families

I write to share a quick update on a researcher and writer previously featured on Girl w/ Pen: Chloe Bird, Ph.D., a Senior Social Scientist at RAND in Santa Monica, was interviewed about her research on gender and household labor for the episode of Dr. Phil which is scheduled to air this Friday, December 2nd.

The “Chore Wars” episode focuses on three couples, married 4 years, 16 years and 39 years, respectively.  The three wives were in conflict over their husbands’ refusal to do more chores around the house. Dr. Phil counseled the couples, and then turned to Bird, who was sitting in the studio audience, to ask her about her research. She discussed some of the sociological issues as to why the division of household labor is such a challenge and how inequity can impact both spouses.

Bird noted,

In the case of inequity in household labor, the intended audience is individuals and couples seeking to find an equitable way to accomplish all the tasks it takes to keep a household going. So, I greatly appreciate the opportunity to communicate research to such a large and diverse audience.

For more on Bird’s medical sociological research, see my prior Girl w/Pen interview with her and her co-author Pat Rieker about their book Gender and Health: Constrained Choices and Social Policies.

2011 brought us two top-selling autobiographical takes on female aging. Jane Fonda’s Prime Time asks readers to explore everything from friendship to fitness to sex, with a goal of having us accept that “people in their 70s can be sexually attractive and sexually active.”  Betty White’s If you Ask Me (And Of Course You Won’t) offers readers a candid and often humorous take on the last 15 years of her life. White warns of the pitfall of our youth-centric culture: “So many of us start dreading age when we’re in high school. And I think that’s really a waste of a lovely life.”  While these celebrity authors paint provocative personal portraits of aging, I’m drawn to the new book by Colgate sociologist Meika Loe, Ph.D.: Aging Our Way: Lessons for Living from 85 and Beyond (Oxford University Press) charts her three-year journey following the lives of 30 diverse “elders” (women and men ages 85 to 102 years old), most of whom were aging at home and making it work.

Adina Nack: How did your last book on the Viagra phenomenon lead you to your new book on the ‘oldest old’?

Meika Loe: For The Rise of Viagra I interviewed elder men and elder women partners of Viagra users. It became clear that ageism impacted their lives and was a key ideology that propelled the Viagra phenomenon forward. Afterwards, I missed those interactions with elders and wanted to know more about their experiences aging at home. Aging Our Way ended up being a book that focuses more on elder women’s experiences, voices that had been marginalized, if not completely absent, from the media coverage of the Viagra phenomenon.  In the 85+ age group, women outnumber men by almost 3 to 1, and close to 80% of elders living at home alone are women. Too many people assume that research on elders is sad and depressing, in comparison to research on Viagra. To the contrary! I find elders’ stories inspirational. Aging Our Way features the lessons I learned from them – lessons for all ages.

AN: Aside from the Viagra interviews, what inspired you to focus on this group of people who are all more than twice your age?

ML: I was extremely close with my grandparents and great-grandparents growing up. More recently, I rent a room from a village elder in the small town where I work. Living with her, an invisible world opened up to me – a world of widows caring for one another and collectively attending to quality of life, mostly in the absence of biological kin.  Like, Carol, my seventy-something landlady, who gets a check-in call from octogenarian Joanne every morning at 8 a.m. Then Carol calls 98-year-old Ruth. All of these widows have lived alone in their homes within 10 square blocks of each other for decades, and now they constitute a social family. Once in a great while, when Carol cannot reach Ruth, she’ll grab the extra key and head to her home to make sure everything is okay. One time she found Ruth on the floor.

AN: That must have been scary – so, even with this type of ‘morning phone tree’, isn’t isolation a problem for these women and men aging alone?

ML: Yes, like most of us, elders attempt that delicate balancing act between dependence and independence every day. So, while many of these elders value independent-living, they’re also adept at building social networks. Ruth H. is committed to making a new friend every year of her life: she reaches out to my campus’s Adopt-a-Grandparent group and has five student walking partners this year, all new friends. That said, aging alone comes with its share of isolation and risk, and I’m reminded of Elizabeth, a Navy veteran and high school English teacher who insisted on living alone in her home, amidst her longtime friends and neighbors, despite her children’s pleas for her to move to Georgia. Elizabeth recently passed away during Hurricane Irene. She was inspecting her basement for flooding and must have fallen. This is such a sad story, but Elizabeth would not have wanted it any other way: she said she wanted to die with her boots on.

