here. - Canadian Women's Health Network

She notes that the authors of the BlackReport accepted both the “hard” and“soft” materialist explanations and rejectedonly the “hard” versions of the otherexplanations. She then describes along-term, negative consequence ofthe focus on this debate:The ‘big question’ addressed in muchof the research literature following theBlack Report was: ‘how much canartefact, selection or behaviourscontribute to observed social classgradients in mortality?’, to which theusual answer given was ‘not much’.This can be seen as having divertedattention from two other ‘big’questions; namely, ‘what are theprecise mechanisms or pathwaysby which social inequalities in healthare generated and maintained inparticular contexts?’ and ‘whateffective actions, if any, can be takento reduce, or ameliorate the effectsof, social inequalities in health? 30As Patricia Kaufert has noted:being invisible within thedeterminants of health model mayprove deleterious for women andlimit our understanding of the waysin which the determinants of healthmay function differently for women. 32The next section of this paper, will reviewand summarize a body of literature whichhas begun to address the connectionsbetween the health of women and theirsocio-economic status.It is to this last question that we will returnin Section G of this paper, documentingbest practices for health services forpoor women.While Health Canada recognizes genderas one of twelve determinants of health,much of the research in populationhealth makes no reference, or limitedreference, to the health of women, andthe few references that are includeddeal mostly with women as mothers. 31Women, Income andHealth in Manitoba22The consequences of this are wellillustrated in the case of the Whitehall Istudy of British civil servants and coronaryheart disease. The Whitehall I study waswidely seen as the standard reference oncoronary heart disease risks in humans.It contained no data about women and sothe risk factors for coronary heart diseasein women were completely excluded, at thesame time as the study was accepted asthe gold standard reference.