Global Summit of Women 2003
Marrakech, Morocco

HEALTH CHALLENGES FOR THE DOUBLE-BURDENED WOMEN
Dr. Amany Asfour, President of Egyptian Business Women Association (EBWA)

The Double Burdened Women

•      Being in the workforce increases a woman’s opportunities  for resources , power, social  identity, self esteem, and involvement with others.

•      Although involvement in paid employment is beneficial for women it is contingent on working conditions, her marital status and her race.

•      It is also dependant on a woman’s stability in a single job and her ability to handle many roles at once

•      Women continually juggle to perform well at home, run a household, provide a loving home for children, spend quality time with their partner and provide care for their elders.

The positive aspects of working outside the home appears to be
 

•      higher self esteem

•      increase confidence

•      Independence

•      Improved financial status

•      Increased social support

•      Compared with employment, house hold labor is often :

•      Less rewarding

•      With less recognition from others

•      Less social interaction

•      No financial compensation

•      Is accompanied with higher levels of distress.

Health risks and occupational hazards affecting women at work

I) Disease causing agents that are reproductive hazards for women in  health care services :

1)Cytomegalovirus ; (CMV)

      Birth defects

      Low birth weight

      Developmental disorders

2)Hepatitis B virus :

     Low Birth weight

3)Human immunodeficiency virus (HIV) :

     Low Birth weight

4)Rubella ( German Measles)

5)Varicella – Zoster Virus :

     Birth defects

     Low Birth weight

II-Chemical and physical agents that are reproductive hazards for women in the work place.

1) Cancer treatment drugs :

     Infertility

     Miscarriage

     Birth defects

     Low birth weight

     Affects :        Health care workers pharmacists

2) Certain ethylene glycol ethers :

        Miscarriage

     Affects :         Electronic

                    - Conductor workers

3) Carbon disulfide :

          Menstrual cycle changes

     Affects :         Viscose rayon workers

4) Lead :

        Infertility

        Miscarriage

        Low Birth weight

        Developmental disorders

     Affects :         Battery makers

Chemical and physical agents that are reproductive hazards for women in the work place.

5) Ionizing radiation (eg. x – rays and gamma rays) :

    Infertility

    Miscarriage

    Birth defects

    Low birth weight

    Developmental disorders

    Childhood cancers

     Affects : Health care workers

                Dental personal

                Atomic workers

6) Strenuous physical labour :

     ( e.g. prolonged standing , heavy lifting ):

     Miscarriage late in pregnancy

     Premature Delivery .

     Affects :  Many types of workers.

Health and safety in the work place

I – Physical stress on the body is a consequence of many different occupations.

    1) Jobs that require long standing hours can result in :

         leg pain

         swelling

         varicose veins

    2) Jobs like secretarial and computer related jobs are accompanied by    

         neck and backaches

         eye strain.

    3) Ergonomic injuries.

         Women on production lines suffer musculoskeletal injuries resulting   from repetitive 

        motions:

        Carpel tunnel syndrome

        Tendonitis

         Injuries

Health and safety in the work place

II – Little job satisfaction or poor sense of wellbeing :

     -Lack of supportive work place policies

     -Unfair pay

     -Concerns for quality child care

     -Inflexible scheduling

     -Lack of support at home

     -Lack of control at work :

     -High work demands, unreasonable dead times

     -repetitive boring work, strained relationships with co-workers and/or supervisors.

     -Sexual harassment in the work place is a major form of stress.

III – Long term exposure to job stress can lead to higher levels of --depression

     -anxiety and mental illness.

Chronic Health Problems affecting Working Women

1-Stress.

2-Depression.

3-Anxiety disorders  (Phobias) generalized anxiety disorder)

4-Eating disorders :

     -Anorexia nervosa

     -Bulima nervosa

     -Poor body image

     -Binge eating disorder

5-Diabetes        (non insulin dependant )

6-Hypertension.

7-Obesity

8-Musculoskeletal deformities related to ergonomic inadequate

Balancing work and family life .

•      The quality of the job and supportiveness of the work place seem to affect a woman’s productivity at work more than her pay and benefits.

•      A high quality job is one that offers meaningful work, autonomy , learning opportunities, and a chance to advance within the company.

•      The more demanding and difficult the job, and the less supportive the workplace, the greater the negative spillover is from one’s work to one’s personal life.

•      As jobs become more demanding and less rewarding, employees often feel more stressed by the end of the workday and have less time and energy for their families.

•      Besides house work, mothers also spend more time on average with their children than fathers do.

Balancing work and family life .

•      Seventy percent of parents feel that they don’t have enough time to spend with their children. Both parents have less time for themselves and couples have less time together.

•      Having many roles contribute to a woman’s strain and stress. The role of mother is often a woman’s principal source of stress; she may enjoy her role and be committed to it, but she still may feel strained by it. Her stress may be exacerbated by society’s normative expectation of “ good mothering” which does not usually encompass full time employment.

Domestic Violence

Domestic violence refers to as battering .It is defined as repeatedly subjecting a woman to forceful physical, social and psychological behavior .

