CIAO DATE: 09/04

Women, Work, Health, and the Quality of Life: A Summary of the Eleventh International Congress on Women’s Health Issues

Teri G. Lindgren and Afaf I. Meleis

January 2001

Institute on Global Conflict and Cooperation

Summary

Gender equity and equality in health and human development are key goals of the Beijing Declaration and Platform for Action (1995, 2000) and WHO/PAHO policy of “Health for All in the Twenty–first Century.” To achieve these goals the androcentric definition of work needs to be addressed. Although Webster provides a broad meaning to the word ‘work’, social, economic, health, and research policies are permeated by a male, capitalistic perspective that defines work narrowly as that which generates income or produces goods. Women’s work takes place in the areas of social reproduction, social capital, and financial capital. Much of what women do is unpaid and reflects an expected extension of the gender roles, thus is devalued because it does not fit the overriding fiscal model.

Governments, communities, and families have relied on women’s gender roles and their unremunerated, invisible work to promote peace and progress worldwide. Justly distributing the costs of social reproduction between men and women, and among the family, community, state, and market is a challenge facing us all. Changing the definition of work to explicitly value the contributions of women in social reproduction and social capital will have far–reaching consequences, affecting social, economic, health and research policies.

Women and “Work”

Gender equity and equality in health and human development are key goals of the Beijing Declaration and Platform for Action (1995, 2000) and WHO/PAHO policy of “Health for All in the Twenty–first Century.” To achieve these desired goals, barriers must be identified, addressed, and removed. One such barrier is the biased definition of work, which is embedded in and drives policies that may negatively impact women and men’s lives. Work is broadly defined by Webster to include all activities and/or efforts, remunerated or non–remunerated, needed to achieve an object or result. However, in a world dominated by a capitalistic economic model, work is synonymous with labor, employment, occupation, and “substantial gainful activity,” and involvement in the formal labor market becomes the de facto definition of work. This narrow definition has intensified the devaluation of non–income–generating informal and formal activities that frame women’s work worldwide, effectively eliminating this type of work from the economic equation.

Women’s work, encompassing the spheres of social reproduction, social capital, and financial capital, tends to fall into two categories: unpaid work in the home or community, or paid employment. Activities related to social reproduction are typically unremunerated, reflecting a myriad of forms that are culturally defined and usually gendered. The work of social reproduction includes everything that women routinely do on a daily basis, such as: maintaining households, homes, and relationships; caring for children and elders; feeding and subsistence farming; gathering fuel and fodder; and fetching water. However, since this work is not paid for, it is not valued, and its contribution is effectively erased from the global market place.

Social capital, which is the development and maintenance of community safety, harmony, and social cohesion through a web of cooperation, trust, and networking leading to mutually beneficial collective action, is likewise primarily the work of women. From participation in community development projects to volunteering in the community, women sustain an important “public good,” but the creation of social capital is seen as expendable as long as financial capital grows.

In addition to unremunerated work, women also work for money in both informal and formal workplaces. “Paid” work in the informal workplace includes subsistence farming, production of goods in the home, trading or exchanging goods and services, and small businesses. Women also participate to varying degrees as paid labor in the formal workplace. In industrialized countries women’s participation in the civilian labor force ranges from 48.9% (Japan) to 60.7% (US), in comparison to men’s participation, which ranges from 61.6% (Italy) to 76.7% (Japan). In South East Asia, 29–55% of women over the age of 15 are economically active. Yet women earn between 25–40% less than men for the same work, and this disparity is increasing. This disparity is due in part to the sexual segregation of jobs. Women work in areas that tend to reflect traditional nurturing roles, such as nursing, teaching, or service industries. Yet these occupations are not valued, providing the lowest pay, prestige, and decision–making power. This discrepancy is being utilized by transnational corporations the developing world, where female labor is being exploited to produce “cheap” consumer goods for the West.

Regardless of the gender inequality evidenced by earning differences, the number of women who are economically productive is increasing. Women are still expected, however, to shoulder most of the burden of social reproduction that accompanies their gender role. Two–thirds of women’s working hours are unpaid: only one–quarter of men’s hours are unpaid. The unequal, gender–based distribution of unpaid and paid work highlights the inadequacies of the current definition of work as only remunerated work.