AN: Do women have an advantage over men when it comes to longevity and aging?

ML: Social epidemiologists Lorber and Moore have shown that women live longer but not necessarily healthier lives. Traditional gender roles take their toll: often, women prioritize caring for others for so long that their own health suffers.  Perhaps as a result, women have higher rates of chronic illness and depression. At the same time, many of the women I followed are enjoying a chapter in their lives where they can focus on themselves, their communities, their gardens, and their own health. Shana, 95, says things like “Now I am finally living for myself. Now I can focus on me.” Most women have lifelong gendered skill-sets for self-care: systems for food preparation, cleaning, bathing, budgeting, and reaching out to others. The men I followed are less adept at those skills: they had never been expected to cook and clean. So men, like Glenn, told me about having to learn these skills after the loss of their spouses.

AN: Does caretaking of others really end at age 85?

ML: Caretaking continues, often in new and familiar ways.  I think of Olga, age 97, caring for her grandson every weekend and putting aside a few dollars every day for her daughter who is battling cancer.  In her subsidized senior housing community, she delivers hot meals, hems pants, and runs errands. By caretaking, Olga feels a sense of community, a web of support. When she needs assistance, she has options and knows where to turn. So contrary to expecting nonagenarians to be sickly and dependent, many not only receive but also give care.

AN: Talk of cutting Social Security and Medicare has been in the news – how did you see these programs impacting elders’ lives?

ML: I have to admit – in my 30s, I see money going out of my paycheck—and I remind myself that that money is put aside for when I need it – I just hope it will be there! Through this research I saw how and why programs like Medicare and Social Security matter. For example, Juana worked in factories her whole adult life, and her small Social Security check keeps her hovering above the poverty line, able to afford rice and beans for the family and to pay for cable TV so she can watch her beloved Yankees.  Medicare covers annual doctor’s visits that likely keep her from spending time in the emergency room, a more expensive cost for society. Like most elders, she depends on Social Security for a significant portion of her income.

AN: Why should we all – not just the elders in the U.S. – read your book?

ML: Undergrads come to my Sociology of Aging course with all sorts of preconceived notions. They dread aging, seeing it as synonymous with depression, disease, and death. Our ageist society has taught them that aging equals loss, and they’re surprised to learn about elders who are aging on their own terms: coordinating self-care, combating isolation and loneliness, and exercising autonomy and control – sometimes in the face of disabilities and chronic illnesses. We all benefit from learning creativity, connectivity and resiliency from our elders. They teach us crucial lessons about all stages in life: living in moderation, designing comfortable spaces, constructing social families, appreciating humor and touch, and building social capital.  And, let’s face it, if we’re lucky, then we will all be elders soon enough.

This week I sent a video of my daughter Maybelle to a friend who recently had a child with Down syndrome. In this video, Maybelle—who’s almost three—is reading word cards, signing and saying the words she sees. My friend responded, “That’s pretty impressive. Is that uniquely Maybelle, or is there some sort of emerging sense that kids with Down syndrome read precociously?”

Of course I was delighted to answer this question for my friend, and I’ll answer it for you: Kids with Down syndrome tend to be good visual learners, so they can often learn to read fairly early. (Downs Ed is a fabulous group in England that’s been leading the research on this.) Kids with Down syndrome may have difficulty speaking effectively, but they can often read quite well–ahead of grade level, etc–if they’re taught to read. This “if” is important, as illustrated by another conversation I had this week.

One of my best friends is an occupational therapist. She just started working with an eight-year-old who has Down syndrome and is in the life skills class at his public elementary school. The life skills class, for those who don’t know, is essentially the class for kids that the school system has decided can’t learn. It’s a segregated special education classroom where kids aren’t taught the kind of academic subject matter you’d learn in second grade; instead, they’re taught how to get dressed, how to sit quietly, how to interact with another human being. As an example of the kinds of academic challenges that are left out of life skills classes, this child is eight, and he can count to three. To three.

