جنسیت، خشونت خانگی و بیماری در مکزیک

Pergamon Soc - Sci - Med - Vol - 45 - No - 8 - pp - 1147-1160 - 1997 © 1997 Elsevier Science Ltd - All rights reserved PII: S0277-9536(97)00023-3 Printed in Great Britain 0277-9536/97 $17 - 00 + 0 - 00 GENDER - DOMESTIC VIOLENCE AND SICKNESS IN MEXICO KAJA FINKLER Department of Anthropology - University of North Carolina - Chapel Hill - Alumni Building - Chapel Hill - NC 27599-3115 - U - S - A - INTRODUCTION A vast social science literature exists devoted to women's health problems in developed nations - - * A great deal has also been written about woraen's health in developing nations - but the majority of these investigations have centered around wo~aen's health in association with their reproductive ca- pacities - t Little attention has been paid - however - to women's sub-acute non-life threatening conditions in developing nations - impairments not directly re- lated to women's reproductive capacities and for which biomedicine lacks remedies - :~ In my study of patients seeking treatment from Spiritualist healers in Mexico I found - in a ran- *See Brown and Harris (1978) - Doyal (1995) - Freud (1990) - and Freud in Young-Breuhl (1990) - Gove (1978) - Gove and Hughes (1979) - Jack (1991) - Kane (1991) - Krieger and Fee (1994) - Martin (1987) - Nathanson (1975 - 1979) - Pandolfi (1990) - Rosenfield (1980) - Roskies (1978) - Travis (1988) - Verbrugge (1978 - 1990) - Weissman and Klerman (1977) - An extensive bibliography can be found in Apple (1990) - tBrowner (1989 - 1990) - Davis and Low (1989) - MacCormack (1994) - Martin (1987) - Morsy (]978) - Raymond (1993) - Secretaria de Salud - 1990 - :~However - see Finkler (1991 - 1994b) - Doyal (1995) and Morsy (1993) - Brief discussion of women's depression and violence against women is noted in Secretaria de Salud (1990) - but the major focus of this publication is on women's reproductive problems and their sequelae - §In addition to biological risks - intrinsic genetic and hormonal differences between men and women - Verbrugge (1990) identifies such reasons for the differ- ences as "psychosocial aspects of symptoms and care - called "illness behavior" in medical sociology - '~ and "health reporting behavior - this concerns how men and women talk about their health problems to others" - ¶For a fine discussion of the different variables contri- buting to women's sickness see Verbrugge (1990) - Verbrugge discusses the various factors that impact on women's health - but even taking into account the bio- logical differences - Verbrugge emphasizes that there still remains a "black box" which fails to o:plain women's non-life threatening conditions - IlSee also the compelling argument of this point by Kleinman (1988) - domly selected sample of 1212 patients (Finkler - 1994a) that 58% were women - Similarly - out of a sample of 267 patients in an outpatient clinic of a government general hospital - 76 - 2% were women - At both sites the women sought treatments for non- life threatening disorders - We must - therefore - ask what lies behind these high frequencies of morbidity among women? A facile response would be to reduce the answer to biological factors and/or to an overall propensity to illness associated with sex sta- tus - § However - biological explanations are unsatis- fying because they only partially explain women's non-life threatening disorders - ¶ To address the issue of women's morbidity is to attend to theoretical issues about the nature of sick- ness - and to the interaction between sickness - gen- der and societ