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Social Determinants of Women’s Reproductive Health. Wendy Hellerstedt, MPH, PhD Epidemiology, University of Minnesota. Inequities in Women’s Reproductive Health. May reflect gender inequity within race, age, etc. . U.S. Pregnancy, Childbearing and Abortion Statistics.

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social determinants of women s reproductive health

Social Determinants of Women’s Reproductive Health

Wendy Hellerstedt, MPH, PhD

Epidemiology, University of Minnesota

inequities in women s reproductive health
Inequities in Women’s Reproductive Health
  • May reflect gender inequity within race, age, etc.
u s pregnancy childbearing and abortion statistics
U.S. Pregnancy, Childbearing and Abortion Statistics
  • Average of 3.2 pregnancies per woman
  • Average of 1.8 (57%) pregnancies result in wanted births
  • 85% of adolescent pregnancies are unintended
  • On average, black women (4.6) have more pregnancies than white women (2.7)
consequences of sexually transmitted infections stis
Consequences of Sexually Transmitted Infections (STIs)
  • Systemic infections
  • Infertility
  • Ectopic pregnancy
  • Spontaneous pregnancy loss
  • Preterm pregnancy risk
prevalence of stis
Prevalence of STIs
  • Chlamydia: 322 cases/100,000
  • HIV: 3750- new cases among women each year
  • Human papillomavirus (HPV): as many as 50% of young women infected
  • Bacterial vaginosis: perhaps 16% of pregnant women are affected
  • Pelvic inflammatory disease (PID): 175/100,000 women are hospitalized every year
sti rates
STI Rates
  • 2/3 of new cases are in persons 25 or younger
  • Black women have higher STI rates than white women
  • Low income women have higher STI rates than middle- and upper-income women
aids and women
AIDS and women
  • 4th leading cause of death for black women (ages 25-44)
  • AIDS rate for black females: 59/100,000
  • AIDS rate for American Indians, Asians, and whites: 2-5/100,000
gender roles and health
Gender Roles and Health
  • Two sources of imbalance
    • Societal level – Historical and sociopolictial forces segregate power and ascribe social norms that maintain discriminatory roles
    • Institutional level – Imbalances maintained by social institutes via practices like unequal pay, discriminatory admissions or hiring, and degradation of individuals through the media
gender imbalances and the division of labor
Gender Imbalances and the Division of Labor
  • Allocation of women and men to certain occupations
  • Can occur in the workplace, family, social institutions
gender imbalances employment
Gender Imbalances & Employment
  • Women earn about 78 cents for every dollar earned by a man in a comparable position
  • Women represent:
    • 99% of secretaries
    • 97% of child care workers
    • 20% of lawyers
    • 25% of physicians
issues of working women
Issues of Working Women
  • Child-care issues
  • Support systems for balancing multiple roles
  • Exposures that can effect pregnancy or fertility
  • Worksite-based prenatal and reproductive health counseling
work and women s health
Work and Women’s Health
  • Good health
    • Many studies report work positively associated with self-esteem, perceived health, and physical functioning
  • Poor health factors
    • High-demand and low-control jobs
    • Lack of employment
    • Absence of family responsibilities
    • Time constraints
    • Conflicting responsibilities
    • Non –supportive work environments
gender imbalances in interpersonal power
Gender Imbalances in Interpersonal Power
  • Individual's control over and vulnerability to environmental and behavioral risk affects health outcomes
  • Political institutions, language, etc. convey societal acceptance of gender inequalities in control and authority
e g domestic violence
E.g., Domestic violence
  • Risks of domestic violence
    • Injury
    • Chronic pain
    • Disability
    • Substance use
    • Depression
    • Unintended pregnancy
    • Increased STI risk
    • Adverse pregnancy outcomes
violence and pregnancy
Violence and Pregnancy
  • Estimated that the prevalence of violence during pregnancy ranges from .9-20.1%
  • Violence may be more prevalent than diabetes
  • Gender inequity affects women AND men
  • Importance to keep gender inequities in mind when providing reproductive health care for both men AND women