Suchergebnisse

Women's health, and what we know about it, is influenced by social factors. From the exclusion of women's bodies in medical research, to the silence and stigma of menstruation and menopause, to the racism reflected in maternal mortality, the relevance of social factors is paramount. After a brief history of research on women's health, we review selected patterns, trends, and inequalities in US women's health. These patterns reveal US women's poor and declining longevity relative to those in other high-income countries, gaps in knowledge about painful and debilitating conditions that affect millions of women, and deep inequalities that underscore the need to redress political and structural features of US society that enhance health for some and diminish it for others. We close by describing the challenges and opportunities for future research, and the promise of a social determinants of health approach for advancing a multilevel, intersectional, and biosocial understanding of women's health.

We examined the distribution of health insurance in China during 1997-2006, a period when government interventions were implemented to improve access to health care. We analyzed data from a survey that follows households in nine provinces that are home to more than 40 percent of China's population. The analysis shows that the percentage of individuals with insurance increased from 24 percent in 1997 to 28 percent in 2004 and then rose dramatically, to 49 percent in 2006. Rural and urban levels of insurance coverage became more similar, reflecting a dramatic upswing in coverage in rural areas that is likely to have benefited millions of rural Chinese. At the same time, the analysis suggests that health insurance reimbursement rates to consumers for inpatient care might have declined in rural villages. Because reimbursement and other insurance characteristics affect health care use, future efforts to reduce rural-urban disparities should address the quality of health insurance and the level of reimbursement in addition to coverage rates.

In a set of propositions on fertility transition, Peter McDonald recently proposed that the decline from replacement‐level fertility to low fertility is associated with a combination of high levels of gender equity in individual‐oriented institutions, such as education and market employment, and low levels of gender equity in the family and family‐oriented institutions. Similarly, the "second shift," or the share of domestic work performed by formally employed women, forms a critical piece of current cross‐national explanations for low fertility. Building on this scholarship, the authors explore whether there is empirical evidence at the individual level for a relationship between gender equity at home, as indicated by the division of housework among working couples with one child, and the transition to a second birth. Results, based on a sample of US couples, indicate a U‐shaped relationship between gender equity and fertility. Both the most modern and the most traditional housework arrangements are positively associated with fertility. This empirical test elaborates the family‐fertility relationship and underscores the need to incorporate family context, including gender equity, into explanations for fertility change.

This study examined the role of women's political leadership at the community level in China, a context that has experienced recent political and socioeconomic change and has a distinctive rural-urban divide. Drawing on longitudinal data from the China Family Panel Studies (N = 40,918~52,406 person-year observations), we found that female community directors outnumbered male directors in urban China but were much less common in rural areas. Female community directors had higher levels of human capital regardless of rural or urban location. Residents living in female-directed communities reported better mental health, but not physical health or life satisfaction, compared to those living in male-directed communities, and this association was most robust among rural women. For rural women, the mental health benefit of living in female-directed communities was partially explained by reduced personal experience of gender discrimination, suggesting that female leadership fosters ideational change toward women that lowers discriminatory behaviors among constituents.

AbstractResearch on neighborhoods and health increasingly acknowledges the need to conceptualize, measure, and model spatial features of social and physical environments. When ignoring underlying spatial dynamics, we run the risk of biased statistical inference and misleading results. In this article, we propose an integrated multilevel spatial approach for Poisson models of discrete responses. In an empirical example of child mortality in 1880 Newark, New Jersey, we compare this multilevel spatial approach with the more typical aspatial multilevel approach. Results indicate that spatially defined egocentric neighborhoods, or distance-based measures, outperform administrative areal units, such as census units. In addition, although results do not vary by specific definitions of egocentric neighborhoods, they are sensitive to geographic scale and modeling strategy. Overall, our findings confirm that adopting a spatial multilevel approach enhances our ability to disentangle the effect of space from that of place, pointing to the need for more careful spatial thinking in population research on neighborhoods and health.

The majority of women in China, including mothers of young children, are in the labor force. This article investigates the relationship between mothers' work and child care and explores how type of work affects level of involvement in children's care. Substantive understandings of the relationship between mothers' work and child care may well depend on the way work is conceptualized and measured, especially nonwage work. Nearly two‐thirds of women in China live in rural areas, where nonwage work predominates. Analysis of data from eight provinces indicates that wage workers spend less time in child care, but so do women with heavy nonwage demands. Women's involvement in multiple economic activities has consequences for both work‐child care compatibility and work intensity, and may be especially important in efforts to categorize women's work in industrializing economies. Because the majority of the world's women do not work in the wage sector, the implications of these findings extend beyond China.