SEE ALSO activism; gender mainstreaming; inequalities agenda; injury; Maternal, Newborn and Child Health; men’s health; reformers; sexual health; violence; zero-sum
Women’s health is concerned with identifying, preventing and treating conditions that are most common or specific to women (WHO, 2013b).
Women live an average of four years longer than men but suffer from a significant burden of ill health of both non-communicable and communicable disease. For women aged 15–44 years, HIV/AIDS is the leading cause of death worldwide with maternal deaths as the second largest cause of women of reproductive age. Cervical cancer is the second most common type of cancer in women with all cases linked to a sexually transmitted genital infection with the human papilloma virus. Violence against women is widespread and for women who have been physically or sexually abused this can lead to higher rates of mental ill health and unintended pregnancies. Public health interventions for women’s health have addressed a range of issues including reproductive and sexual health, female genital cutting, maternal health, the menopause, breast and ovarian cancer, osteoporosis and gender-based violence (WHO, 2013b).
Women have historically come together to share their knowledge and experiences about health and in particular activist groups have played an important role in this networking relationship. Code Pink, for example, is an international organization dedicated to uniting women against domestic violence. The group follows feminist ideals and advocates open and respectful communication and creative tactics. Code Pink uses the internet, media coverage, pop culture and protests that offer highly visual events to attract public and political attention. Code Pink has also created a number of partnerships with other organizations concerned with men’s health (Code Pink, 2012).
Women’s health movements have fought for their right to choose and be informed about better health options. The first birth-control pill, for example, became available as a prescription drug in the 1960s in the United States. Though it was initially met with enthusiasm, investigations by women’s health groups exposed the risks of such a highly hormonal, and largely untested, fertility regimen and, more significantly, exposed the lack of information shared with women as patients, who took the pill every day. The pill remains a popular method of birth control but women are no longer expected to take instructions on the choice of contraception without question (Daly, 2007). Another example of the work of women’s groups in regard to health occurred in the 1970s when the standard procedure in the United States for breast cancer was to perform a tumour biopsy and radical mastectomy in a single surgical operation. This was a very invasive procedure in which muscle tissue and lymph nodes were removed along with the breast but most doctors would not perform a separate diagnostic biopsy. Women fought for their right to make decisions about their own bodies thus openly challenging the medical profession until the standard treatment for suspected cases of breast cancer was changed to a total simple mastectomy as the primary surgical treatment (Lerner, 2001).
Associating health issues to one gender fails to recognize the key role that gender relations play in the generation of specific social and health practices for both men and women. Gender mainstreaming in which gender equality is achieved by integrating women’s and men’s issues aimed at improving health (Smith and Robertson, 2008) is a seen as a preferable and advanced approach to gender-based health concerns.
Activism will continue to be a key strategy for women’s groups in regard to their health and rights, for example, for a commitment to non-discrimination and informed consent. This is because in many societies women still struggle for the right to be better informed and to be able to make decisions about their own bodies. To redress these imbalances of power will require radical action, evidence-based strategies and the support of the public health profession.
•Daly, S. (2007) ‘Women’s Health Activism’ in G. L. Andersen and K. G. Herr (eds), Encyclopedia of Activism and Social Justice (London: Sage)
•Dubriwny, T. (2012) The Vulnerable Empowered Woman: Feminism, Post Feminism and Women’s Health (Critical Issues in Health and Medicine) (Biggleswade, UK: Rutgers University Press)
•World Health Organization (2013b) Women’s Health. Available at http://www.who.int/topics/womens_health/en/ Accessed 21 January 2013
SEE ALSO health promotion; injury; non-communicable disease; social determinants of health; violence
A workplace health approach is based upon four fundamental complementary principles: health promotion, occupational health and safety, human resource management and sustainable development (Chu et al., 2000).
Workplace health took on a renewed impetus after the 60th World Health Assembly in 2007 that endorsed the WHO Global Plan of Action on Workers’ Health (2008–2017). The Plan stipulates the need to address all aspects of workers’ health, including primary prevention of occupational hazards, protection and promotion of health at work and improved response from health systems to workers’ health. To promote workers’ health the workplace should not be detrimental to health, priority should be given to the prevention of occupational health hazards and an integrated response to the specific health needs of working populations should encompass all components of health systems and all of the workplace community.
‘A setting is a place or social context in which people engage in daily activities and in which environmental, organizational and personal factors interact to affect health and wellbeing’ (WHO, 1998, p. 19). Examples of workplace settings include factories, offices and hospitals. Settings can be used to promote health by reaching people who work and spend time in them, using them to gain access to services, through the interaction of different settings with the wider community, through change to the physical environment or an organizational structure. The approach aims to make systematic changes to the whole work environment by focusing on the core activities of the setting and not just as a channel through which to access and educate people (Naidoo and Wills, 2009).
The built environment refers to the human-made surroundings that provide the setting for activities including buildings, green spaces, neighbourhoods, cities and supporting infrastructure such as water and energy networks. In public health, the built environment refers to physical environments that are designed with health and wellness as integral parts of communities. Studies have shown, for example, that built environments designed to improve physical activity are linked to higher rates of physical activity, which in turn, positively affects health (Carlson et al,. 2012). The social environment refers to the immediate physical and social setting in which people live or in which activities happen. It includes the socio-cultural context, the people, places and institutions in which and with whom they interact. The interaction may be in person or through social media, which has helped to promote ‘global communities’ and ‘digital cities’ by building arenas in which people can interact, share knowledge, experience and mutual interests (Nomura and Ishida, 2003).
Occupational safety and health, also called occupational health and safety or workplace health and safety, is concerned with protecting and promoting the safety, health and welfare of people at work and in employment. Occupational safety and health applies to everyone including co-workers, employers, customers and those who might be affected by the workplace environment. The main focus is on the maintenance and promotion of workers’ health and working capacity, the improvement of the working environment to become conducive to safety and health and the development of a working culture which supports health and safety at work. Occupational safety and health also promotes a positive social climate and the enhancement of productivity. The concept of working culture is reflected in practice in the managerial systems, personnel policy, principles for participation and training policies. Employers and their organizations have a duty of care to ensure that employees, and any other person who may be affected by their activities, remain safe at all times. If an organization fails to protect the safety and health of others there is specific legislation in many countries that can be used to instigate punitive and compensatory action. The International Labour Organization sets standards on occupational safety and health and provides essential tools for safety at work. In 2003 the International Labour Organization adopted a global strategy to improve occupational safety and health including a preventive safety and health culture, the promotion and development of relevant instruments, and technical assistance (International Labour Organization, 2004).
The concept of the health-promoting workplace is a reorientation of workplace health promotion developed to be more holistic and to address both individual risk factors and broader organizational and environmental issues. For example, instead of using the workplace setting as a convenient location to change individual behaviours, workplace health promotion involves both workers and management collectively, endeavouring to change the workplace into a health-promoting setting (Chu et al., 2000). Organization-wide approaches to promote positive mental health at work can reduce work-related stress, enhance job control, increase staff involvement and productivity. In the United States, employee-assistance programmes provide counselling services for employees and their families and have been found to be highly cost-saving, with improvements in productivity and a reduction in absenteeism (Kelly et al., 2005).
KEY TEXTS
•Chu, C. et al. (2000) ‘Health-Promoting Workplaces – International Settings Development’, Health Promotion International, 15 (2): pp. 155–167
•Naidoo, J. and Wills, J. (2009) Foundations for Health Promotion. 3rd edn (Edinburgh: Bailliere and Tindall), Chapter 14.
•Scriven, A. and Hodgins, M. (2011) Health Promotion Settings: Principles and Practice (London: Sage)