Battering includes : interpersonal violence, social embarrassment ,financial torture

1 – Physical violence :

     Slapping , choking, punching, kicking, pushing and using object weapons .

2- Sexual violence :

     Forced sexual activity.

3 – Property violence

     Threatened or actual destruction of property.

4 – Psychological and social violence.

     Threats of harm, physical isolation of women, extreme jealousy, mental degradation and threats of harm to children, pets or other loved ones.

     -Women tends to either over react or commutatively react.

Causes for domestic violence

•      Power and control

•      Growing up in a cycle of violence and abuse

•      Restored concept of man hood

•      Jealousy .

•      Hopelessness and despair

•      Under employment of spouse

•      Economic disequilibrium .

Health outcomes of violence against women

1)Physical conditions

    Injury and functional impairment

     Disability  (Temporary or permanent)

     Obesity

       Chronic pain syndrome.

       Irritable bowel syndrome and other gastro intestinal disorders.

2)Mental Health :

       Depression

       Anxiety disorders

       Eating disorders

       Post traumatic stress

       Sexual Dysfunction

       Substance abuse

Health outcomes of violence against women

3)Negative health behavior :

        Smoking, alcohol , drug abuse.

        Sexual risk taking.

        Physical inactivity.

        Over eating.

4)Reproductive health :

       Unwanted pregnancy

       Sexually transmitted disorder

       Gynecological disorders:

       Pelvic inflammatory disorder

       Pregnancy complications :

       Low Birth weight

       Miscarriage

5)Fatal Outcome :

      Homicide

      Suicide

      Maternal mortality

      AIDS related deaths .

Informed Decision Making

•      Working women, with and without children experience significant stress that affects their heaths , relationships, work productivity and young children.

•      Supportive companies produce workers who are less stressed, feel more successful in balancing of work and family, more satisfied with their work and home lives and are more committed to their employers.

Solutions :

1)Employers should help employees prepare for parenthood through planning, pre conception health care and counseling and treatment for substance abuse.

2)There is a need for expanding the family and Medical Leave Act. (FMLA).  12 weeks for care for newborns seriously ill relative Recover from own serious illness

3)Employers can help new mothers return to the workplace by providing breastfeeding support through lactation assistance programs and private breast feeding rooms.

4)To help caregivers in general employers need to determine a way to provide flexible work schedules and help employees find affordable childcare and eldercare during all working hours.

5)Women also need to be aware of their rights in the work place.

6)Discrimination should not be tolerated and actions can be taken if a woman suspects she is being treated  unfairly because of gender, race , age, religion, pregnancy or disabilities.

7)work-setting should be appropriate for females as males to avoid Ergonomic inadequate

Thank You

Managing Health Challenges for the Double-Burdened Woman
Jónína Bjartmarz, MP  Iceland

It is a fact that women in most  societies are double burdened and it is an other fact that health risks come with the double work load and  the pressures of women´s work at home and work at work.  The question is what we can do about this? What can be done, what can we,  women as individuals do about this,  what can  we do as individulas to maintain a healthy balance  and what can society do?  - Having listened to my exelent co-panelist  and the different perspective of their presentation I´m sure that you all belive that we  talked or met before this  session and decided on how to tackle,  deal and cover the issue from different angels – which we did not. -   Dr. Amany Asfour has shared with us her  expertise  on both the positive aspects of working outside the home  and the differential health risks at stake for the double burdened women and     Elisabet Trallero has told us  how she copes with her long working day and many different roles and responsebilities and    I´m for one is  by now persuaded  that regular exercise and healthy eating habits are of vital importance.

My perspective  on the issue is societies role and responsebilities   based  among other things on   WHO´s recognition of women´s dual role and double workload and its effects on women´s health and.  I also want to tell you about one factor that can facilitate the coordination of family life and work, give you some facts that demonstrate women´s contribution to Iceland´s economy- show how much they are worth and finally emphasize the importance of measures that encourage women to have children -  for the demographic composition of the population.  

The Effects of a Double Work Load on Women's Health

The massive changes in the status of women in many parts of  the world changes regarding education, employment participation, and emploment choices – have sharpened our focus on the fact that women's health is and issue that merits special consideration. But discussions of women's health must be based on liberal definitions of the term "health". They must explore in particular the effects of the social environment and must attempt to shed light on the links between socio-economic factors and the health risk factors specific to women.

According to the objectives outlined in the World Health Organization's Health for All program, approved in 1991, member nations must, among other things, work systematically to diminish women's health problems, especially those which can be traced to their social status and their dual role as workers and two fronts. The WHO objectives formally recognize this dual role and double workload of women, as well as the effects of this duality on women's health. In the wake of this, member nations such as Iceland have committed themselves to minimizing the health problems resulting from women's social status and the strain on them due to their multiple roles.

The WHO plan for 1998 does not include any special objectives entitled "Health of Women rather, emphasis is placed on the effects of equality and social status on women's health. One point made in this regard is that women's twofold workload also affects the quality of care that children and elderly people receive.