Maybelle is almost three years old, and she can count to ten, say the alphabet, and read more than 100 words. I share this with you and with other people in the world not because it’s “uniquely Maybelle.” She’s not a prodigy. She’s a child with Down syndrome who has been given the opportunity to achieve, and—like most of us in the world—when given an opportunity, she rises to meet it. I don’t mean to suggest that she, or anybody, will achieve every opportunity that’s presented, of course. But it’s rare for any of us to achieve without being provided with the space, the support, and the belief that make achievement possible.

Maybelle is one hell of a reader. I am incredibly fortunate to have friends who are speech therapists, early interventionists, and scholars of Down syndrome. These folks told me about high expectations and helped shatter my stereotypes about Down syndrome. I think about the eight-year-old that my friend is working with. His parents probably followed the advice of the authorities at the school, who perhaps haven’t been doing their jobs all that well and haven’t learned that full inclusion in typical classrooms is almost always recommended for kids with Down syndrome. I’ll bet good money that, if given the opportunity, this child would learn to count, to read, to perform fairly well in an inclusive classroom with his same-age peers. But if he isn’t provided with that opportunity, he isn’t going to achieve.

Thirty years ago educators believed it was impossible for people with Down syndrome to learn to read (click here if you want to hear some of my reflections on this). It’s long past time for our false beliefs and low expectations to be sad relics of an era we’ve moved beyond.

Update from Alison: I very quickly got feedback from several people about this post that has made me want to apologize and clarify. I’m sorry to imply that kids–any kids, with Down syndrome or not–should be performing in a certain way if they’re getting the “correct” opportunities. All kids are unique individuals, and their strengths and challenges are going to be specific to them. This of course has nothing to do with Down syndrome: some kids are going to be readers, some kids are going to be athletes, some are going to have artistic sensibilities, some are going to have the knack for fixing things that are broken, some are going to be beautifully attuned to other people’s emotions. Etc. And these strengths will emerge at various times in their lives. I know about one kid who really didn’t read at all until the Harry Potter books came out, and then–as a teenager–he learned to read, and loved to read.

I want us to live in a world with high expectations and lots of opportunities for all our kids. And I want us to appreciate our kids for their gifts, whatever they are, and whenever they emerge. You’re right to be skeptical of my assessment of the eight-year-old I haven’t met: a child’s ability to count, or speak, or read isn’t evidence of lack of opportunity. And it’s lack of opportunity that’s my concern, not the individual gifts and talents of any particular kid in the world.

Again, I apologize, and I appreciate the feedback!

There are rare moments when I read an article or listen to a recording and can’t form words to respond. Today is one of those moments and it is because you really should just listen to this recording for yourself. It’s that perfect.

The NYTimes invited four women who are at the top of their respective fields of science in for a roundtable discussion. They shared their thoughts about:

Differences between men and women in science:

TAL RABIN: Even when we do make it to the conferences, I think that there is still something different about the way that we promote ourselves.

I remember standing next to one of my co-authors, and he was talking to some other guy, and he was telling him, “I have this amazing result. I just did this, I just did that.” And I was sitting and thinking there, what result is he talking about? Until he got to the punch line. It was a joint result. It was a result of mine also. I would have never spoken about my result in the superlatives that the guy was speaking about it.

MS. KOLATA: What would you have done?

DR. RABIN: I would have said, you know, “I have this very interesting result, and we achieved very nice things.” But not “This is the best thing since we invented the wheel, and here it is.”

Having a family:

MS. KOLATA: It must be exciting for your children to grow up with a mother who has such passion for what she does.

DR. APRILE: It depends on the child. The second of my daughters used to say, “Mommy, why can’t we have dinner at 6 p.m. like everybody else?” They finally accepted these crazy hours that I had to live with.

Asking where the women are going:

DR. KING: I think the choke point is going from a postdoc to an assistant professorship to a tenure-track position. In my experience the largest remaining obstacle is how to integrate family life with the life of a scientist.

