fellowship as a model

Our goal in this paper is twofold. First, it provides a brief overview of the macrotrends in women's health education over the last 25 years. Second, these trends are a backdrop for a discussion of women's health education as exemplified by a detailed review of the curriculum for the Women's Health fellowship at the Cleveland Clinic Foundation. We have termed the underpinning of the curriculum the "leadership triad" consisting of (1) clinical skills, (2) focused research, and (3) interdisciplinary education. These elements are presented in a detailed curriculum for a 2-year fellowship program. We see these elements as fundamental to the Cleveland Clinic's fellowship program, and a useful model for those contemplating or refining their advanced women's health curriculum.     

Women's health policies associated with obesity, diabetes, high blood pressure, and smoking: a follow-up on the women's health report card

This study sought to elucidate associations between state-level policies related to women's health and state prevalence of obesity, smoking, high blood pressure, and diabetes among women. Using data from national sources compiled for Making the Grade on Women's Health: A National and State-by-State Report Card, state policies on key women's health issues were evaluated on the degree to which policies adequately protected women's health. Blocked regressions assessed the policies associated with state outcomes. Antidiscrimination policies were prominent for high blood pressure, smoking, and obesity; models accounted for significant variance for all outcomes. State policies that support women may improve women's health.     

Improving the implementation of health workforce policies through governance: a review of case studies

Introduction  

Responsible governance is crucial to national development and a catalyst for achieving the Millennium Development Goals. To date, governance seems to have been a neglected issue in the field of human resources for health (HRH), which could be an important reason why HRH policy formulation and implementation is often poor. This article aims to describe how governance issues have influenced HRH policy development and to identify governance strategies that have been used, successfully or not, to improve HRH policy implementation in low- and middle-income countries (LMIC).     

'Health's a difficult beast': the interrelationships between domestic violence, women's health and the health sector. An Australian case study

This paper reports on the Australian component of a five nation study undertaken in Australia, Canada, Thailand, Bangladesh and Afghanistan examining policy networks that address women's health and domestic violence. It examines the relationship between health and domestic violence in Western Australia and analyses the secondary role assumed by health. The study adopted a qualitative research paradigm and semi-structured interviews. Snowball sampling was used to identify relevant and significant stakeholders and resulted in a final sample of 30 individuals representing three key areas: the 'health policy community', the 'domestic violence prevention community' and 'other interested stakeholders', that is, those who have an interest in, but who are not involved in, domestic violence prevention work. Results suggest that the secondary positioning of health is associated with the historical 'championing' of the issue in the women's movement; limited linkages between the health policy community and the domestic violence prevention community and within the health policy community itself; the 'fit' between domestic violence and the Western Australian Health Department mandate; and the mis-match between domestic violence and the medical model. The conclusion indicates a need for collaboration based on effective links across the domestic violence community and the health policy community.     

Representation of women's health in general medical versus women's health specialty journals: a content analysis

Background  

Women's health, traditionally defined, emphasises reproductive and maternal conditions without consideration of social contexts. Advocates urge a broader conceptualisation. The medical literature influences the definitions and delivery of women's health care. We compared how women's health was represented in leading general medical (GM) versus women's health specialty (WS) journals.     

Social support: a critical factor in women's health and health promotion

Social networks and social support have been found to be beneficial to the health of individuals in a variety of ways--reducing mortality rates, improving recovery from serious illness, and increasing use of preventive health practices. Social relationships appear to be particularly important to women. Suggestions for health promotion and disease prevention activities include the use of buddy systems, feminist pedagogical techniques, group activities, and linkage to natural supports. Health promotion with women is an underdeveloped area of social work practice with great potential to increase the health of client populations.     

Local enactments of national health promotion policies: A Danish case

Governments of welfare states are firmly committed to public health, resulting in a substantial number of public health policies. Given the multilevel structure of most welfare systems, the influence of a public health policy is related to its ability to spread geographically and move across organisational levels. Visiting, observing, and interviewing 15 policy workers from 10 municipalities during a 2‐year period, this study investigated what happened to a Danish national health promotion policy as it was put into practice and managed in the Danish municipalities. The analysis reveals that the policy was practiced in at least 5 different ways: as an ideal, a cookbook, a tangible artefact, a creative deconstruction, and a mapping. The various practices each enacted a different version of this policy, and some of these enactments brought unintended but valuable effects. Without recognising the concrete enactments and their locally experienced effects, our understanding of national public health policies risks becoming detached from praxis and unproductive. Public health policy makers must pay methodological and analytical attention to the policies' multimodality and their concrete locally experienced effects.