... making process. Most of the sons interviewed felt the need to 'look after', or ... more ... making process. Most of the sons interviewed felt the need to 'look after', or 'to protect' their elderly mothers from 'danger' or 'risky situations', as exemplified by Mrs Hare's son: I ... who coerces. A typical example was Mrs Hare's son: Mr ...
... Nordic countries) would help men as well as women to cope with their family responsibilities,... more ... Nordic countries) would help men as well as women to cope with their family responsibilities, including care of children and, where ... Towards women's independence: pension systems in three contrasting European welfare states, Journal of European Social Policy 42: 255 ...
Abstract A theoretical framework is proposed by which women as well as men may be included in cla... more Abstract A theoretical framework is proposed by which women as well as men may be included in class theory, and a methodology is suggested by which one aspect of women's class location, their relationship to the labour market, may be measured. It is argued that social class in a Weberian sense may be seen as comprising two distinct although related dimensions.
A number of recent reports have emphasized that 'the elderly'are far from a homogeneous group. Ta... more A number of recent reports have emphasized that 'the elderly'are far from a homogeneous group. Taylor: and Ford (1983), for example, examined age, sex, and social-class differences in a sample of elderly people in Aberdeen, finding substantial inequalities between subgroups in their income, social support, health, and psychological functioning.
This article draws on data from two major empirical studies of sleep to examine the use of audio ... more This article draws on data from two major empirical studies of sleep to examine the use of audio diaries as an approach to researching sleep. Sleep has only recently emerged as a topic of interest to the sociologist, providing a valuable resource through which to examine the roles and ...
Two contrasting hypotheses have been presented to predict women's health variations. The Mult... more Two contrasting hypotheses have been presented to predict women's health variations. The Multiple burden hypothesis predicts that combining a paid job, being married, and having children is likely to be detrimental to women's health. The multiple attachment hypothesis predicts that multiple roles provide attachment to the community, which is likely to be beneficial to women's health. These hypotheses are examined in Britain and Finland, which have different patterns of women's employment participation. Lone mothers form a critical case, since they have fewer attachments and greater burdens, and therefore are expected to have poorer health. The socioeconomic position of lone mothers differs in Britain and Finland, but in both societies they are likely to have fewer attachments. We assess the extent to which health variations between women with different family and parental role combinations are because of the differences in their socioeconomic status and material circ...
This paper examines inequalities in ill-health among men and women in Britain and Finland, using ... more This paper examines inequalities in ill-health among men and women in Britain and Finland, using national survey data from the mid-1980s. Age-standardised illness ratios are compared followed by multivariate logistic regression analyses. The degree of social inequality in ill-health for women and men is greater in Finland than in Britain. British employed women in each class report less limiting long-standing illness than their Finnish counterparts. A major difference between the two countries is the poor health of British housewives. We relate these differences to societal variations in the participation of women in paid employment. In Finland women participate fully in paid work, whereas in Britain women are more likely to be full-time housewives or part-time employees. Unlike Finland, state provisions do not support the economic independence of British women. Structural variables, encapsulated by occupational class and employment status' are the primary factors associated wit...
... Role theorists view the transition into economic inactivity in later life as problematic for ... more ... Role theorists view the transition into economic inactivity in later life as problematic for men but not for women (Casey 1992; Ginn and Arber 1996). ... Men with professional or managerial back-grounds had half the odds of being members as those who had held man-ual jobs. ...
As physicians are pressured to deliver an increasing number of preventive services, follow guidel... more As physicians are pressured to deliver an increasing number of preventive services, follow guidelines, engage in evidence-based practice, and deliver patient-centered care in managerially driven organizations, they struggle with how much control they have over their time. A secondary analysis was conducted with data from 3 parallel studies of clinical decision making in Germany, the United Kingdom, and the United States with 128 physicians per country. Physicians reported how much time they were allocated and how much time they needed for high-quality care for new patient appointments, routine consultations, and complete physicals. They also reported how much control they had over their time in the office and spending adequate time with patients. German, British, and American physicians were allocated (on average) 16/11/32 minutes for a new patient appointment, 6/10/18 minutes for a routine visit, and 12/20/36 minutes for a complete physical, but felt that they needed more time. Ove...
