No,
this is not what you think. It has nothing to do with sex but rather
with the difference between the sexes.
But
first about Wadjda. This week I saw the first feature film ever shot
in Saudi Arabia. And perhaps even more significantly, it is the first
feature written and directed by a Saudi Arabian woman, the talented
Haifaa Al Mansour. Her tale is about a 12-year-old girl, Wadjda, who
wants to buy a bike. In the setting of Riyadh this is very special,
throwing open closed doors on women’s lives.
Much
of the action takes place in Wadjda’s all-girl school, run by a
wicked witch, Ms. Hussa (Ahd), who singles the girl out as a
troublemaker. But then Wadjda’s suddenly converts to religion in an
attempt to win the school’s annual Qu’ran contest so she can buy
the bike she wants. She wins the contest, but the school gives the
money to Palestine instead of a bike. The story is funny and
interesting, but most of all the movie is about women in Saudi
society.
The
role of women in society is also something we will look at separately
when considering support for older people. My colleague is writing an
interesting short background paper on this topic for our meeting
later this month. It includes many reasons why it is important to pay
special attention to women when discussing the care for older people.
Let me share a few observations that opened my eyes.
There
are more older women than older men
This
is something that most people already know. In most countries, women
outlive men and therefore women represent a growing proportion of all
older people: 53% of the “young-old” (till 75), 58% of the “old”
(75-85), and 66% of the “oldest old” (over 85). These are
worldwide figures and also in low and middle income countries
populations are ageing (often at a more rapid rate than in high
income countries). Hence, also in poor countries there are already
many older women.
Women
tend to be on their own at the end of their lives
Not
only do women outlive men, but due to social and cultural norms in
many countries, women partner with older men. This means that many
women spend many years caregiving for older spouses and other
relatives. This decreases the chances for women of getting caregiving
support by their partners. Women who lose a partner are also less
likely to repartner than men, further decreasing the chances of
support. So women are often on their own, without company and without
support.
Women
face special health issues later in life
Although
the health status of older women does not differ significantly from
older men, there are some differences. Because women get older than
men, they probably have more and more complex chronic diseases and
end up in institutions more often. The four biggest causes of
disability in older women are vision and hearing impairment, dementia
and osteoarthritis. Every year, more than 2.5 million older women
lose their independence through visual impairment. Dementia is
another cause of disability that disproportionately impacts women.
But
women have less access to care
Much
of this burden could be avoided if women had access to the necessary
care, particularly surgery for cataracts. Especially in lower income
countries, women are sometimes simply denied access to health care,
let alone long term care.
Older
women also have lower financial security than older men. Although
women’s educational attainments and labor force participation have
increased, older women are more likely to be poor than older men.
Moreover, women are less financially prepared for older age than men,
are more likely to have worked part-time and spent fewer years in the
workforce. These factors contribute to lower probability of coverage
of long-term care in later life, especially in countries that do have
employment-based insurance schemes.
Women
provide most of long term care
Informal
caregiving responsibilities fall more heavily on women, many of whom
are older with health problems of their own. Caregiving
responsibilities also come with economic costs, as caregivers often
reduce or adjust their working hours to accommodate these
responsibilities. The paid long-term care workforce is
overwhelmingly female. Almost all nurses and home care aides in both
institutional, home and community-based settings are women.
All these factors justify that we pay a bit of special attention to older women. Or in WHO terms, to give a gender perspective to care and include equity considerations.
Now
going back again to the Saudi film. This movie is rather about young
than old women. Still it shows that many women have to struggle hard
in life, are often on their own and have to care for even young and
healthy men. Not being allowed to drive a car alone, it makes sense
to find a bike to escape from the other sex.
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