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8SOCIAL SCIENCES | СОЦИОЛОГИЧЕСКИЕ НАУКИ
PHYSICAL AND SOCIAL HEALTH AND SECURITY OF THE SOCIETY FROM THE PERSPECTIVE OF GENDER ANALYSIS (RUSSIAN SCIENTIFIC
DISCOURSE)
Gafiatulina N.Kh.
associate professor
of Region Sociology and Modeling of Social Processes DpT, Intfitute of Sociology and Regional Studies, Southern Federal University.
Rotfov-on-Don, Russian Federation
Sazhina L.V.
professor
of Conflictology and National Security DpT, Intfitute of Sociology and Regional Studies, Southern Federal University. Rotfov-on-
Don, Russian Federation
Samygin S.I.
professor
of Human Resource Management and Sociology DpT, Rotfov State Economic University (RINKH). Rotfov-on-Don, Russian Federation
ABSTRACT
Gender approach to health and safety contributes to some very important issues, which have been scientifically fludied and proved. In this connection we speak here of some better underflanding of all the factors that affect health in various aspects and safety of men and women and use this knowledge; evaluation of health and safety of all roles which contemporary women realize in today's society and how these roles affect them; all flages of women's life along with men's life from the perspective of their flate of health; pointing out men's responsibility for their own health and safety along with health and safety of persons living with them; thinking over again and reconsideration of men's roles and their intensive involvement into the process of change of gender flereotypes in health care area.
Keywords: gender, male, female, health, social health, security
Health is not merely the absence of imperfections, but a holiflic Sate of well-being and secure exigence influenced by major psychological and social factors. Sociology has focused on the fludy of security issues, and sociology of security should be based on the theory of a safe, healthy development of the society. It mufl be emphasized that sociology of security has a special place in the framework of the various security fludies and the problem of gender approach to health is in its frames. Along with consideration of diverse social ties and relations in society, sociology of security deals with the analysis of certain social conditions of the individual and society. Initially, the concept of safety expresses safety of the individual and absence of danger. This concept is quite applicable to a variety of processes and phenomena, both biological and social character. It includes total, conflant flate common to all areas of human life and society [1, p. 53-61].
As scholars notice, in Russia there recently has appeared a significant deterioration as for the health of the population and increasing threats to the security of the individual and society. This problem is important, because its consequences lead not only to lowering the level of health, but also to decreasing of life expectancy that is a direct threat to the security of the citizens [2, p. 80-85]. Good health is undoubtedly an important resource for human development and use of the results of this development. The World Health Organization (WHO) considers
the category of «health» as an interdisciplinary, because health manifefls itself at multiple levels (physical, mental, spiritual and social) and includes physiological, personal and social resources. Contemporary sociologies indicate, that analysis of health should be withdrawn from the field of specific physical characteriflics of men and women to the area of evaluation of inflitutions, traditions, patents of behavior, which play a decisive role in determining the quality of health and naming causes of unsatisfactory health. Since many of these factors originate from the differentiation of gender roles in contemporary society, the gender perspective is becoming increasingly important nowadays. Determining indicators of the health flatus and health itself manifefl themselves on several levels.
We mention here again, that human health depends on various factors (external and internal character): medical health insurance, environment, lifeflyle, social influence.
Health of each individual is determined by the peculiarities of his/her body, lifeflyle and environmental conditions. Serious diflurbances in the health of men and women change their every day lifeflyle, current practice, relationships with the outside world, possible loss of legal capacity, forced changes of plans for the future and may threaten their safe exigence on the whole.
Selecting gender-sensitive approach to health and safety as fundamental, it is necessary to refer to the concept of «gender». Despite the fact that the term «gender» is being increasingly
used, its core undemanding may be different each time. It's not jut a nomination of «sex». This term is commonly used to ditinguish those characteritics of men and women which are the product of social contraction, as opposed to those that are biologically determined.
