Assignment#1 Factors Affecting Women’s Health, Well-Being and Quality of Life
New York City College of Technology
Prof. Lynda M. Konecny
Tatyana Lekomtseva
Fall 2013/ NUR 4020
09/24/13
1. Identify the variety of factors that impact on the health of each of these groups: poor, ethnic minority, elderly and lesbian women.
a. Poor women
Generally, women of lower socioeconomic status have poorer health outcomes and die sooner than those in higher income groups (Williams, Cunich & Byles, 2013). Single women, especially single mothers are more at risk for becoming poor during their lifetimes (Condon, 2004). According to (Condon, 2004), about half of all single Latina and African American either are poor or on the verge of poverty. Poor education, low income and unhealthy living and working conditions are common social and economic factors that associated with poor health (Williams, Cunich & Byles, 2013). Poor education can be a significant factor that impact on the health of women. Poor women have less educational and vocational opportunity, which in turn, leads to having only low paying and low status job (Williams, Cunich & Byles, 2013). What is more, even in positions of equal value, women are often paid less than men. Furthermore, many of these low status job do not offer health insurance or employee health benefits. Poor education also can be significant factor that impact on preventive care. According to Condon (2004), health promotion, screening, and disease prevention also correlate with low education. Many studies have found that for women who have attained higher education and higher incomes to be more likely than other women to use screening tests such as a Pap smear, mammography and breast self-examination (Condon, 2004). Greene (2008) reported that early pregnancy and childbearing became both causes and effects of poverty. Early childbearing reduces women’s ability to have an education.
Low income is one of the factors that impact on health. It became a strong predictor of women who don’t use healthcare services and is associated with poor health outcomes (Condon, 2004). Most poor women have no health insurance and lack the funds to get health services or to engage in health-promoting activities (Condon, 2004). The chances of a child’s dying during the first year of life are much higher in poor families than in the middle class (Schaefer, 2006). This higher number results in part from the inadequate nutrition received by low-income mothers. Poor nutrition can cause weakness, exhaustion and make women more susceptible to infections. Hungry women can be so weak that they won’t have enough breast milk to feed their babies. Healthy food is critical to women’s health. According to Condon (2004), “many diets of American women from low income class are high in animal proteins sugars, fats and alcohol and low in fiber and other essentials nutritions”. Poor diets and lack of exercise are major contributors to “chronic illness such as coronary heart disease, cancer, diabetes, hepatitis, arthritis, and osteoporosis” (Condon, 2004). Women with low income become ill because of poor nutrition, poor living conditions, and high stress level. Poor women are often overwhelmed by the emotional, social, and financial stresses in their lives and they have no power to comply with any treatments.
Unhealthy living and working conditions are another factors than can have impact on women’s health. According to Condon (2004), “Native Americans have high rates of infectious disease because of inadequate sewage disposal and contaminated water on reservations”. High percentage of poor women live in high-poverty neighborhoods where they are more likely to be assaulted, raped, or even killed (Schaefer, 2006). According to Schaefer (2006), another factor in the link between poor women and health is working conditions at the work place. Poor women are more likely to be exposed to difficult working conditions such as long hours, dirty and physically demanding jobs, shift work, and temporary jobs (Schaefer, 2006). Women who are working under temporary contracts can experience higher stress and anxiety because of job insecurity.
b. Ethnic minority women
The health profiles of many ethnic minorities reflect the disparities in the United States. The disparities occur for a variety of reasons including unequal access to health care, discrimination, language and cultural barriers( Condon, 2004). Poverty, low education, and lack of social support also can contribute to the poorer health outcomes for this group of women. According to Condon (2004), ethnic minority women who tend to have low paying job or even no job, are more likely to be uninsured. Ethnic women may receive lower-quality insurance and use public clinics compare with wealthier women. As a result, “ African American women have higher death rates from heart disease, pneumonia, diabetes and cancer” (Condon, 2004). Compared with white women, the death rate from stroke is twice as high among African American women (Schaefer, 2006).
