Sociological Images

In 1919 the U.S. federal government passed the 18^th Amendment, prohibiting the “manufacture, sale, or transportation of intoxicating liquors.”  Alcohol was banned. Well, kind of.  Two groups were still allowed to buy and disseminate alcohol: clergy and physicians (source).

Clergy were still allowed to purchase wine for sacrament (reportedly leading to many a falsely-devotional newly-certified minister, priest, or rabbi illegally selling bucket loads of liquor to the rest of us). And physicians were allowed to prescribe liquor for medicinal purposes. Alcohol, it was believed, was energizing and it was used to treat anemia, tuberculosis, typhoid, pneumonia, and high blood pressure. Pharmacies did a booming business in those years, as you might imagine.

According to the Rose Melnick Medical Museum:

This new law required physicians to obtain a special permit from the prohibition commissioner in order to write prescriptions for liquor.The patient could then legally buy liquor from the pharmacy or the physician. However, the law also regulated how much liquor could be prescribed to each patient.

…

Patients of all ages used alcohol. A common adult dose was about 1 ounce every 2-3 hours. Child doses ranged from 1/2 to 2 teaspoons every three hours.

Physicians prescribed their “medicine” with prescription pads doled out by the commissioner:

Unfortunately for some, you couldn’t prescribe beer.

Even after Prohibition was lifted in 1933, pharmacies sold plenty of liquor.  In many places women were banned from bars and saloons, so while men visited the bartender, women visited the doctor.  Visit our post on The Stormin’ of the Sazerac to see a great vintage picture of a group of women enjoying the famous cocktail on the first day they were allowed to drink at The Roosevelt Bar, New Orleans.

Cross-posted at Family Inequality.

I have criticized sloppy statistical work by some international feminist organizations, so I’m glad to have a chance to point out a useful new report and website.

The Progress of the World’s Women is from the United Nations Entity for Gender Equality and the Empowerment of Women. The full-blown site has an executive summary, a long report, and a statistics index page with a download of the complete spreadsheet. I selected a few of the interesting graphics.

Skewed sex ratios (which I’ve written about here and here) are in the news, with the publication of Unnatural Selection, by Mara Hvistendahl. The report shows some of the countries with the most skewed sex ratios, reflecting the practice of parents aborting female fetuses (Vietnam and Taiwan should  be in there, too). With the exception of Korea, they’ve all gotten more skewed since the 1990s, when ultrasounds became more widely available, allowing parents to find out the sex of the fetus early in the pregnancy.

The most egregious inequality between women of the world is probably in maternal mortality. This chart shows, for example, that the chance of a woman dying during pregnancy or birth is about 100- 39-times higher in Africa than Europe. The chart also shows how many of those deaths are from unsafe abortions.

Finally, I made this one myself, showing women as a percentage of parliament in most of the world’s rich countries (the spreadsheet has the whole list). The USA, with 90 women out of 535 members of Congress, comes in at 17%.

The report focuses on law and justice issues, including rape and violence against women, as well as reparations, property rights, and judicial reform. They boil down their conclusions to: “Ten proven approaches to make justice systems work for women“:

1. Support women’s legal organizations

2. Support one-stop shops and specialized services to reduce attrition in the justice chain [that refers to rape cases, for example, not making their way from charge to conviction -pnc]

3. Implement gender-sensitive law reform

4. Use quotas to boost the number of women legislators

5. Put women on the front line of law enforcement

6. Train judges and monitor decisions

7. Increase women’s access to courts and truth commissions in conflict and post-conflict contexts.

8. Implement gender-responsive reparations programmes

9. Invest in women’s access to justice

10. Put gender equality at the heart of the Millennium Development Goals

As a number of readers emailed us to point out, yesterday was International Women’s Day, designed to highlight both women’s accomplishments and the persistence of gender inequality worldwide. Ben Buursma noticed an ad in an Indonesian newspaper celebrating International Women’s Day and marketing “Books to empower all women,” though it turns out what they empower women to do is “look into the minds of men” and “find, keep, and understand a man”:

Emma M. H. sent in a link to the the White House Council on Women and Girls report on the status and well-being of U.S. women on a variety of social indicators. Interestingly, while both men and women are waiting longer to get married, the gender gap in age at first marriage has remained relatively constant for decades:

Men are more likely to be either married and never-married, while women currently more likely than men to be divorced or widowed:

Over time, the percent of women who have never given birth has gone up, particularly for the 25-29 age group, though in the last decade there has been a slight downward trend for women aged 30-44:

One note about that graph: the report uses the phrase “had a child” and “childbearing,” so I think this data would include women who have adopted children but never given birth.

I was surprised to see that rates of Cesarean sections have gone up in the past decade:

Women are now outperforming men in terms of educational attainment, earning the majority of bachelor’s degrees, though notice the number of degrees in engineering/computer science earned by women hasn’t increased since 1998:

However, women still make less than men at each level of educational attainment:

The report has lots more data on family life, work, education, health, crime, and so on. I’ll post on other topics in the future.

Finally, Ben N., Kay C., Gregory S., and Dave Z. all sent in this video starring Daniel Craig that highlights global gender inequality (though unfortunately I can’t find any reference that provides sources for the statistics in the video, so take it for what it’s worth):

Kristina K. sent in a link to an interactive map at the New York Times that shows the results of Gallup’s 2010 polls of well-being. [UPDATE: Reader Danielle pointed out I forgot to provide a link to the map. Sorry! You can find it here.] Gallup surveys 1,000 people per day about a variety of indicators of well-being, including questions about physical, mental, and emotional health, various health-related behaviors, ability to access health care, access to adequate food and housing, and perceptions of their communities. Here are the overall composite scores, by congressional district (a higher score is better):

The general geographic pattern indicates a swath of relatively low well-being curving from Louisiana up through Michigan, while those in the upper Great Plains and the inter-mountain West are doing better than average.