The WHO objectives emphasize the necessity of helping both men and women tho shoulder various types of responsibility and to perform various roles – as individuals, parents, workers and caregivers – so that the walls built of inequality may be broken down when people's health and development are at stake.

The Equal Right and Responsebilities of Men to Domestic Life and Participation in childcare

Due to women's increased participation in the labor market, attitudes are changing regarding the roles of women and men in society. It is increasingly demanded that mothers and fathers be offered equal opportunities to be active both within the family and in the labor market. -  Some years ago I heard a statement attributed to former Norwegian Prime Minister Gro Harlem Brundtland, that women have the right to equal opportunities in the labor market, but they also have the right to family life. I agree wholeheartedly, but in the name of equal rights for women, and in the name of lightening the burden of women, I find it necessary to add that "men have the same ritht. Men have equal rights to enjoy family life, childrearing and homemaking, and should have the same opportunities as women to balance work and family life." And there is every logical reason to speak of their rights in this regard – not only of their responsibility.

It is traditional role of women in all societies to stand sentinel to the national treasure that is our children and our families. The fact is that, even in those places where women's participation in the employment market equals or approches that of men, and where formal legal gender equality is the order of the day, women today appear to make greater compromises in their paid work in order to meet the needs of children and family. And,  we must not forget the gender-linked wage inequality that plays an important part in this attitude of women. In light of the treasure that women spend a significant part of their lives guarding – family and children- it is, on the one hand, quite sensible to speak of this attitude as a positive trait.

On the other hand, it is clear that women's position of the issue of family responsibility and division of labor in the home weakens their position in the employment market. Thus it is imperative to emphasize strongly that the caring for and nurturing of children and family are not only responsibilities resting on both mother and father but also rights that men and women enjoy in equal mesure.

Equal rights to childbirth leave

One factor that can facilitate the coordination of family life and paid work is equal rights to childbirth leave.   Three years ago  the Icelandic Parliament passed new legislation on this.   I believe that Iceland is the first country to pass laws that make no gender based distinction with respect to parental rights. Both fathers and mothers will now have independent non-transferable rights to three-months' paternity or maternity leave. Additionally, parents are entitled to three-months' paid joint leave, which they can divide between them as they choose. The parent in question is to receive 80% of his or her total wages and is not to lose job-related benefits. The childbirth leave is funded with a 4.34% tax on all wage and salary payments,

The aim of the equal maternity and fraternity leave is twofold: to ensure that every child is cared for by both parents and to enable women and men to coordinate family life and paid work. It's purpose is also to encourage men to fulfill their obligations and enjoy their rights concerning children and family, in a manner equal to that fo women. Also, efforts are being made to facilitate women's participation in the labor market and place them on equal footing with men; the new lagislation represents an attempt to equalize the status of the sexes in this regard; to make the men as unpopular as the women.

We hope and believe this legislaton will help to eliminate wage inequality between men and women – a difference that can only be explained on the basis of gender – to give women and men aliket he opportunity to combine family and profession, and to lighten the double burden on women by dividing that burden between women and men.

The question on how to reduce the health risks that come with the preasures of women´s double workload is an acute issue/task  in my country. 

 Participation in the labor market on the part of both sexes is greater in Iceland than even  in the other Nordic countries and is the highest in the entire OECD as 89,55% of Icelandic man and 84% of Icelandic women are active in the job market. -  In addition,only 40% of Icelandic women work part-time rather than full-time.  This amounts to 27% more female participation than the EU average, and 25% more than is the average for the OECD.

This facts  demonstrate  the acute need for neccessary strageties and measures for   satisfactory harmonizing  of work and family life  in the interest of women and their health. They also  demonstrate womens tremendous contribution to our  economy.  - They show how much women are worth and the necessity to implement measuers that enable women and men to  balance work and family life and reduce the burden on women.

 In this context led us not  forget the importance of the demographic composition of the population, for state and local government income, trough taxation.-

The Nordic model of social care, the Nordic welfare model is a part of their character  and the people in general support high taxes and high quality public service as part of the Nordic identities.  The generous welfare depends on two main factors. One is  the political one that the working people are ready to pay the necessary funds and secondly  on the demoghrapic factor, that there is a big enough work force so that there are enough people of working age to meet the demands of the needy.

An ageing population is surely  not favorable for the sustainability of the Nordic welfare states.

The reason that I mention this in this context is that in the wider perspective it becomes obvious that society, through  legislation and government policies must aim at encouraging women and man to have children, not discouraging  them.

The double work load of women discourage´s them to have children.  So there is one more reason to implement measures that help balancing work and family life,  secure women´s important participation in the work force and tremendous contribution to our ecconomy and reduce the burden of women in consideration of their health

 This is done  with different socio-economic measuers such as  child benefits to parents and / or child related tax reductions, pre-schools  that answers the need of employed parents and now create capacity for over  83% of children undir 5 years old  and last but not least through the new very successful  legislation on    generious and equal maternity and paternity leave.