Despite having access to healthcare, many ethnic minorities are treated unequally as a result of racial prejudice. According to Schaefer (2006), the stress resulting from racial prejudice and discrimination helps to explain the higher rates of hypertension found among African American women compared to white women. Falling to seek treatment early and to use screening tests, plays a significant role in increasing risk of developing chronic illness and poor health (Condon, 2004). Many healthcare providers can use discriminatory behaviors toward ethnic minority women. These behaviors include ” lack of respect, inattention, and judgmental remarks” (Condon, 2004). As a result of such unprofessional behavior, ethnic women are not coming back for continued care.
Many ethnic minority women adhere to cultural beliefs that make them less likely to use the formal healthcare system. For example, many Mexican women may interpret their illnesses according to traditional Latino folk medicine (Schaefer, 2006). Many Mexican women will consult with their folk healers first because health care providers are not believed to be knowledgeable in treating such illnesses (Estes, 2006). African American women can use home remedies first and may not seek the medical help and treatment until illness is serious (Estes, 2006). Many ethnic minority women may experience a variety of language barriers. Many women do not speak English and must rely on their family members for the translation of very private information. According to Condon (2004), lack of fluency in English prevents many ethnic minority women from participating fully in health care facility where health information materials are not available in their native language.
c. Elderly women
Changes in health occur with advancing age. Many social and economical factors can contribute to poorer health outcomes in elderly women. Low income and poverty, inadequate health care and cultural barriers all contribute to the health of elderly women.
According to Schaefer (2006), the high poverty rates are among the groups who were more likely to be poor at earlier points in the life. It is true for elderly members of racial and ethnic minorities and female-headed households. Conditions related to high degrees of poverty affect the health of elderly women and include poor nutrition, depression, poor living conditions and inadequate health care (Condon, 2004).
Researchers Xu, Patel, Vahrsatian and Ransom (2006) indicated that elderly women’s health insurance coverage may significantly affect their health behavior. Elderly women who didn’t have health insurance reported significantly worse in their health status (Xu et al., 2006).” Women who had health insurance coverage were more likely to visit their family doctor or dentist, use prescription medications and have a hospital stay” (Xu et al., 2006). Adequate health care such as regular screening services and follow-up checks could help elderly women detect many illnesses in the early stages and save their lives (Xu et al., 2006).
Cultural barriers can contribute to the poor health of elderly women. Beliefs about health and illness are even more important for the elderly women. Elderly women especially ethnic minority have more distrust of the healthcare system due to perceptions of the healthcare system as insensitive (Condon, 2004). Elderly women tend to use folk medicine, home remedies or even prayers.
d. Lesbian women
According to Condon (2004), “ the lesbian population is as diverse as the population at large and crosses all ethnic, religious, and economic boundaries ”. Lesbian women are at risk for the same health problems as other women including sexually transmitted diseases (Condon, 2004). The major barrier to optimal healthcare for lesbian women is societal prejudice against them (Condon, 2004).
Lesbian women experience significant health disparities in preventive health care and health outcomes (Hutchinson, Thompson & Cederbaum, 2006). Researchers indicated that lesbians are less likely than others to have health insurance coverage than heterosexual women (Hutchinson, 2006). It is possible because of common discriminatory policies in the workplace where employers may not add same-sex partner onto a health insurance. Another important factor in lesbian women’s avoidance to seek preventive care is related to their perceptions of healthcare providers (Condo, 2004). According to Hutchinson (2006), lesbian women who felt that their doctor was sensitive and knowledgeable of lesbian issues and needs were more likely to have preventive screening. What is more, they were more likely to comply with treatment and return for follow-up care.
2. How does women’s culture influence their health beliefs and practices?
All cultures have their own health beliefs and practices. According to Condon (2004), health beliefs and practices can influence women’s responses to illness, pain, and treatment. It is very important for all health providers including nurses to understand the health belief patterns of female patients which can be very helpful in understanding why women may refuse to participate in a given treatment or why they insist on a specific treatment ( Estes, 2006). The health beliefs and practices are coming down through the centuries from one generation to another. And each generation can add something new to this pile. Cordon (2004) identified “ three major health practice paradigms such as the magico-religious, the holistic, and the biomedical” . All cultural groups who use the magico-religious practice may believe that illness can be caused by supernatural forces. What is more, spirits can can cause not only illness but also death or misfortune. Another type of the health practice paradigm is the holistic paradigm. The main idea in the holistic paradigm is that people should remain in balance with nature and the environment.(Cordon, 2004). The last one is the biomedical paradigm. This health practice paradigm is based on the scientific model. The scientific model is based on the cause-and-effect relationship. According Cordon (2004), the magico-religious paradigm and the holistic paradigm are important in the Mexican, the Haitian and Native American cultures. Chinese health-related beliefs are based on the holistic paradigm.