Percent reporting experiencing a lot of stress:

Percent who have ever been told they have depression:

Of course, this may reflect differences in rates of depression, but it could also reflect differences in medical professionals’ likelihood of identifying a set of symptoms as depression and bringing it up with a patient. For example, we see significant differences by state in the frequency of Caesarean sections among pregnant women.

Percent of people who smoke:

Percent reporting an inability to buy sufficient food:

The Gallup page on well-being presents more data. Here is a map of 2009 overall well-being that is a bit easier to read since it’s presented by state rather than congressional district:

Hawaii had the highest overall score, at 70.2; West Virginia had the lowest, 60.5. If you go to their site and click on a state, you can get a breakdown of scores in each area (emotional well-being, physical health, healthy behaviors, and so on).

Finally, the NYT provides some demographic information on who was most likely to have said they spent a lot of the previous day laughing or smiling vs. being sad:

The Guttmacher Institute reports that the decades long fall in the rate of surgical abortions has plateaued:

Decreasing abortion rates is something that most Americans support.  Sharon Camp, president and CEO of Guttmacher, suggests that greater availability of cheap effective contraception might help jump start the decrease.  That seems like a politically safe recommendation.  What say you?

Via Michelle Chen at Ms.

At Ms., Amy Williams posted about the pre-conception care movement.  Pre-conception care is health care aimed at making the bodies of fertile women most conducive to a healthy pregnancy.  The movement asserts that women of childbearing age should be receiving care with pregnancy in mind, whether or not the woman intends to get pregnant.  The Preconception Care webpage at Healthy Beginnings, for example, reads as follows:

In a presentation on the topic, Rebecca Kukla,  Professor of Philosophy and Obstetrics and Gynecology at the University of South Florida, explains that preconception care is an “official priority” for the Center for Disease Control and the US Office of Minority Health.   So what’s to be concerned about here?

First, the approach reduces women to their potential to make babies. Concern for women’s health is motivated not by concern for the woman herself, but her ”merely imaginary future children.”   What is the value of old women, transgender women, involuntarily infertile women, and women who have been voluntarily sterilized?  What principles guide their health?

Second, treating women as potential fetus carriers sometimes interferes with the best practices for treating women. Kukla explains that doctors driven by this approach may be inclined to choose drugs that are known to improve fertility and enhance pregnancy outcomes, instead of the most effective drugs for whatever condition is at hand.  As an extreme example, consider a woman diagnosed with cancer for whom a hysterectomy is the most aggressive treatment?  Whose interests should the doctor consider?  Hers?  Those of her “merely imaginary future children”?

Third, treating women as potential fetus carriers encourages doctors and others to police women’s behaviors more stringently than men’s. Anything she does that doesn’t maximize her fertility and baby-making condition can be seen as a problem needing fixing.  Men’s life choices are simply not subjected to this sort of social scrutiny.  We already see this sort of intervention against women who are told to avoid alcohol even if they are unaware of being pregnant and have no intention of getting pregnant.

Fourth, Kukla points out that the approach skews women’s health towards those things that we think affect fetal outcomes. Should these conditions necessarily take priority over others?

Finally, this approach makes women, like myself, invisible. I am a fertile woman in my 30s who has chosen not to have children.  I truly hope that my health care is not being compromised by my doctor’s concern for the babies I am never going to have.  Nor do I think it’s cute that her concern for me is driven by my reproductive potential.

UPDATE: Heather Leila, in the comments, critiqued this post.  ”Having participating in the Office of Minority Health´s preconception campaign,” she writes, “I can attest that none of the above 5 points speak to the reality of the program.”  She continues:

It´s easy for women commenting on this blog to be offended when it is suggested they are not in full control of their fertility. But the truth is that many women are not. They don´t have the access or the education about contaception. 50% OF ALL US PREGNANCIES ARE UNPLANNED.

OMH´s campaign addresses contraception and avoiding unwanted pregnancy. OMH recognizes that many women don´t want to become pregnant, now and later. The campaign seeks to reduce unwanted pregnancy alongside improving preconception health as a way to reduce infant mortality. The campaign also speaks directly to men – taking some of the pressure off women.

This post failed to mention that the OMH campaign is based on the very racial disparity in infant mortality that SI posted on just a few weeks ago.

Lastly, the campaign is geared towards women, not to their doctors. In no way would this campaign promote doctors valuing fertility over a woman´s life. Never would it suggest witholding a hysterectomy to protect fertility. The campaign is NOT about increasing fertility. It is about decreasing infant mortality. Two very different things.

It seems like neither Dr. Kukla nor Sociological Images has taken the time to fully understand this campaign before criticizing it. I think there is a lot to analyze and criticize within the campaign, but Dr. Kukla´s 5 points do not address true aspects of the program. They are invented.

Heather has posted about pre-conception care at her own blog, A Minha Vida.

In the first five minutes of the clip below, economist Jeffrey Sachs explains to Dalton Conley that ending poverty in Africa requires a demographic transition, one where we move from high fertility and high mortality to low fertility and low mortality.

How to encourage such a transition?

1. Bring down mortality with advanced medicine. Declines in childhood mortality lead families to choose to have fewer children (’cause they don’t have to).

2. Make sure girls go and stay in school; they’ll get married later, and have less babies.

3. Provide free contraceptive services and family planning education.

Also see Dr. Sachs explain why Africa ended up so poor in the first place.