Stress, Depression and Tiredness among Women: The Social Production and Social Construction of Health
Walters, Vivienne, Denton, Margaret, The Canadian Review of Sociology and Anthropology
In their recent review of the sociology of health in Canada, Coburn and Eakin (1993) note that sociologists have paid relatively little attention to the social determinants of health and illness. While other research has revealed persistent links between health status and various sociodemographic variables, such "epidemiological-like studies view the various factors . . . in isolation from one another, as separate factors torn out of the broader social structure within which they are located" (Coburn and Eakin, 1993: 87). With increasing public scepticism of bio-medicine and a growing awareness of the social bases of health and illness, sociologists are well positioned to contribute to debates about the social determinants of health. In addition to the contribution that sociology can make to an understanding of the ways in which definitions of health and illness are socially constructed - exploring the social processes that shape them - the discipline can also help to explain the social contexts in which what we regard as health problems are generated and perpetuated. Sociology can help to unravel the complex links between the social production and social construction of health. And if we are appropriately self-conscious, we can critically reflect on the significance of the growing recognition of the social bases of health and illness.
In this paper, our goals are more modest. We aim to set women's health problems in social context, showing their links with the social and material conditions of women's lives. At the same time we show the difficulties associated with relying on women's own definitions of their health, as they can be shaped by different discourses of health that may influence the reporting of health problems. We present data that were collected in a recent study in Hamilton. The research was prompted by an interest in the social production of women's health and a recognition that much of the research on women's health has tended to focus on reproductive health (Walters, 1991).
The feminist literature on women's health has focussed on the development of a critique of bio-medicine, showing the historical and contemporary consequences of increasing medical dominance and the medicalization of women's lives. Since the earlier work of Ehrenreich and English (1979) and then Riessman (1983), studies have focussed on childbirth (Oakley, 1984), menopause (Fausto-Sterling, 1985; Kaufert and Gilbert, 1987; McCrea, 1983), eating disorders (Currie, 1988; Orbach, 1986) and mental illness (Miles, 1988; Penfold and Walker, 1983; Stoppard, 1988; Walker, 1984). Yet, in seeking to reveal the implications of medicalization and medical dominance, the agendas of feminist scholars have often been shaped by the focus of medicine. This emphasis has been reinforced by the theoretical importance of women's roles with respect to daily and generational reproduction. While they do not constitute the exclusive emphasis, many studies have therefore focussed on reproductive issues: pre-menstrual syndrome (Pirie, 1988), pregnancy and childbirth (Graham and Oakley, 1986), post-partumdear depression (Rosenberg, 1981), various reproductive issues through the life cycle (Martin, 1989) and menopause (Kaufert and Gilbert, 1987). Most recently, attention is being focussed on new reproductive technologies.
Social scientists have directed less attention to the development of what has been called "feminist epidemiology" (Doyal, 1983; Kaufert, 1988) - the social production of women's health. In part, this may be a result of the strong emphasis on historical and qualitative research; the feminist literature has shied away from "counting." There is, however, a growing body of research that traces the links between women's health and their paid and unpaid work roles (e.g., Lowe, 1989; Lowe and Northcott, 1988; Messing, 1991; Messing and Reveret, 1983; Rosenberg, 1984; Tierney, Romito and Messing, 1990). This is one of the strongest themes in this emergent area of investigation, one characterized by different arguments that, although they appear at first glance to be contradictory, point to the complex relationships between work and health. …