What they would say to their daughter about going into science:

DR. RABIN: The truth is that I feel differently. I think that the life of a scientist is a fantastic life. I think it is exciting because every day there is something new that you can go and think of. There are challenges, no doubt, and the times when you can’t solve things. So I think it is all a wonderful life. And not to mention even things like time flexibility, traveling around the world, meeting a lot of exciting people. I think that these are fantastic jobs.

This is the type of conversation I would have KILLED for as an undergraduate. The one faculty member I tried to have this conversation with rebuffed me. She was pretty old school, couldn’t go to Harvard with the men and it took me awhile to figure out why she wouldn’t address the gender issue. I don’t blame her either. When you build up a defense mechanism, it is hard to let it go.

What I love about the conversation are the differing opinions. As I tell my students, there are no firm answers. You gather up all the data you can and make the best decision you can. From this conversation, one can see that difference decisions all lead to some awesome science making.

I started talking with my 8-year-old son and 10-year-old daughter about sexuality as soon as they started to ask questions like, “How are babies made?”  From my point of view, books have all the answers, and I turned to It’s So Amazing: A Book about Eggs, Sperm, Birth, Babies, and Families by Robie H. Harris and Michael Emberley as a starting point.

But recent news has me wondering how and when to initiate other, more difficult conversations about sexuality and power.

For example, my neighbor and I were talking over our 10-year-old daughters’ heads at the bus stop on Monday morning about Dominique Strauss-Kahn, the managing director of the International Monetary Fund who has been arrested and charged with sexually attacking a maid.

Our conversation went like this:

Neighbor: “Did you see the news about Dominique Strauss-Kahn?”

Me: “Yes, it really does show that incidents like that are about power.”

Neighbor: “That’s for sure.”

My daughter Maya hovered nearby, sensing that we were discussing something juicy, but not entirely understanding.  She interrupted us with a question about school, and we changed the subject.

And then yesterday the news broke that Arnold Schwarzenegger fathered a child with one of his household employees.

I admit to turning the paper facedown on the kitchen table.  I would have found a way to talk about the Schwarzenegger story, of course, but I wasn’t eager to have the conversation.

As someone who jumped in early with the “sex talk,” I wonder why I’m shying away from talking about sexuality and power.  Maybe I want to protect my children from linking sexuality and violence when they still want to believe the best about people’s intentions.  After reading Veronica Arreola’s great post, “Can We Whistle Stereotypes Away?” I think I might be doing a better service to my kids if I’m honest in acknowledging that some men abuse power over women.

GWP readers, what do you think?  Is there a right time for the other sex talk?  Do you have advice about how to navigate this topic?

Seems like quite a few other folks have been reimagining the possibilities of Mother’s Day as well!

• In “Mother’s Day is more than a greeting-card holiday,” Karen D’Souza also returned to the origins of Mother’s Day and wrote about how Julia Ward Howe imagined a day of peace.
• Nicholas Kristof urged readers to celebrate by “saving” a mother and in a separate essay, pointed out that investing in family planning worldwide would result in 94,000 fewer women dying in pregnancy each year.  (Full disclosure: I’m not a fan of the rhetoric of “saving”—it’s something we spend a lot of time critiquing in my Transnational Feminism class—but I deeply appreciate how Kristof continues to remind everyone that women’s “issues” are indeed newsworthy.)
• Also in The New York Times, Stephanie Coontz observed that “it’s too bad that nostalgia for a golden age of motherhood that never existed still clouds our thinking about what’s best for mothers, fathers and their children.”  At Ms., Laura Paskus urged readers to honor all mamas—including “immigrants, single, young, queer and low-income” mothers—on Mother’s Day.  And over at Strollerderby, Rebecca Odes drew attention to all the nannies who help mother children, and who should be a part of Mother’s Day as well!

In the spirit of infusing new meanings into Mother’s Day—and in keeping with the Mother’s Day Challenge I issued to myself and interested readers—I did two things.  Right after eating brunch, and sending flowers to my mom (about whom I’ll write more later), and right before going on a family hike, I gave to two organizations:

Mothers’ Day Movement.  Founded by six women who were “shocked to learn that $14 billion was spent in the US in 2010 on Mother’s Day celebrations including flowers, cards and meals,” they selected Shining Hope for Communities, a Wesleyan student-founded organization working in Kibera, Kenya, as the target of their 2011 fundraising efforts.  (The co-founder and president of SHOFCO, Kennedy Odede, grew up in Kibera.)  I am totally impressed that college students founded SHOFCO, and I remembered well the insightful opinion essay, “Slumdog Tourism,” written by Odede in The New York Times last August.