The holistic paradigm is based on the old Chinese philosophy. Many Chinese women may view their health as gift from parents and ancestors and also as the result of a balance between yin (cold) and yang (hot) (Estes, 2006). Illness caused by an imbalance. That’s why Chinese women prefer to use medical care system together with Chinese methods of acupuncture ( a yin treatment) and moxibustion ( a yang treatment where heated wormwood can applied to appropriate spots). Some Chinese health-related beliefs can cause problems between Chinese women and American healthcare providers. For example, Chinese women believe that by using moxibustion treatment during labor and delivery may help to turn breech babies. Another health-related belief is that lack of blood and lack of internal energy may produce long illness (Estes, 2006). Blood is the source of life. As a result, Chinese women may fear painful, intrusive tests especially the blood test. Chinese women have a respect for the body and belief in reincarnation. “Women from this cultural group may refuse autopsy or intrusive surgeries because of their belief that person must die with the body intact “ (Estes, 2006). In addition, Chinese women believe that a good doctor can accurately diagnose an illness by using only his or her senses such as touch, smell, vision and listening (Estes, 2006). Chinese women may not to trust their health care providers who order and use intrusive diagnostic tests.
Native American women’s health beliefs and practices are based on two old paradigms such as the holistic paradigm and the magico-religious paradigm (Cordon, 2004). Native American women believe that health and well-being result from being in harmony with nature and universe. Native American women can reject germ theory as cause of illness because of their belief that every illness and pain is a price to be paid for something that happened in the past or will happen in the future (Estes, 2006). Native Americans tend to take time to form an opinion of health providers and develop trustful relationship. Women from this cultural group may use traditional healers in whom most faith placed. The traditional healer or a medicine man can use herbs and special ceremonies and rituals to cure illness and regain harmony and health (Estes. 2006). These ceremonies and “ rituals can include singing, chanting, dancing and even use of narcotic substances to influence the spirits to heal the sick person “ (Estes, 2006). According Estes (2006), cleansing and purifying the body is also an important part of Native American women’s life. They believe that use of sweat lodge ceremonies can help them to repair their minds, their bodies and their spirits.
The magico-religious and the holistic paradigms are also important in the Mexican culture. The Mexican Americans comprise the largest group from Hispanic population in the United States (U.S. Census Bureau, 2010). Many Mexican American women believe that illness can be prevented by: being good, eating good food, and working proper amount of time. Some Mexican women believe that illness can cause by body imbalance between caliente (hot) and frio (cold) or wet and dry. Also, they believe that a person is sick because of the evil eye or punishment from God (Estes, 2006). In addition, the Mexican American women try to avoid any illnesses by praying and wearing religious amulets or medals. Many Mexican women usually seek help from older women in the family before going to a traditional healer who specialized in the use of herbs to restore health or balance (Estes, 2006). Some Mexican women believe that they can use “hot”and “cold” food to prevent and treat illness. The Mexican women tend to have more concerns with present time than with future and therefore may focus on short-term solutions rather than long-term goals (Estes, 2006). As a result, women from this culture don’t use screening tests, such as mammography and clinical breast examination as much as recommended by health providers in the United States (Condon, 2004).
African Americans became the second largest ethnic minority group in the United States (U.S. Census Bureau, 2010). The African American category includes people of Haitian origin. Many Haitian women believe that any illness can be caused by supernatural forces such as angry spirits, enemies or even dead people or natural forces such as irregularities of blood flow, volume, purity, color or even temperature (Estes, 2006). Some Haitian women think that natural illness can be caused by hot and cold imbalance in the body. Hot/cold and light/heavy properties of food are used by the Haitian women to gain the mind-body-spirit harmony (Estes, 2006). Natural illnesses can start first to treat at home. Then, the Haitian women can use medical treatment and folk medicine at the same time.Supernatural illnesses can be treated by different kind of healers including herbalist or leaf doctor, voodoo pries or priestess or midwife (Estes, 2006). What is more, the Haitian women may use amulets and prayer to protect them from supernatural illnesses.