Recent National Health Service (NHS) structural and policy changes have brought with them shifts ... more Recent National Health Service (NHS) structural and policy changes have brought with them shifts in the ideals, pace, and physical location of work, with significant consequences for staff. Hospital nurses have experienced increased devolution of managerial responsibility ...
Nonmedical determinants of medical decision making were investigated in an international research... more Nonmedical determinants of medical decision making were investigated in an international research project in the United States, the United Kingdom, and Germany. The key question in this paper is whether and to what extent doctors' diagnostic and therapeutic decisions in coronary heart disease (CHD) are influenced by patient gender. A factorial experiment with a videotaped patient consultation was conducted. Professional actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patient-actors of different gender, age, race, and socioeconomic status. The videotapes were presented to a randomly selected sample of 128 primary care physicians in each country. Using an interview with standardized and open-ended questions, physicians were asked how they would diagnose and treat such a patient after they had seen the video. Results show gender differences in the diagnostic strategies of the doctors. Women were asked different questions, CHD was mentioned more often as a possible diagnosis for men than for women, and physicians were less certain about their diagnosis with female patients. Gender differences in management decisions (therapy and lifestyle advice) are less pronounced and less consistent than in diagnostic decisions. Magnitude of gender effect on doctors' decisions varies between countries with smaller influences in the United States. Although patients with identical symptoms were presented, primary care doctors' behavior differed by patients' gender in all 3 countries under study. These gender differences suggest that women may be less likely to receive an accurate diagnosis and appropriate treatment than men.
Abstract Two contrasting theories of the relationship between paid employment and women's health ... more Abstract Two contrasting theories of the relationship between paid employment and women's health are examined using data from the 1975 and 1976 General Household Survey. The 'role accumulation' hypothesis, which proposes that paid employment has beneficial effects on health, was supported for women without children, and for women over 40 with children. However, the causal ordering is unclear, for there is evidence that ill-health reduces the likelihood of labour-force participation especially among women over 40. When those reporting chronic illness are excluded, the association between being a housewife and short-term illness largely disappears. The contrasting hypothesis, that for married women with children the strain of occupying multiple roles leads to poorer health, was also supported, but only for women under 40 who work full-time and have children. These women reported higher levels of illness, although this was less clear among women working in professional and managerial jobs. It is concluded that full-time work for young mothers may be detrimental for their health unless there are adquate financial resources to help with the burden of maintaining the multiple roles of housewife, mother and employee, or until the sexual division of labour in the home changes.
This paper addresses sleep, which to date has been a neglected area within the sociology of healt... more This paper addresses sleep, which to date has been a neglected area within the sociology of health and illness. We explore the extent to which the concepts of medicalization and healthicization provide appropriate models for understanding the management of women's sleep disruption. The prescription of sleeping pills remains as an indicator of the medicalization of sleep, while the trend towards the healthicization of sleep as part of healthy lifestyle practice is reflected in the increased focus of the media, pharmaceutical and complementary health care industries on sleep. The paper analyses qualitative data on women aged 40 and over to argue that the medicalization-healthicization framework fails to encapsulate a complete understanding of how women manage sleep disruption within the social context of their lives. It suggests that by looking inside the world of women's sleep we uncover a hidden dimension of self-directed personalized activity which plays a key role in women's response to sleep disruption. We propose an alternative model for the management of women's sleep which incorporates a core of personalised activity, linked to strategies associated with healthicization and medicalization.