Consequences of a Narrow Economic Definition of Work

The current Western definition of work is based on a model that focuses solely on three forms of capital: financial, man–made, and basic resource. This narrow economic focus has impacted socio–economic, political, and health policies related to women and men, as well as affecting research on women and their health. It has limited the recognition of women’s contributions to the social and fiscal well–being of societies, thereby permitting gender inequality and inequity to persist. Indeed, the current definition effectively fosters the continued devaluation of women and reinforces their place as second–class citizens. “Boys are being raised believing women deserve less and are less valuable. Girls are being raised to think that this is correct, they are female and thus not good enough.” This situation is oppressive, permitting the abuse of women in their homes and workplaces, and allows a climate of violence and harassment to persist.

Women’s access to and control of available resources has been restricted because women continue to be seen as nonproductive. This leads to women receiving fewer inputs than men but still being judged according to standards in which androcentric definitions of skills, knowledge, and risk are embedded. This, in turn, has allowed for an unequal distribution of work risks and rewards.

Research into the health and safety consequences of work, including the risks, stress, and overload that women face has been severely limited. Women’s work has been seen as “safe,” but women are frequently exposed to hazardous conditions. This occurs both in the home, from such things as chronic exposure to low–level toxins in cleaning agents, and in the workplace, where stress and repetitive injuries are common. Barriers toward uncovering the risks women face are cyclical: There is little known risk associated with women’s work, so there is little incentive to research the risk. Little research is done on women’s work, leading to little risk being known, and so on. Additionally, using the dichotomous variable employed/not employed has constrained researchers’ abilities to ask questions about interactions of work, health, safety, risks, and strategies within women’s multi–role, multidimensional lives. Although there are some indications of shared themes of stress, devaluation, stigmatization, and overload experienced by women world–wide, data on the full gamut of health risks for women related to unremunerated or low–paid work have not been fully explored.

Access to many social welfare programs in the Western world is based on a male model of work. Unemployment and worker’s compensation can only be accessed through the formal workplace. Social security benefits are indexed to a male–based expectancy of working full–time for 35 years, yet women take an average of 7.5 years off from their employment for family responsibilities. Men on average take 1 year for sabbatical or administrative leave. Cost–containment efforts in health care have been predicated upon the expected availability of the unpaid, invisible work of women, shifting the cost of care from institutions to families without confronting the burden of care placed on the shoulders of women. Likewise, government programs have actively sought women’s unremunerated participation in community work to extend their budgets and still meet their expected goals.

Policies

It is evident that the narrow definition of work supported by a Western capitalistic perspective does not capture the reality of work for women. It reinforces gender inequities, devalues women’s contributions to the economy and social capital, and makes invisible most of the work that women do on a daily basis. Indeed, it continues to marginalize women in the home, the workplace, and in research.

Based on the discussion in this paper, we recommend two broad policy changes. The first is addressed primarily to world leaders and economic decision–makers, such as the economists and planners of the World Bank and International Monetary Fund. National and global economic models must redefine work to incorporate the full scope of women’s contributions to the world product, thereby making visible the economic value of unpaid social reproduction and social capital. The unremunerated work of women can no longer be ignored. It must be taken into consideration when determining resource allocation, compensation, and benefits for both women and men.

The second policy relates to criteria for funded research. The requirement of a more comprehensive definition of work, one that incorporates all dimensions of women’s work, could fundamentally change the nature of research questions and results. The use of work as a dichotomous variable should not be accepted without a justification for its narrowness. Additionally, researchers from many disciplines need to collaborate to develop variables and theoretical models that will expand knowledge of the nature of work and its impact on the lives, health, and well–being of individual women and men, families, groups, and communities throughout the world.

Only through changing social, political, and economic policies will women’s contributions be validated and recognized as essential to world economies. This explicit redefining of work to include women’s work is a major step towards meeting the United Nations’ goals of gender equality and equity, development and peace.