Save the Children: Every Mother Counts campaign.  They have a midwifery training program in Afghanistan, which ranked as the worst place to be a mother in their Mothers’ Index.  I like the emphasis on training.

I didn’t quite make it to writing any letters to my political representatives as I had planned… but I figure that Father’s Day is around the corner, and I’m planning on pitching a surprise to my husband after I serve up his brunch: co-authorship?

Just in time for Mother’s Day, Save the Children has published its twelfth annual State of the World’s Mothers Report.  This report includes the Mothers’ Index, a ranked list of 164 countries around the world.  Like last year, Norway tops the list for the best place to be a mother.  Afghanistan is worst.  The U.S. fell three places, to number 31 on the list.

In other words, the U.S. ranks closer to the bottom than the top of the 43 developed countries examined in the report.

Of course, as the report reminds us, the numbers don’t always tell the whole story—an individual mother’s situation can vary greatly within the same country.  Nonetheless, national-level comparisons do suggest trends and provide overviews that can provide a valuable framework for digging deeper.

For those of us living in the U.S., these national numbers should give us pause.  Why didn’t mothers in the U.S. fare better?  And why are we falling in the rankings instead of improving?  These startling numbers complicate the rosier picture of motherhood and family that many Americans tend to hold.

The first reason for our low ranking is our maternal mortality rate, an issue I wrote about last month for Girl w/Pen and Ms.  As the State of the World’s Mothers Report points out, the U.S.’s rate for maternal mortality is 1 in 2,100—the highest of any industrialized nation.  In other words, a woman in the U.S. is “more than 7 times as likely as a woman in Italy or Ireland to die from pregnancy-related causes and her risk of maternal death is 15-fold that of a woman in Greece.”

Other reasons for our low ranking include the under-five mortality rate (forty countries beat us on this one) and the percentage of children enrolled in preschool—only 58%, making us the fifth lowest country in the developed world for educating young kids.

Finally—surprise, surprise—our country lags in supporting working women with children, and in creating pathways for women to political office nationally:

The United States has the least generous maternity leave policy—both in terms of duration and percent of wages paid—of any wealthy nation.

The United States is also lagging behind with regard to the political status of women. Only 17 percent of congressional seats are held by women, compared to 45 percent in Sweden and 43 percent in Iceland.

This report made me feel a lot of different emotions about the state of motherhood in the U.S. as well as globally—shock, anger, outrage—not to mention gratitude. I’m fortunate enough to have healthy kids and privileged enough to be able to pay for things like health insurance and preschool. Given the state of things for many mothers, this is no small potatoes! And yet, the more I thought about this report and my reaction to it, the more I began to think about how important it is to use feelings to propel us to something more—understanding, wisdom, action, and working together.

This view of motherhood lies at the origins of Mother’s Day.  Long before Hallmark made sentimentality synonymous with Mother’s Day and restaurants began the tradition of the Mother’s Day brunch (neither of which I plan to reject come Sunday!), Julia Ward Howe imagined a very different kind of occasion.  In her 1870 Mother’s Day Proclamation, she called for a day when women could come together and work towards peace.  In the aftermath of the violence and carnage of the U.S. Civil War, she called for women to

…meet first, as women, to bewail and commemorate the dead.

Let them solemnly take counsel with each other as to the means

Whereby the great human family can live in peace…

After grief, counsel.  After sorrow, solidarity.  After remembrance, action:

To promote the alliance of the different nationalities,

The amicable settlement of international questions,

The great and general interests of peace.