Using novel methods, this paper explores sources of uncertainty and gender bias in primary care d... more Using novel methods, this paper explores sources of uncertainty and gender bias in primary care doctors' diagnostic decision-making about coronary heart disease (CHD). Claims about gendered consultation styles and quality of care are re-examined, along with the adequacy of CHD models for women. Randomly selected doctors in the UK and the US (n=112, 56 per country, stratified by gender) were shown standardised videotaped vignettes of actors portraying patients with CHD. Patients' age, gender, ethnicity and social class were varied systematically. During interviews, doctors gave free-recall accounts of their decision-making, which were analysed to determine patient and doctor gender effects. We found differences in male and female doctors' responses to different types of patient information. Female doctors recall more patient cues overall, particularly about history presentation, and particularly amongst women. Male doctors appear less affected by patient gender but both male and especially female doctors take more account of male patients' age, and consider more age-related disease possibilities for men than women. Findings highlight the need for better integration of knowledge about female presentations within accepted CHD risk models, and do not support the contention that women receive better-quality care from female doctors.
This paper sheds light on the debate about whether class inequalities have given way to new divis... more This paper sheds light on the debate about whether class inequalities have given way to new divisions by employment status, by comparing changes in health inequalities among British and Finnish men and women between 1986 and 1994. Britain experienced high unemployment in the 1980s whereas Finland experienced a sudden increase of unemployment in the early 1990s. We examine how these contrasting labour market situations have influenced changes in health inequalities by employment status and social class using comparable population surveys. In Finland health inequalities by employment status narrowed among men, whereas in Britain they widened or remained stable, with a less strong pattern of change for women. We found similar or slightly larger health inequalities by class among all adults than among the currently employed, with larger class inequalities in Finland than in Britain. We conclude that in countries with high levels of unemployment, there are smaller class inequalities in health among the employed labour force because of the greater chance of a`healthy worker effect'.
Abstract The extent to which men are the primary carers of infirm elderly people and the amount o... more Abstract The extent to which men are the primary carers of infirm elderly people and the amount of support men carers receive from the statutory and voluntary services relative to women carers is examined using data from the 1980 General Household Survey. It is shown that men make a larger contribution to caring than is often recognised.
... making process. Most of the sons interviewed felt the need to 'look after', or ... more ... making process. Most of the sons interviewed felt the need to 'look after', or 'to protect' their elderly mothers from 'danger' or 'risky situations', as exemplified by Mrs Hare's son: I ... who coerces. A typical example was Mrs Hare's son: Mr ...
... Nordic countries) would help men as well as women to cope with their family responsibilities,... more ... Nordic countries) would help men as well as women to cope with their family responsibilities, including care of children and, where ... Towards women's independence: pension systems in three contrasting European welfare states, Journal of European Social Policy 42: 255 ...
Abstract A theoretical framework is proposed by which women as well as men may be included in cla... more Abstract A theoretical framework is proposed by which women as well as men may be included in class theory, and a methodology is suggested by which one aspect of women's class location, their relationship to the labour market, may be measured. It is argued that social class in a Weberian sense may be seen as comprising two distinct although related dimensions.
A number of recent reports have emphasized that 'the elderly'are far from a homogeneous group. Ta... more A number of recent reports have emphasized that 'the elderly'are far from a homogeneous group. Taylor: and Ford (1983), for example, examined age, sex, and social-class differences in a sample of elderly people in Aberdeen, finding substantial inequalities between subgroups in their income, social support, health, and psychological functioning.
This article draws on data from two major empirical studies of sleep to examine the use of audio ... more This article draws on data from two major empirical studies of sleep to examine the use of audio diaries as an approach to researching sleep. Sleep has only recently emerged as a topic of interest to the sociologist, providing a valuable resource through which to examine the roles and ...
Two contrasting hypotheses have been presented to predict women's health variations. The Mult... more Two contrasting hypotheses have been presented to predict women's health variations. The Multiple burden hypothesis predicts that combining a paid job, being married, and having children is likely to be detrimental to women's health. The multiple attachment hypothesis predicts that multiple roles provide attachment to the community, which is likely to be beneficial to women's health. These hypotheses are examined in Britain and Finland, which have different patterns of women's employment participation. Lone mothers form a critical case, since they have fewer attachments and greater burdens, and therefore are expected to have poorer health. The socioeconomic position of lone mothers differs in Britain and Finland, but in both societies they are likely to have fewer attachments. We assess the extent to which health variations between women with different family and parental role combinations are because of the differences in their socioeconomic status and material circ...