3. Identify the variety of common stressors for women.
What do we mean when we say we are “stressed out” ? According to Condon (2004), stress is the belief that a given situation is both threatening and demanding and that one does not have the ability to cope with it. Most of us frequently experience many stressors, any stimuli or events that are capable of producing physical or emotional stress (Wood,Wood & Boyd, 2006). In general, American women have taken on multiple roles to adapt to changes in American society. Today, many women have to meet household and family responsibilities and at the same time job responsibilities if they are working outside the home. Condon (2004) indicated that almost three out of every four women work outside their homes and 99% of all U.S. women will work for pay at someday in their lives. For most women, short-term and long-term stress can occur in the daily experiences of life including workplace stress, relationship conflict, the stress of taking care of their elderly parents and children. In addition, women can be stressful because of death of a spouse, divorce, major personal illness, marriage, pregnancy and retirement. Common stressors for women at workplace include: work overload, hostile bosses, lack of recognition, sex discrimination and sexual harassment ( Condon, 2004). In addition, even today working women still make less money then men at every level of experience and education. Another source of stress for many women who work outside their homes is conflict between their family and work roles. Condon (2004) indicated that conflicts between professional and parental roles are especially stressful for the single mother with one or many children. The multiple role pressure and the number of children in the family can increase the negative effects of occupational stress on the health and well-being of working women. However, unemployment can be far more stressful for many women than any job-related stress. All women are more likely than men to be poor at any age (Condon, 2004). Any women who live in poverty are exposed to more physical and psychological stress than others (Wood, Wood & Boyd, 2006).
4. Identify a variety of techniques women can cause to either minimize stress or cope with it.
Women experience stress in different ways, and these differences sometimes determine which coping techniques are most effective in stress management for specific person (Condon, 2004). Some women who experience stress mainly mentally, may find relaxation in activities such as reading an absorbing book, mediating, or playing a challenging game ( for example, chess) (Condon, 2004). Other women can experience stress physically often benefit from vigorous exercise, such as swimming or jogging or from methods of deep muscle relaxation or yoga. Women who experience stress both mentally and physically may find their relaxation in both: exercises and activities that engage the mind (Condon, 2004). Condon (2004) mentioned about a cardiologist Herbert Benson who interested in stress and the body/mind connection and who invented the term relaxation response. The relaxation response is the opposite of the stress response. Recognizing the connection between mind, body and emotions can help women manage stress. Women can use many methods and techniques that can divert their mind from stressful thoughts and allow the relaxation response to occur. These methods include: progressive muscle relaxation, biofeedback, breathing techniques, imagery therapy, music therapy, hypnotherapy, yoga, humor therapy, massage and meditation (Condon, 2004).
1. Progressive muscle relaxation includes consciously relaxing each part of the body, beginning at bottom of your body and slowly working one’s way up to the head (Condon, 2004). After the all parts of the body relaxed, the person should lie still for a few moments and enjoy the feeling. The relaxation response can also be achieved while engaging in exercises, even though the body is not fully relaxed. Regularly obtaining the relaxation response can help to decrease the amount of stress perceived and protect the body from the negative effects of stress (Condon, 2004).
2. Breathing techniques involves proper breathing which can influence many systems of the body. In the United States, breathing techniques started to use to promote relaxation and control stress by women during childbirth. Dr. Weil (Condon, 2004) recommended breathing exercises to control anxiety and anger. Dr. Andrew Weil’s recommendations include: 1. Breathe in through the nose over a count of four. 2. Hold the breath for a count of seven. 3. Exhale through the mouth slowly over a count of eight. Then, repeat this cycle four times (Condon, 2004).
