Vivienne Walters

Stress, anxiety and depression: Women's accounts of their health problems

In a study of a stratified random sample of 356 Canadian women, stress, anxiety and depression were among the most frequently reported health problems. The first part of this paper outlines the different social characteristics of those who reported stress, anxiety and depression. Women experienced mental health problems differently depending on their socio-economic status, ethnicity, family structure, the quality of family relationships and the nature of their participation in the labour market. It is argued that we need a more detailed analysis of these aspects of womens estate if we are to understand the social production of mental health and variations between women. Subsequent sections of the paper discuss womens own understanding of the sources of their mental health problems. While they spoke of the particularities of their own lives, these were often located in the context of broader social influences. They emphasized the social aetiology of mental health, noting the importance of gender roles and images of women. They described the heavy workload of women, issues of identity and their social legacies. In conclusion, it is noted that women appear to normalize the mental health problems they report. This may, in part, reflect the lack of social reinforcement and validation of their experiences.

Paid work, unpaid work and social support: A study of the health of male and female nurses

Paid work, unpaid work in the home and social support are important elements of the social production of health and illness, though their combined effects on both women and men have only recently become a focus of research. This paper examines their association with the health problems of nurses, presenting data from a survey of a proportional random sample of 2285 male and female nurses registered in the Province of Ontario. The data are first analysed for the full sample and then multiple regression analyses are run separately for male and female Registered Nurses. The demands of paid work (overload, exposure to hazards), unpaid work (time pressures, caring for a dependent adult) and overall stress in life are associated with greater health problems. There is also evidence of significant links between social support and health. A poor relationship with a supervisor is associated with health problems. On the other hand, enjoying a confiding relationship with a friend and having up to 4 children reduces the likelihood of experiencing health problems. The features of nursing associated with fewer health problems are challenge, statisfaction with work and working under 20 hours a week. Several common themes emerge in the analyses of women and men: overload, hazard exposure, satisfaction with work, having 3-4 children and level of overall stress in life. Yet the models are also very different and point to the need for further analyses of the social production of health problems in relation to gender. They also suggest that female nurses, in particular, may suffer the effects of restructuring in the health care sector. Workload issues are especially important for women. Younger women, those reporting time pressures and caring for a dependent adult are more likely to report health problems. Having a confiding relationship with a friend is associated with fewer health problems for women. Among men, those who dislike housework are more likely to experience health problems. Satisfaction with work and overall stress in life were associated with health problems for both men and women, though there may be gender differences in what generates satisfaction and stress.

Chronic stress and the social patterning of women's health in Canada

Existing research on the social patterning of womens health draws attention to the significance of social roles and socioeconomic position. Although we know a great deal about health differences according to the occupancy of these positions, we know a lot less about why such patterns exist. This paper addresses this gap by examining the pathways through which social structure is linked to health using data from a 1994 Canadian national probability sample of women, aged 25-64 years. We begin by charting differences in womens self-rated ill-health, distress, and reports of long-standing health conditions by socioeconomic position and social role occupation. We then assess the extent to which these patterns can be understood in relation to the chronic stress arising from these social locations. Socioeconomic position, assessed by housing tenure, education, and household income, was positively related to health. Employment enhanced womens health, as did being currently married and a mother living with children. The ongoing stressors that distinguish the experiences of various structural locations accounted for some of the health effects of social structure, particularly for socioeconomic position. However, chronic stress was largely irrelevant to the pathways linking social roles to health. In fact, employed women and parents living with children enjoyed better health despite their greater stress.

The Effectiveness of Bill 70 and Joint Health and Safety Committees in Reducing Injuries in the Workplace: The Case of Ontario

The shift towards the internal responsibility system and the mandating of Joint Health and Safety Committees in the early 1980s represented a radical departure in terms of how health and safety were regulated in the workplace. This paper examines the effectiveness of this institutional change using firm level data provided by the Workers Compensation Board on lost time accidents from 1976 to 1989. It finds that where management and labour had some sympathy for the co-management of health and safety through joint committees, the new system significantly reduced lost-time accident rates. At workplaces where either labour or management resisted the spread of co-management the mandating of committees appears to have little effect on lost-time accident rates.

Complaints against nurses: a reflection of 'the new managerialism' and consumerism in health care?

This paper discusses the effects of restructuring on nursing as a profession through an examination of the issue of complaints in Ontario. It argues that new managerialist techniques and associated changes in the nature of work are reducing the autonomy of nurses and making it difficult for them to meet the standards of their profession. Simultaneously, the Ontario government has increased the power of the public in the disciplinary process and the College of Nurses of Ontario is encouraging patients to register their complaints. The growth of consumerism in health care, coupled with the disciplinary process, individualizes complaints and deemphasizes their relationship to restructuring. Moreover, in response to the increasing number of complaints - complaints which more often come from the public - nursing organizations have encouraged the legalization of the disciplinary process, thus fostering the individualization of the issues.

I just cope from day to day: Unpredictability and anxiety in the lives of women

Data are presented from in-depth interviews with 35 women in an industrial town in South Wales, U.K., many of whom were from low income households. The research aimed to explore womens own concerns about their health and the ways in which health problems affected their lives. This paper focuses on one prominent theme in these interviews: unpredictability. In particular, women described how their lives had become less predictable and amenable to control as a result of health problems--epilepsy, asthma, ME, anxiety, nerves and panic attacks, for example. Womens accounts are used to show how they experienced these problems, how they influenced womens self-identity and the ways in which women struggled to cope with the dreadful uncertainty that characterized their days. They often hid these problems, and the privacy of this aspect of their lives is striking. The data are set within the context of class and gender relations which diminish womens control over their lives and erode their self-esteem and sense of autonomy. Class and gender combine with ill health to create the conditions for womens sense of unpredictability and powerlessness. They can aggravate and provoke the health problems women described: women spoke of the challenges they faced in their roles as wives and mothers, the problems associated with widowhood, the loss of their jobs, the impact of unemployment and their efforts to cope with severe financial problems. In part, these provided them with a framework for understanding the uncertainty, anxiety, nerves and panic they experienced.

Age and Gender in Women’s Accounts of Their Health: Interviews with Women in South Wales

In-depth interviews with 35 women in a working-class community in South Wales suggest that there are generational differences both in the ways women talk about health and in their health experiences. These are linked with women’s differing social circumstances; changes over time in the ways in which health and ill health are explained; and the physical changes which are an unavoidable part of embodiment. The ability to perform their roles with respect to social reproduction was a key element in women’s definitions of their health. Older women talked about arthritis and the ways in which it was a challenge to keep doing things while younger women talked about the stress they felt in juggling the roles of mother, wife, daughter and worker. Younger women were also more likely to talk about the problematic nature of gender relations and high levels of unemployment. Age thus structures women’s health problems and the ways they explain them.

Company doctors' perceptions of and responses to conflicting pressures from labor and management.

Company doctors are faced with contradictory pressures generated by conflicts between labor and management. This paper examines the primary areas of conflict reported by a sample of company doctors in Ontario, Canada. It shows how doctors are constrained by pressures and how the structural context of practice shapes the nature of occupational medicine and encourages policies and practices which tend to be biased toward corporate interests. Doctors manage contradictory pressures by excluding certain contentious issues from their sphere of responsibility, attempting to improve lines of communication with workers and unions, and claiming the role of objective third party on the basis of their medical expertise. This claim to medical objectivity and neutrality is an element of professional ideology which legitimizes their role and inhibits their examination of the conflicting interests of labor and management in relation to occupational medicine.