Spiritual_Wellness_Holistic_Health_and_the_Practic

324 Philosophical Foundations of Health Education
unequal distribution of power and resources. Those with secure employment, a good
education, adequate medical care, and regular leisure activities do not develop diseases
that plague the impoverished. Consequently, satisfying jobs, decent housing, and
good schools serve as strong factors in disease prevention and should be targets of
intervention if we are to reduce disparities in health.
Gender
Women are more likely than men to bear a significantly greater proportion of the burden
of disease and illness in American society. Since the 1970s there has been considerable
interest in the relative health of women and men and the extent to which gender
differences play a role in determining the health status of Americans and Western
Europeans (Hunt & Annandale, 1999). While there is consensus that gender disparities
in health continue to be mediated to some degree by women ’ s unequal status in
society (Cook, 1994; Doyal, 1995; Fee & Krieger, 1994), in addition to the inherent
physiological differences that influence their proclivity to greater disability and morbidity
than males (Arber & Cooper, 1999; Belgrave, 1993; Graham, 1998), a noteworthy
recent finding by Kawachi, Kennedy, Gupta, and Prothrow - Smith (1999) is that
indices of American women ’ s health status strongly predict both American male and
female mortality rates. Severe marital violence is also highest in those states where
gender inequality is the highest.
Another important observation documented by Bayne - Smith and McBarnette
(1996) is that among women in the United States, the particular disparities that have
limited the intellectual growth of minority women, arguably account, in part, for their
inferior health status, both physical and mental, when compared to their more well -
endowed Caucasian counterparts and males who live in poverty. Indeed, Roberts
(1999) found African American female adolescents who were poor and living in inner
cities to bear a disproportionate burden of poor health outcomes compared to white
women. As such, interdisciplinary collaborations examining the structural inequities
and combined consequences of sexism, racism, and inner - city poverty for young
women of color are necessary to inform public health interventions designed to
improve the health of African American female adolescents.
In addition to societal - wide inequities in health status generated by gender discrimination,
gender inequities in access, particularly to quality prenatal care, have a
strong bearing on the health status of infants. There is a two - fold risk of sudden infant
death in American minority populations (Hill, 1999). Moreover, gender may also
influence access and exposure to material and other resources differentially and inequitably
(Stacey & Olesen, 1993).
Age
An excess of morbidity with more severe domains of poor health is likely to be found
among elderly people. Work by Fitzpatrick and Van Tran (1997), who have studied the
effects of age, gender, and health among African Americans, found both the objective