3. Biofeedback is the process of gaining the information that is presented to a woman about whether she is achieving a desired change in the body at that moment (Condon, 2004). Condon (2004) mentioned five common types of biofeedback: Electromagnetic (EMG) that measures muscle tension; Thermal biofeedback that measures skin temperature; Electrodermal activity (EDA) that measures sweat production; finger pulse biofeedback that measures pulse rate and force and the last one is respiratory feedback that measures breathing in terms of rate, volume and rhythm. At the beginning of any kind of biofeedback, women set an intention to relax the mind and body and involve of using a breathing or progressive muscle relaxation exercise and while they are relaxed, women visualize the desired physiological response (Condon, 2004). Biofeedback is useful for relaxation, the treatment or control of anxiety, hypertension, some cardiac arrhythmias, asthma and hyperventilation.
4. Imagery therapy is the therapy that use mental images to promote relaxation and to gain insight into problems and circumstances (Condon, 2004). Imagery can use visual, olfactory, auditory, tactile and kinesthetic. In this therapy, women can use visualizations of real people, memories, dreams, or situations (Condon, 2004). These images can be very helpful to connect the body, mind and spirit. Researchers concluded the three outcomes in imagery therapy: physiological shifts, psychological insights, and much better awareness of emotions (Condon, 2004). Imagery therapy is beneficial for decreasing anxiety, pain and reactions to stress.
5. Meditations are specific techniques used to quit the mind for a period of time (Condon, 2004). Many women use meditations primary to relieve stress and tension. Meditation can help women to change their thoughts from being negative to positive and peaceful. Condon (2004) included two different techniques of meditation: mindfulness meditation and transcendental meditation. In mindfulness meditation, a person sits quietly and just simply observes the thoughts and allows them to pass. In transcendental meditation, a person is focused on a mantra, or sacred word or phrase (Condon, 2004). Many researchers did support that meditation can be very beneficial for women with such problems as anxiety, depression, chronic pain, and coronary heart disease Condon, 2004).
6. Yoga
The basic of yoga include meditation and physical practices that can be beneficial for women in the promotion of relaxation.The physical part of yoga composed from postures called asanas, together with special breathing techniques (Condon, 2004).
7. Music Therapy
Music, art, drama and dance therapies can addresses the cognitive, physical, social, and spiritual aspects of the self (Condon, 2004). Each therapy may combine behavioral science to produce relaxation and get desired changes in emotions, physiology, and behavior (Condon, 2004).
8. Hypnotherapy
Hypnotherapy is the therapy that uses hypnosis in reaching therapeutic goal (Condon, 2004). During the classical hypnosis, a person becomes deeply relaxed and enters a trancelike state.
9. Humor Therapy
According to Condon (2004), laughter stimulates the release of catecholamines, hormones, and endorphins that important to the healing process. Humor also diminishes anxiety, tension, and fear and help to release anger and frustration.
10. Massage
It has been well documented that massage increased blood flow, which improves oxygenation. Massage is usually experienced as highly enjoyable and extremely relaxing (Condon, 2004).
References
1. Condon, M.C. (2004). Women’s health:body, mind,spirit. An integrated approach to wellness and illness.Upper Saddle River, NY: Pearson Education.
2. Estes, M.E.Z. (2006). Health assessment and physical examination (3rd ed.). Clifton Park, NY: Thompson Delmar Learning.
3. Greene, M. (2008). Poor health, poor women:how reproductive health affects poverty. Retrieved from www.wilsoncenter.org
4. Hutchinson, M.K., Thompson, A.C., & Cederbaum, J.A. (2006). Multi system factors contributing to disparities in preventive health care among lesbian women. JOGNN. Volume 35, Issue 3
5. Schaefer, R.T. (2006). Sociology, a brief introduction.(6th ed.). New York: McGraw-Hill.
6. Williams, J.S., Cunich, M. & Byles, J. (2013). The impact of socioeconomic status on changes in the general and mental health of women over time:evidence from a longitudinal study of Australian women. International Journal for Equity in Health, 12:25.
7. Wood, S.E., Wood, E.G., & Boyd, D. (2006). Mastering the world of psychology. (2nd ed.). Boston: Pearson Education.
8. Xu, X., Patel, D.A., Vahration, A. & Ranson, S.B. (2006). Insurance coverage and health care use among near-elderly women.Women’s Health Issues 16, 139-148.
