The hidden penalties of gender inequality: fetal origins of ill-health
The hidden penalties of gender inequality: fetal origins of ill-health
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DOI：
10.1016/s1570-677x(02)00006-0
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发表时间：
2003-01-01
影响因子：
2.5
通讯作者：
Sen, Amartya
中科院分区：
文献类型：
--
作者：
Osmani, Siddiq;Sen, Amartya
本文件关注的是两性不平等和产妇匮乏与儿童（无论男女）和儿童长大后的成人（无论男女）的健康之间的相互关系。该文件的基本信息是，妇女在营养和保健方面的匮乏以其子女-无论男女-无论是儿童还是成年人健康不良的形式反弹到整个社会。妇女的贫困可以通过各种途径影响整个社会的健康。本文着重于通过母亲营养不良的途径。母亲的剥夺对胎儿的健康产生不利影响，这反过来又导致长期的健康风险，不仅延伸到童年，而且延伸到成年。然而，儿童和成人通过胎儿剥夺而感受到母亲剥夺的后果的方式存在重大差异。特别是，导致其各自风险因素的途径以及这些风险因素实际转化为健康不良的情况大不相同。这些差异最好通过“重叠健康过渡”的概念来理解，其中两种不同的疾病并存。两性不平等通过儿童营养不良的途径，加剧了较不富裕人群中原有的疾病状况。与此同时，它也加剧了相对较富裕人群中的新疾病，其途径被称为“巴克假说”。因此，性别不平等导致双重危险-同时加剧两种疾病，从而增加重叠的健康过渡的经济成本。(C)出版社：Elsevier Science B. V.
This paper is concerned with the interconnections between gender inequality and maternal deprivation, on the one hand, and the health of children (of either sex) and of adults that the children grow into (again, of either sex). The basic message of the paper is that women's deprivation in terms of nutrition and healthcare rebounds on the society as a whole in the form of ill-health of their offspring-males and females alike-both as children and as adults. There are a variety of pathways through which women's deprivation can affect the health of the society as a whole. This paper focuses on the pathways that operate through undernourishment of the mother. Maternal deprivation adversely affects the health of the fetus, which in turn leads to long-term health risks that extend not just into childhood but into adulthood as well. There are, however, important differences in the way children and adults experience the consequences of maternal deprivation via fetal deprivation. In particular, the pathways that lead to their respective risk factors and the circumstances under which those risk factors actually translate into ill-health are very different. These differences are best understood through the concept of 'overlapping health transition' in which two different regimes of diseases coexist side by side. Gender inequality exacerbates the old regime of diseases among the less affluent through the pathway of childhood undernutrition. At the same time it also exacerbates the new regime of diseases among the relatively more affluent through a pathway that has come to be known as the 'Barker hypothesis'. Gender inequality thus leads to a double jeopardy-simultaneously aggravating both regimes of diseases and thus raising the economic cost of overlapping health transition. (C) 2002 Published by Elsevier Science B.V.