Health Care Biases against Women

Health Care Biases against Women



Abstract

This essay explores an alternative paradigm for epidemiology, one which is explicitly informed by the feminist perspective. We intend to expand upon recent critiques and debates within emergent fields of “critical”, “popular”, and “alternative” epidemiology to examine how epidemiology's conceptual models — which are meant to contribute to prevention of social inequalities in health, but may instead reinforce social hierarchies based on gender, race, and class — constrain our understanding of health and disease.

Table of Contents

INTRODUCTION4

BODY: DISCUSSION AND ANALYSIS4

Critical epidemiology7

Popular epidemiology9

CONCLUSION11

Health Care Biases against Women

Introduction

If biological finality of death can only be explained in wider social context then complex realities of women's sickness and health must be explored in similar ways. In order to do this, traditional epidemiological methods have to be turned on their head. Instead of identifying diseases and then searching for cause, we need to begin by identifying major areas of activity that constitute women's lives. We can then go on to analyze impact of these activities on their health and well being. (Barroso 1994)

Body: Discussion and Analysis

Epidemiology is currently engaged in the moment of critical self-reflection, debating its models, theories, methods, levels of analysis, guiding principles, ethics, and future role in protecting public's health. 1 These debates have been precipitated by increasing concern over “reductionism” of mainstream, university and government-agency-funded epidemiology in United States. Namely, critics from within epidemiology have argued that epidemiology, as “basic science” of public health, has adopted the biomedical, clinical science model for study of disease “risk factors”, which has taken epidemiology away from its fundamental roots in public health . In particular, myopic focus of biomedicine on micro level causes of diseases in individuals (e.g., human genes, infectious agents) has subsequently been translated within “modern”, “analytical”, “risk factor” epidemiology into the “single exposure-single disease” paradigm of illness that does little to generate effective preventive health strategies, especially for chronic illnesses. (Beck 1992)

Critical epidemiology

The critical epidemiology of Krieger and colleagues,4 which includes provocative, feminist-informed insights on nature of contemporary epidemiological practice, provides the crucial springboard for more explicit feminist epidemiological approach to be described below. (Beck 1992)

Krieger and colleagues criticize empirical methods and underlying constructs of US epidemiological research and describe the newly emerging approach for investigating relationship between racism, sexism, classism, and health “that has yet to be synthesized into the well-defined paradigm”. Although Krieger and her colleagues do not explicitly mention feminism, critical gender theory, or women's studies in their “new approach”, feminist methodological strategies and research principles appear to be guiding their work, including their path breaking epidemiological studies of race, class and gender oppression in women's health outcomes. (Beck 1996)

The critical, feminist-informed stance advocated by Krieger and her colleagues includes all of following elements: (1) collapsing binary constructions of biological/social, body/mind, physical/spiritual to explore dynamic interplay between exposure and susceptibility in determining “risk”; (2) continuously and reflexively asking how gender/race/class/nation function on individual, family, societal, and global levels in shaping daily life and experiences of health and illness; (3) ...