Women's Health, Women's Lives

What Makes Women Sick: Gender and the Political Economy of Health. Lesley Doyal. New Brunswick, NJ: Rutgers University Press, 1995. xii. 280 pp.
Gender and Health: An International Perspective. Carolyn F. Sargent and Caroline Brettell. eds. Upper Saddle River, NJ: Prentice-Hall, 1966. + 370 pp.
Women, Poverty and AIDS: Sex, Drugs and Structural Violence. Paul Farmer. Margaret Connors. and Janie Simmons. eds. Monroe, ME: Common Courage, 1966. xxi. 473 pp.
Choosing Unsafe Sex: AIDS-Risk Denial among Disadvantaged Women. E. J. Sobo. Philadelphia: University of Pennsylvania Press, 1995. ix. 232 pp.
Women in Pain: Gender and Morbidity in Mexico. Kaja Finkier. Philadelphia: University of Pennsylvania Press, 1994. xix. 238 pp.     

Women's health. The childbearing years and after.

Health and development planners have tended to see women primarily in context of their reproductive role. As a result, solutions to women''s health needs have been restricted to expanding and improving maternal and child health systems. There has recently been a major shift in direction, largely because of the influence of the world conference on population and development held in Cairo in 1994. Dr Guiseppe Benagiano, director of the special programme of research, development and research training in human reproduction based at the WHO, says, "We need to remind ourselves constantly that reproductive health is not simply a biomedical issue but one with serious implications for our general health and by extension, for all our efforts in human social and economic development." The 1993 world development report on health identified the lack of a clear strategy for engaging women in health care and suggested that child health services, prenatal care, treatment of sexually transmitted diseases, and family planning services should be provided jointly at convenient times. In an example of this, the Chilean Institute of Reproductive Medicine now offers integrated family planning services at the same time as child health services, and Thailand is experimenting with mobile health clinics to reach women in their homes. As the proportion of elderly women increases, old age is increasingly being seen as a female issue. With the impact of urbanisation and industrialisation, more of these women are living isolated lives, often suffering from chronic debilitating diseases. In his opening statement to the global commission on women''s health in April 1995 which focused on health conditions of women in old age, Dr Hiroshi Nakajima, the WHO''s director general, said: "Our goal should not be solely to extend lives in the physical sense, but to ensure that the added years are worth living."     

Women's mating strategies

What does a woman want? The traditional evolutionist's answer to Freud's famous query is that a woman's extensive investment in each of her children implies that she can maximize her fitness by restricting her sexual activity to one, or at most, a few high-quality males. Because acquiring resources for her offspring is of paramount importance, a woman will try to attract wealthy, high-status men who are willing and able to help her. She must be coy and choosy, limiting her attentions to men who are worthy of her and emphasizing her chastity so as not to threaten the paternity confidence of her mate. The lady has been getting more complicated of late, however. As Sarah Hrdy¹ predicted, we now have evidence that women, like other female primates, are also competitive, randy creatures. Women have been seen competing with their rivals using both physical aggression^2,3 and more subtle derogation of competitors.⁴ While they are still sometimes coy and chaste, women have also been described recently as sexy and sometimes promiscuous creatures, manipulating fatherhood by the timing of orgasm^5,6 and using their sexuality to garner resources from men. The real answer to Freud's query, of course, is that a woman wants it all; a man with the resources and inclination to invest, and with genes that make him attractive to other women so that her sons will inherit his success. Her strategies for attaining these somewhat conflicting aims, and her success in doing so, are shaped by her own resources and options and by conflicts of interest with men and other women.