So here’s my Mother’s Day Challenge to myself this year: after enjoying whatever treats my family makes for me, and feeling lots of warm tenderness toward them (note to kids: you will be good), and making sure I have time to write in my journal, and calling my own mother on the phone—I’m going to do one thing, one action, toward addressing one of the issues raised by this report.  I haven’t decided what, quite yet.  But here are some ideas I scribbled down this afternoon, a personal list to start my brain juices flowing:

• Write a letter to one of my representatives about some of the issues that really matter to mothers and families.  (Education!  Parental leave!  Women’s health!)
• Send money to Emily’s List.
• Write an opinion essay.  Send it out.
• Go to a protest, like this one sponsored by Mothers & Others United in the Hudson Valley.
• Find out more about the campaigns to connect kids across the borders of class and geography—the UN’s Girl Up and Save the Children’s k2kUSA are ones I’ve recently run across.  Think about how to plug my own family into these networks.
• Find out more about efforts in my own backyard.  (I could start by actually reading all those items in my church’s bulletin!) Ask someone how I and my family can get involved.
• Make a donation to one of these campaigns, or one of the many organizations working for women’s rights and healthy families.
• Write down in my calendar that I will bring up all these issues up again on Father’s Day.

I invite anyone and everyone to join me in this challenge.  Share ideas and actions from your own list.  (And be sure to watch the video about Julia Ward Howe below, released from Brave New Foundation in 2009, which includes an inspiring reading of her Mother’s Day Proclamation.)  Happy Mother’s Day!

A blog-friend (i.e. someone I know only because we read each other’s blogs) posted this last night, and I had a look. It’s a post about the fact that PBS News Hour has started a six-part series called “Autism Now,” and the series was at least partly inspired by the fact that host Robert MacNeils’s grandson Nick has autism.

After watching the first part of the series, I shared this with blogger Melissa:

Okay, so here’s a quick comment based on having watched only a tiny bit of the PBS clip. It troubles me a bit how autism is framed here as (mostly? entirely?) a medical condition–worse, as a medical problem. It strikes me as troubling, like Nicholas is now defined not as a person but as a used-to-be-person-now-tragedy.

The clip starts by explaining that they’re going to explore “how Nick was transformed from that healthy boy to Nick today.” Nick’s mom, Alison MacNeil, describes seeing a very young Nick exhibiting behavior that is often affiliated with autism. “I had this sinking feeling in my stomach,” she explains, “because I knew something was wrong.” At one point MacNeil interviews his granddaughter, Nick’s ten-year-old sister, and she shares with him, “I hope that [Nick] gets healed soon.”

MacNeil notes his own painful feelings at the challenges he has in connecting with Nick. He frames his relationship with Nick as strange, so different than his relationship with his children and other grandchildren. These are valid feelings for MacNeil himself to be grappling with, but the show seems to suggest that the pain results from Nick’s “abnormality,” not from MacNeil’s need to reframe his expectations for his grandson. Further, he describes his admiration for his daughter and son-in-law’s “patience and courage,” and he seems impressed that his son-in-law comes home from work every day and spends 90 minutes riding the bus with Nick. The show, then, seems to be characterizing autism in two ways: as an illness that must be understood by medicine and healed, and as a tragedy, a tragedy that makes the parents heroic. Nick isn’t okay as he is today. He’s not normal. He needs to be fixed. Thank goodness that Alison and Dave are so patient and courageous.

As I wrote to Melissa, I find this troubling. I don’t have a child with autism, so I can’t speak to that experience on a personal level, but this show strikes me as participating in the sort of dehumanizing rhetoric I often see in public discourses around children with cognitive disabilities.

As good timing would have it, I watched the first part of the series last night, after I got home from a graduate class in which we’d been talking about autism. We were discussing public representations of autism and the cultural work various representations are doing. We had a look at Ari Ne’eman, the first openly autistic Presidential appointee ever. In an interview with Wired magazine, he advocates neurodiversity, a framing of autism and other cognitive disabilities not as deficiencies, defects, or tragedies, but as different ways of being. He explains,

There’s a strange idea out there that neurodiversity advocates think that autistic life is all flowers and rainbows, but I don’t know anyone who thinks that way. Most of us have had deeply personal experiences of social isolation, bullying and abuse, lack of support, discrimination, and plenty of other problems. But it’s much more productive for us to focus on how we can improve people’s lives than to keep presenting people as pitiable burdens.

No more pity. It doesn’t help anybody.

