Module 1.2 health status


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Module 1.2 health status

  1. 1. Women’s Health Status
  2. 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. 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. 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. 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]
  6. 6. 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
  7. 7. How Do We Measure Health? Official Records  Death  Birth  Hospitalizations Surveys  National  Local  Community
  8. 8. 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?
  9. 9. 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
  10. 10. 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
  11. 11. 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
  12. 12. How Do Women Fare? Live longer (Mortality) but more chronic disease and disability (Morbidity) Differences exist among women by…  Class  Region  Race/Ethnicity
  13. 13. 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
  14. 14. 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
  15. 15. 2011 HHS Poverty GuidelinesPersonsin Family or Household 48 Contiguous States and D.C. Alaska Hawaii1 10,890 13,600 12,5402 14,710 18,380 16,9303 18,530 23,160 21,3204 22,350 27,940 25,7105 26,170 32,720 30,1006 29,990 37,500 34,4907 33,810 42,280 38,8808 37,630 47,060 43,270For each additionalperson, add 3,820 4,780 4,390SOURCE: Federal Register, Vol. 74, No. 14, January 23, 2009, pp. 4199-4201
  16. 16. 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
  17. 17. 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 WhitesKaiser Family Foundation Publication #6089-09
  18. 18. Types of Discrimination Race/ethnicity Age Gender Sexual Orientation Health Status Weight Behaviors SES
  19. 19. 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
  20. 20. Model of Discrimination & Health StressDiscrimination Health Unequal Treatment
  21. 21. Model of Discrimination & Health StressDiscrimination Behavior Health Unequal Treatment