This paper examines inequalities in ill-health among men and women in Britain and Finland, using ... more This paper examines inequalities in ill-health among men and women in Britain and Finland, using national survey data from the mid-1980s. Age-standardised illness ratios are compared followed by multivariate logistic regression analyses. The degree of social inequality in ill-health for women and men is greater in Finland than in Britain. British employed women in each class report less limiting long-standing illness than their Finnish counterparts. A major difference between the two countries is the poor health of British housewives. We relate these differences to societal variations in the participation of women in paid employment. In Finland women participate fully in paid work, whereas in Britain women are more likely to be full-time housewives or part-time employees. Unlike Finland, state provisions do not support the economic independence of British women. Structural variables, encapsulated by occupational class and employment status' are the primary factors associated wit...
... Role theorists view the transition into economic inactivity in later life as problematic for ... more ... Role theorists view the transition into economic inactivity in later life as problematic for men but not for women (Casey 1992; Ginn and Arber 1996). ... Men with professional or managerial back-grounds had half the odds of being members as those who had held man-ual jobs. ...
As physicians are pressured to deliver an increasing number of preventive services, follow guidel... more As physicians are pressured to deliver an increasing number of preventive services, follow guidelines, engage in evidence-based practice, and deliver patient-centered care in managerially driven organizations, they struggle with how much control they have over their time. A secondary analysis was conducted with data from 3 parallel studies of clinical decision making in Germany, the United Kingdom, and the United States with 128 physicians per country. Physicians reported how much time they were allocated and how much time they needed for high-quality care for new patient appointments, routine consultations, and complete physicals. They also reported how much control they had over their time in the office and spending adequate time with patients. German, British, and American physicians were allocated (on average) 16/11/32 minutes for a new patient appointment, 6/10/18 minutes for a routine visit, and 12/20/36 minutes for a complete physical, but felt that they needed more time. Ove...
Recent National Health Service (NHS) structural and policy changes have brought with them shifts ... more Recent National Health Service (NHS) structural and policy changes have brought with them shifts in the ideals, pace, and physical location of work, with significant consequences for staff. Hospital nurses have experienced increased devolution of managerial responsibility ...
Nonmedical determinants of medical decision making were investigated in an international research... more Nonmedical determinants of medical decision making were investigated in an international research project in the United States, the United Kingdom, and Germany. The key question in this paper is whether and to what extent doctors' diagnostic and therapeutic decisions in coronary heart disease (CHD) are influenced by patient gender. A factorial experiment with a videotaped patient consultation was conducted. Professional actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patient-actors of different gender, age, race, and socioeconomic status. The videotapes were presented to a randomly selected sample of 128 primary care physicians in each country. Using an interview with standardized and open-ended questions, physicians were asked how they would diagnose and treat such a patient after they had seen the video. Results show gender differences in the diagnostic strategies of the doctors. Women were asked different questions, CHD was mentioned more often as a possible diagnosis for men than for women, and physicians were less certain about their diagnosis with female patients. Gender differences in management decisions (therapy and lifestyle advice) are less pronounced and less consistent than in diagnostic decisions. Magnitude of gender effect on doctors' decisions varies between countries with smaller influences in the United States. Although patients with identical symptoms were presented, primary care doctors' behavior differed by patients' gender in all 3 countries under study. These gender differences suggest that women may be less likely to receive an accurate diagnosis and appropriate treatment than men.