Ne’eman has received a surprising number of hostile responses to his appointment to the National Council on Disability, responses that seem in part to be based on his perspective on autism. As one of the people in class last night observed, “Changing our culture to accommodate people with autism is much more immediate and pragmatic than all these efforts to find a cure for autism. Maybe that’s why it’s threatening: it’s saying that the mainstream culture has to change, rather than saying that people with autism have to be different, or disappear.”

I don’t mean this post in any way as an individualized critique of the MacNeil family. The family clearly loves Nick and advocates accommodations and support for him—and for them—and this show is certainly meant to raise awareness about autism. But the show itself strikes me as an example of how easily (even unintentionally) autism and other cognitive disabilities can be framed as tragedies to be mourned, and/or conditions that are unacceptable and need to be fixed. I’d rather see more public emphasis on neurodiversity, on changing our society so that we can accommodate and support as many different types of people as possible.

Yesterday marked the one-year anniversary of President Obama signing the Affordable Care Act.  I encourage everyone to become familiar with what the Act has already accomplished, as well as the plans through 2015 (see an interactive timeline online).

Today, I dedicate this month’s column to reflecting on one of the new consumer protections that is scheduled to become effective January 1, 2014, No Discrimination Due to Pre-Existing Conditions or Gender:

Before the Affordable Care Act became law, insurance companies selling individual policies could deny coverage to women due to pre-existing conditions, such as cancer and having been pregnant. 

A WhiteHouse.Gov fact-sheet describes the ways in which, “The Affordable Care Act Gives Womem Greater Control Over Their Own Health Care.”  When I first read it, even as a feminist medical sociologist familiar with health care inequities, a few lines jumped out at me:

Right now, a healthy 22-year-old woman can be charged premiums 150 percent higher than a 22-year-old man.

Less than half of women have the option of obtaining health insurance through a job.

Today, maternity benefits are often not provided in health plans in the individual insurance market.

I appreciate the many positive effects this law has on women, men and children, but I find myself asking: why did the Affordable Care Act not include this provision — to eliminate discrimination to due to gender — among its original 2010 provisions?  A comparable provision was effective as of September 23, 2010 for children:

…health plans that cover children can no longer exclude, limit or deny coverage to your child under age 19 solely based on a health problem or disability that your child developed before you applied for coverage.

Now, don’t get me wrong, I’m all for protecting children’s rights to receiving coverage.  As a mom, I understand the instinct to want to protect one’s child before one’s self.  However, it feels like the policy-makers did not take into account the body of research on the direct correlations between maternal health and child health.  To put it simply, an unhealthy mom is not good for the health of her child — whether or not her child has excellent or poor health care coverage.

For example, a 2005 article in the journal PEDIATRICS documents research findings that,

“Maternal depressive symptoms in early infancy contribute to unfavorable patterns of health care seeking for children.” 

Another 2005 article examined the psychological and physical health of adult caregives of children with cerebral palsy and found that:

The psychological and physical health of caregivers, who in this study were primarily mothers, was strongly influenced by child behavior and caregiving demands…These data support clinical pathways that require biopsychosocial frameworks that are family centered, not simply technical and short-term rehabilitation interventions that are focused primarily on the child.

It’s easy to imagine the ways in which a child’s health might suffer if her/his primary caretaker has poor mental and physical health.  And, solely providing health care to the child did not necessarily improve the health outcomes of the caregiving moms.

One more example along the lines of the effects of maternal depression is the case of pediatric asthma.  A 2007 article in the Journal of Health Economics reports a study which shows:

…treatment of mother’s depression improves management of child’s asthma, resulting in a reduction in asthma costs in the 6-month period following diagnosis of $798 per asthmatic child whose mother is treated for depression.

Our health care system will likely save more money once we end insurance company discrimination on the basis of sex/gender.  Now, I recognize that not all women are mothers, but the overwhelming majority of mothers are women.  So, if the gendered division of labors in most families remains such that moms are primarily in charge of maintaing and protecting the health of their children, then wouldn’t we want these caregivers to have access to affordable, quality health care before 2014? 

That said, I am grateful that this law passed and hope that we will continue to work on ways to strengthen coverage for all Americans.