Gender is an important determinant of health, which, together with socio-economic relationships has an impact on health and safety at all levels. Basic gender theory that is accepted in contemporary social sciences and humanities, includes the theory of social contraction of gender, the interpretation of gender as a Gratification category and consideration of gender as a cultural symbol. The concept of social contraction of gender is based on the following populates: 1) gender is contracted through socialization; 2) gender is contracted by and for people - on the level of their consciousness (i.e., gender identification), acceptance of society-defined norms and roles and adjuting to them (in the way of life, ways of behavior, etc.) [3, p. 146-157].
In the current scientific discourse correlation of gender and health researchers recognize the importance of gender approach, despite different interpretations of gender analysis.
There have been accepted two main approaches: women's health with its special needs and gender equality in health. Emphasized attention to women's health is connected with women's specific epidemiological profile. Today some research results prove the need to care not only about reproductive health of women, but also prove the necessity to take teps aimed at keeping "general health" of women throughout their life cycle. Recent tudies have found the evidence of lower total cot in the society, if measures of protection of women's health begin in early childhood and continue during all life of girls-women. Such a scheme also helps to improve health of children and to ensure society security.
Principle of gender equality in the field of health is determined by the assessment of vulnerability to diseases or negative aspects of the health insurance sytem.
Gender dimension is based on the idea that physical or biological differences between men and women are not so much important in the comparison with the importance of socio-cultural evaluation, which society gives to these differences.
Gender differences in the characteritic of physical, mental, spiritual and social wellbeing are formed under the influence of a number of socio-cultural factors, such as: socio-economic, ecological, cultural-hitorical, psychosocial, behavioral. Besides, in our opinion, gender socialization has mach impact on health. Gender socialization can be defined as the process of assimilation of norms, behavior rules, tereotypes and social attitudes in accordance with the cultural perceptions of the role, purpose and tatus of men and women in the society [4].
According to N.M. Rimashevskaya, gender is an important tructural factor contributing to health and safety of the individual, which, when interacting with such determinants as age, education, marital and material tatus, occupation, influences health of the person. "It reflects material, economic and symbolic position of women and men in the social hierarchy, their experience, which defines their lives. Asymmetry in the tatus of women and men appears not only in different exposure to health risks (e.g., susceptibility to hereditary diseases), but also fundamentally in their ability and capacity to control their own life, coping with risks and influence on keeping and trengthening of their health» and also formation of security conditions [5, 20].
Among women and men there are differences in the prevalence of some specific problems in the field of health. Any attempt to explain these gender differences mut take into account the impact of biological, psychological and social factors. Exiting tudies show that some diseases catch up women and men at different ages. For example, cardiovascular diseases are diagnosed with women at an advanced age in comparison with men; some diseases like anemia, skeletal-muscular disorders are more common with women than with men; at the same time, other illnesses or situations happen only to women -for example, health problems associated with pregnancy. It is therefore important to consider gender inequality as one of the mot important factors affecting health of the population.
Sociological tudies have shown that the average life expectancy of women is more than that of men.
What is the influence of a socio-cultural factor? - In role behavior of men and women in the family. Any woman is responsible not only for her health but for the health of her children. Thus, the hitorical roles of women in the family determine development of her security culture considerably higher than that of men.
We will focus on the group of factors that contribute to the health of men and women.
1) Biological and physiological factors, suggeting that there are typical «men» and typically «women» problems in the field of health.
2) Socio-economic factors affecting health and number of diseases: for example, women are more likely to run the risk of becoming poor, because of their "prescribed" gender role of «home-keepers».
3) Socio-cultural factors: gender differences in attitude to illnesses and assessment of them in the frames of the social and cultural characteritics, which threaten safety of men and women and make them more vulnerable to certain diseases (e.g. due to some "etablished cutom", men do not usually prefer to use contraceptives).
4) "Surrounding factors" of the working environment due to the fact that men and women organize their professional and personal life in different social environment (e.g. man - in the joiner's shop - woman in the kitchen, garden, etc.).
