Payne, S. The Health of Men and Women 2006 Cambridge : Policy £15.99 ISBN 10 0-7456-3454-0 (pbk) The paradox that women live longer than men but that they experience a greater burden of ill health is resolved in this meticulous exploration of women's and men's health. Recent discussions of gender inequalities in health have recognised that the nature of these inequalities and whether they disadvantage women or men depends upon the aspect of health and illness that is under investigation. In this book Sarah Payne documents the differences and similarities in women's and men's health, showing that they arise not only from the structural and cultural dimensions of gender but also from biological factors and the operation of health services. The six chapters of the book focus on different aspects of health beginning with a general and wide ranging discussion of how sex and gender affect health and illness and moving through discussions of mental health, reproductive health and death and dying. Each chapter presents a wealth of data on women's and men's health, covering the developing as well as the developed world and paying attention to the ways in which class, ethnicity and sexuality influence women's and men's health. Each chapter concludes with one or more case studies which focus on a particular aspect of health in order to illustrate how the different dimensions of gender interact with biological factors as well as class, ethnicity and sexuality to explain the health status and experiences of women and men. The rich data on women's and men's health which are presented in the main body of the book are structured by a particular way of conceptualising and explaining the health differences between women and men. As well as biological differences between the sexes having an impact on women's and men's health it is argued that there are three aspects of gender relations which are significant. These are resources, health behaviour and health care. Payne argues that access to resources is a major influence on health with poor health being associated with poverty and social exclusion. Similarly, structural factors such as occupation affect health and occupational differences between women and men can explain many gender differences in health and illness. Thus while manual labour, usually undertaken by men, is likely to involve risk of accident and injury, much of the work done by women involves stress which can affect mental rather than physical health. The second factor is health-related behaviour. Payne points out that men are more likely than women to engage in risky behaviours such as smoking, drinking, eating unwisely and not exercising enough and that these differences also contribute to an explanation of differences in health. Health care and women's and men's use of it also have an effect on health with men being less likely to use health care than women. But the delivery of health care services may also be gendered. Thus in the case of heart disease, women are treated ‘less aggressively’ than men which, amongst other things, is related to a poorer understanding of heart disease in women and a lack of research. Conversely men who have depression may not be diagnosed because of the association of depression with women and the stigma attached to men admitting that they are suffering from depression. After discussing in careful detail all the different aspects of health and illness covered in the main body of the book, Payne uses the final chapter to put forward a model of the relationship between sex, gender and health. It includes biological factors, structural/material factors, gender discourses, and treatment and resources. This model makes it abundantly clear that gender is multi-faceted and affects women's and men's health in a variety of ways, all of which have to be taken into account when discussing gender inequalities in health. Payne shows that the gender paradox is far too simple a way to understand gender differences in health and that, although men's annual risk of mortality is higher than women's, whether women's health is better or worse than men's depends on a multitude of factors. What is impressive about this book is that it brings together discussions of women's and men's health which often take place separately from each other, and looks at both through a gendered lens. Payne succeeds in showing the complexity of the relation between sex, gender and health and the rich data she presents, together with her clear conceptual model, will make this book immensely useful for teaching as well as an invaluable resource for research.
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Sep 1, 2012
Silvia Rueda 
Open Access