product? Finally, I will look at the implications for health-care systems of the
differences between the two conceptualizations of women: the 'equal rights'
view of women on the one hand, and on the other the rather more disturbing
notion of women's oppression.

Before producing a shopping list of burning questions, we need to make a
basic distinction among three terms: health, health care and medical care. The
last is the easiest to define: medical care is that provided by a medical
professional, with the aim of treating or preventing illness. Health care need
not be provided by a medical professional, but can be an activity of
non-medical, non-professional groups and even of individuals themselves.
Health, as by far the most complex of the three terms, need not have
anything to do either with health care or with medical care, and here I am, of
course, referring to that substantial body of evidence demonstrating that
changes in broad indicators of the health of communities are rarely brought
about by changes in the provision of medical care. Although this type of
evidence is limited by the indicators of health chosen (since the most
oft-used indicator of health is death -- which is more than strange, when you
think about it), it does point in the direction of a certain definition of health
which is relevant for us at this conference. The definition is that health
requires, or is impossible without, a moral basis of good social relations.

The reason why we need a conference on women and health is because
women are the major social providers of health and health care, and they are
also the principal users of health- and medical-care services. In these two
ways, the truth of the matter negates the dominant cultural message. The
dominant cultural message is that doctors, not women, ensure health and
that men, not women, are biologically the more vulnerable sex, with a
mortality and physical morbidity record exceeding that of women from the
cradle to the grave. ¹ There is therefore something acutely paradoxical about
women's relationship to health and health care which needs to be unravelled.

As providers of health and health care, women are important through their
role in the division of labour. In their domestic lives, they provide health care
by attending to the physical needs of those with whom they live. They
obtain food, provide and dispose of the remains of meals, clean the home,
buy or make and wash and repair clothing, and take personal care of those
who are too young or too old, or too sick or too busy to take care of their
own physical needs. These activities are known as housework, a somewhat

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