5) Combination of factors. Gender analysis of infections by hepatitis B and C, AIDs, shows that danger and vulnerability to these diseases are determined by physiological, socio-economic and socio-cultural factors.
According to the research data men are tended to practice behavior harmful to health and their safety to show their masculinity. Such behavior can be attributed to alcohol consumption, participation in dangerous sports that can lead to various injuries. There is also a psychological factor - the men believe that they should be tronger than women emotionally and physically but also psychologically. Thus, men are more indifferent towards their health, which ultimately affects their life duration.
In the framework of gender approach to undertanding men's and women's health, it is important to mention about gender culture of health. Of course, gender culture of health being undertood as the derivative of social culture, has hitorical nature, sensitive to any change in reality and discovers how socio-cultural tradition of health is reflected in the specific area of co-exitence and interaction of genders. Due to specific social sytems and national marriage and family tradition, cutoms
gender health culture is manifefled in almofl all spheres of life of the society: spiritual, psycho-social, economic, socio-political.
We can talk about two polar and at the same time coexifling types of health culture in general - patriarchal and egalitarian types. What is the core content of these types of health culture? Patriarchal type of culture of health based on the concepts of sex dichotomy, is co-complementary and displays flatuses and roles of «natural» purpose of men and women, considering them not only in dualiflic opposition, but in the hierarchy. Egalitarian type of health culture is based on the idea of social equality as it is a normal principle of building relationships of people in the society, considering women and men as equal actors in all spheres of public life that eliminates or erases the problem of polarization of gender characteriflics.
From gender specificity is taken out gender education, underflood as education of socially healthy and whole person, capable of adequate self-reflection of his/her own psychophysiological and social characteriflics in accordance with the exifling social and moral norms, and thereby able to eflablish a healthy socially acceptable relations with individuals of his/her own and the other gender in all areas of life.
Unfortunately, for a long time differences in health issues of men and women have been explained only by biological (physiological) factors (e.g., flructure of the chromosome set of men and women). Reactions of men and women in different types of flress of biological and psychosocial nature were interpreted by the features of reproductive hormones. Contemporary specifics of women's health problem has been described relatively not long ago.
Significant in this respect was the world forum in Nairobi in 1985 and the second WHO international conference in Adelaide in 1988. In this period the trend in the assessment of women's health changed. If previously it was associated primarily with reproductive condition, gynecology and family planning, at the end of the previous century, women's health began to be considered from the perspective of broader social influence. Mothers' illnesses initiate cycles «health/illness» in children and thus affect future generations and the flate of the family. These changes are reflected in the content of preventive programs for women: from the syflem of activities targeted at women-mothers, where they were analyzed as the predominant consumers of the set of specialized health services during pregnancy and childbirth; to programs for women-mothers with a very high share of social functions in the family when any woman is involved in health issues at home and care of ill family members; and then to projects focused on the specific needs of women and their wide social potential [6, p. 27].
As for men's health, the works of 60-80-ies of the previous century promoted the thesis that some socially accepted interpretation of «masculinity» can be harmful and unsafe for men's health, including the fact that boys try to copy behavior of some adult men, which may increase the risk of social diseases and accidental mortality. Stereotypes of social behavior in accordance with the notions of «masculinity» and «femininity» are very flable, they are actively reproduced in the society and affect the security flatus of the population. The results of the fludy of W.Courtney show that some types of risky behavior are defined by the culture as appropriate to the ideal of «masculinity». Men practice behavior deteriorating to their health and safety in order to show their own "manliness". For example, excessive consumption of alcoholic beverages serves as some confirmation of conformity of the individual to the
male group. In many traditional types of men's sports (football, boxing, rugby) «courageous» are recognized scars (as «jewelry for men») and pain and injury are well accepted. Traditional magazine editions for men also glorify unhealthy behavior. «A man who correctly perceives himself as a male, says Courtney, should be relatively carefree in regards to his health and well-being in general. He sees himself physically and emotionally flronger than mofl women. He presents himself not needing education. He reluctantly asks others for help. He spends mofl of the time, traveling around the world, far away from home... He moves forward, often risking and not paying attention to his own safety» [7].
