Susan Pickard - Ageing, the Body and the Gender Regime: Health, Illness and Disease Across the Life Course

Susan Pickard

This book is informed by three overarching premises. The first is that, whilst the gender order in the advanced liberal nations of the global north has changed enormously since the 1970s, these changes have been uneven and have not, moreover, all been in a direction that can be described as progress. Indeed, the current (postfeminist) gender order comprises a highly complex coexistence of old and new norms and expectations, freedom and constraints, within a neoliberal social order underpinned by individualism (Fraser, 2009; McRobbie, 2009; Gill, 2007) involving a shift in gender performance by both men and, especially, women. The second premise is that a key mode through which the complexity of this order can be explored is through the lens of health, including expressions of well-being, experiences of illness and the construction of diagnostic categories (Annandale, 2009; Lewin and Olsen, 1985). At the same time, this works in the opposite direction in that the interconnection with the gender regime sheds light on the meaning of health and illness in a way that demonstrates not just the social determinants of health but also the insoluble connection between health and society, body and culture.

This is visible in two ways. Firstly, there is the emergence of illness patters and behaviours in women and men traditionally associated with the other sex. Secondly, there are expressions of somatic suffering, in individual experience and on a cultural basis (for example, through new diagnostic labels or social representations) that can then be viewed as the result of ongoing structural and cultural inequalities (not just differences) that continue to order the gender regimes in advanced liberal nations. The third and related premise is that these changes and their consequences can be explored using a life course perspective. This perspective is well equipped to display the varieties of different embodied expressions of health and illness associated with the different problems, challenges and frictions related to age, stage and the roles, relationships and norms that emerge at these points and in so doing lends a different perspective to gender. Across the life course, womens health displays multiple effects of inequality, both interwoven and cumulative. Whilst sociological explanations mostly emphasise the impact of lower income as well as cultural and environmental factors such as domestic violence and crime (Bird and Rieker, 2008), women also experience stressful role friction of various kinds at various points as their lives have become more complex than mens, taking on new roles whilst retaining old ones. This is an important aspect because as Bird and Rieker suggest, by themselves sociological approaches in terms of models of inequality and health disparities are not sufficient to address paradoxical gender differences in health (2009: 43), such as why women live longer but unhealthier lives. Meanwhile, medicine continues to problematise female bodies in a variety of ways that, inter alia, individualise the effects of structural inequalities whilst medicalising normal bodily changes, thereby profoundly affecting the way one lives and interprets ones bodiliness.

With this foundation, the chapters in this book address a lacuna, or indeed several lacunae, in the current scholarship. Firstly, in this broad interdisciplinary field of health inequalities, the latter are mostly researched with reference to socioeconomic inequality, as the fundamental social cause (Bird and Rieker, 2008). Furthermore, the greater part of this research comprises large-scale surveys and statistically-based analysis, which are not designed to tease out the complex and nuanced links with sociocultural discourses and practices. Where