Abstract Two contrasting theories of the relationship between paid employment and women's health ... more Abstract Two contrasting theories of the relationship between paid employment and women's health are examined using data from the 1975 and 1976 General Household Survey. The 'role accumulation' hypothesis, which proposes that paid employment has beneficial effects on health, was supported for women without children, and for women over 40 with children. However, the causal ordering is unclear, for there is evidence that ill-health reduces the likelihood of labour-force participation especially among women over 40. When those reporting chronic illness are excluded, the association between being a housewife and short-term illness largely disappears. The contrasting hypothesis, that for married women with children the strain of occupying multiple roles leads to poorer health, was also supported, but only for women under 40 who work full-time and have children. These women reported higher levels of illness, although this was less clear among women working in professional and managerial jobs. It is concluded that full-time work for young mothers may be detrimental for their health unless there are adquate financial resources to help with the burden of maintaining the multiple roles of housewife, mother and employee, or until the sexual division of labour in the home changes.
This paper addresses sleep, which to date has been a neglected area within the sociology of healt... more This paper addresses sleep, which to date has been a neglected area within the sociology of health and illness. We explore the extent to which the concepts of medicalization and healthicization provide appropriate models for understanding the management of women's sleep disruption. The prescription of sleeping pills remains as an indicator of the medicalization of sleep, while the trend towards the healthicization of sleep as part of healthy lifestyle practice is reflected in the increased focus of the media, pharmaceutical and complementary health care industries on sleep. The paper analyses qualitative data on women aged 40 and over to argue that the medicalization-healthicization framework fails to encapsulate a complete understanding of how women manage sleep disruption within the social context of their lives. It suggests that by looking inside the world of women's sleep we uncover a hidden dimension of self-directed personalized activity which plays a key role in women's response to sleep disruption. We propose an alternative model for the management of women's sleep which incorporates a core of personalised activity, linked to strategies associated with healthicization and medicalization.
Using novel methods, this paper explores sources of uncertainty and gender bias in primary care d... more Using novel methods, this paper explores sources of uncertainty and gender bias in primary care doctors' diagnostic decision-making about coronary heart disease (CHD). Claims about gendered consultation styles and quality of care are re-examined, along with the adequacy of CHD models for women. Randomly selected doctors in the UK and the US (n=112, 56 per country, stratified by gender) were shown standardised videotaped vignettes of actors portraying patients with CHD. Patients' age, gender, ethnicity and social class were varied systematically. During interviews, doctors gave free-recall accounts of their decision-making, which were analysed to determine patient and doctor gender effects. We found differences in male and female doctors' responses to different types of patient information. Female doctors recall more patient cues overall, particularly about history presentation, and particularly amongst women. Male doctors appear less affected by patient gender but both male and especially female doctors take more account of male patients' age, and consider more age-related disease possibilities for men than women. Findings highlight the need for better integration of knowledge about female presentations within accepted CHD risk models, and do not support the contention that women receive better-quality care from female doctors.
This paper sheds light on the debate about whether class inequalities have given way to new divis... more This paper sheds light on the debate about whether class inequalities have given way to new divisions by employment status, by comparing changes in health inequalities among British and Finnish men and women between 1986 and 1994. Britain experienced high unemployment in the 1980s whereas Finland experienced a sudden increase of unemployment in the early 1990s. We examine how these contrasting labour market situations have influenced changes in health inequalities by employment status and social class using comparable population surveys. In Finland health inequalities by employment status narrowed among men, whereas in Britain they widened or remained stable, with a less strong pattern of change for women. We found similar or slightly larger health inequalities by class among all adults than among the currently employed, with larger class inequalities in Finland than in Britain. We conclude that in countries with high levels of unemployment, there are smaller class inequalities in health among the employed labour force because of the greater chance of a`healthy worker effect'.
Abstract The extent to which men are the primary carers of infirm elderly people and the amount o... more Abstract The extent to which men are the primary carers of infirm elderly people and the amount of support men carers receive from the statutory and voluntary services relative to women carers is examined using data from the 1980 General Household Survey. It is shown that men make a larger contribution to caring than is often recognised.
Uploads
Papers by Sara Arber