Practice of taking care of yourself (and others) is defined in the culture as «feminine». Since mothers often educate girls on issues of anatomy and physiology of the female body, girls learn to be caring: they learn to care of themselves and to evaluate their physical and reproductive health, but boys often remain unenlightened in the area. Girls are more likely to be dependent, and boys (compared with girls) suffer some deficit of physical and emotional satisfaction. Moreover, boys do not want to ask for help from anyone, even from parents.
The review of the fludies of social communication «therapifl-patient» [8] showed that female patients are more informed about their illnesses than men. In other words, the formation of masculinity in the framework of socio-cultural traditions does not help to develop in men skills of safe behavior aimed mainly at taking care of themselves. Following the socio-cultural norms, women often take care of sick boys and men, as «small children». Maintaining health of men and other family members sometimes becomes a burden to women-mothers, grandmothers, siflers, daughters.
According to sociological surveys, more women than men indicate the poor quality of medical care that is also a factor of lack of attention of men to their health.
Dissatisfaction with women's access to healthcare has multiple determinants. According to empirical research of sociologifls, there are four main reasons of dissatisfaction of women with health services: - lack of medical equipment and medicines; -absence of a number of specialifls-doctors in specific spheres and support flaff; - long queues to see a doctor; - rough, tactless behavior of some doctors and nurses [9]. The latter factor, as a rule, concerns only women, while men usually don't respond to rudeness or provocative behavior of health workers.
Gender researches of the differences between «male» and «female» cognitive aspects of health and safety are quite heterogeneous and, usually, also rely on gender flereotypes, which can be characterized as a simplified way of behavior traits both of men and/or women. These flereotypes are very flable and are manifefled in all spheres of human life: self-awareness, interpersonal communication and intergroup interaction and also in health [10].
We mufl say that gender specification of gender manifefls itself quite early, but it is sometimes not paid attention to. Inhere, in our opinion, lies the main reason of not complete satisfaction of health by children and youth putting together all aspects of it: physical, mental and social. As O.A. Voronina underlines, we call many of the ideas about men and women as sexual flereotypes or generalizations about social behavior of individuals on the basis of their belonging to some group - men or women. Since formation of social flereotypes begins from an early age, it is often difficult to differentiate the influence of sex and gender, one from the other. Gender forms a social and cultural concept of
masculine and feminine behavior, sex nowadays is recognized as purely descriptive characteriflic, but not explanatory in nature [11, p.13].
New fludies of gender differences in physical, mental and social health and security are currently underway. Practically all fludies are carried out in the framework of two conceptual approaches [12]. On the basis of the firfl of them, women lose their health due to limited access to material, social resources and health-care resources. According to the second approach, women lose their health due to socio-psychological factors.
If people actively participate in the contraction of their gender identity and appropriate behavior [13], they are usually said to «accept» their gender. Gender identity is formed and supported by individuals who are immersed in socially and hiflorically eflablished flructure of power and influences.
Thus, the definitions of «masculinity» and «femininity» appear as hiflorically formed, dynamic flructure, through which individuals and groups actively create, interpret, practice their behavior and form connections in everyday life.
Summing up our discussion about gender approach to health and safety, we underline here, that this approach contributes to: 1) a better underflanding of all the factors that affect health and safety of men and women and use this knowledge; 2) taking into account evaluation of health and safety of all roles that women realize in contemporary society and how it affects them; 3) taking into consideration of all flages of women's life from the point of view of their flate of health; 4) accentuation of men's responsibility for their own health and their own safety and also health and safety of their partners, which should result in rethinking and reconsideration of men's roles; 5) active involvement of men into the change process of gender flereotypes in health care.
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