Feminist Activism in the 1990s

Gabriele Griffin

• Publisher: Routledge
• Year: 2005
• ISBN:
  9781135746988
• Edition: 1
• Topic: Politics & International Relations
• Subtopic: Politics
• Index: Politics & International Relations

Feminist activism is often taught as an historical phenomenon, and many students entering courses on women's studies are not familiar with current feminist work in the field. This book documents a wide variety of different forms of feminist activism in the 1990s, from organisations such as "Rights for Women" and "Southall Black Sisters" to "Asian Women's Work in Refuges". It raises questions about the meaning of feminist activism and its interpretation within women's studies and other academic disciplines. The chapters suggest, against much current representation within women's studies and elsewhere, that feminism is still alive.; With a comprehensive introduction providing an historical overview of the development of feminist activism from second wave feminism onwards, this text is intended to be of use as a resource for all students of women's studies and related courses.

Part I
Fighting for Women's Health

Chapter 1
Doing It Ourselves: Promoting Women's Health as Feminist Action

Nicki Hastie, Sarah Porch and Lou Brown

In this chapter, we explore the possibilities for feminist action within agencies working in the field of health promotion. Health promotion work around women's health faces considerable challenges in the 1990s following the publication of Government targets for disease prevention (The Health of the Nation White Paper, 1992) and recent reforms and structural changes within the National Health Service (NHS) (Troop and Killoran, 1990; Ham, 1991). We demonstrate how conventional medical practice and Government bodies have consistently ignored the debates and research around women's health needs which grew out of the Women's Liberation Movement, and consider, in particular, how The Health of the Nation has impacted on activities and strategies for women's health. We argue that, at a time when the health of women as a group is considered to be low priority,¹ the commitment of strong and wide-ranging feminist-based activities and campaigns in the community keep alive the politics in health promotion for women.

As part of this study we conducted a postal survey of Health Authority Health Promotion Departments throughout England. Our questionnaire aimed to examine existing practice in women's health within these departments, and to gather opinions on The Health of the Nation as it affects women's health. Our emphasis on England, at the expense of Scotland, Wales and Northern Ireland, deserves some explanation. The Health of the Nation is the strategy document relating to the health of people in England alone. Wales, Scotland and Northern Ireland are covered by their own specific documents and in many respects demand to be treated separately.² Time factors and the potential size of the survey if extended to the whole of Great Britain influenced our decision to focus on the situation in England. Additionally, England has by far the largest number of Health Promotion Departments in the British Isles, allowing us to review a wide range of activities and projects.³ However, information we have gained through correspondence with health promotion workers in Wales suggests that the climate is similar to that in England, allowing certain analogies to be drawn.

Feminist Activism and the Women's Health Movement

In conducting our research, we have been reminded of hostilities toward feminism and the fear of activities which carry the label ‘feminist’. One respondent to the survey commented: ‘I think it is unfortunate that you are going to use an outdated concept like “feminist” to describe women's activism in health promotion.’ Her statement may imply either that feminism is a thing of the past, or a sense of distrust of feminism as a divisive strategy which irritates and alienates some/many individuals. In any event, she did not offer an alternative to ‘feminist’. This individual's view, although isolated amongst the responses, is significant because it underlines that we need to be clear about what we understand by ‘feminist activism’ throughout this chapter.

We investigate these concerns within the history and context of the women's health movement, which has analysed and campaigned around the role that women play in health and healing systems, both as recipients and as providers of health care. The women's health movement is linked to the re-emergence of feminism in the 1960s/1970s. As feminists began to question the level of women's health status and the quality of care received within conventional health services, the rallying cry of the women's health movement encouraged women to ‘take control of our bodies and our care’. One of the earliest books supporting this position was Our Bodies Ourselves (originally produced by the Boston Women's Health Collective; British edition by Phillips and Rakusen, 1978), shortly followed by specific volumes focusing on self-help therapies (e.g. McKeith, 1978; Ernst and Goodison, 1981) which took a woman's right to choice and control in her own health as their central philosophy.

Feminist interventions into health and health care have contributed valuable definitions to the concept of ‘being healthy’. These are important correctives to the traditional medicalized models which understand health through the parameters of sickness and disease. From the beginning, the emphasis of the women's health movement was on the promotion of preventive rather than curative medicine, and on meeting the needs of the ‘whole woman’ (Doyal, 1983; Orr, 1987). Feminists redefined women's health through a holistic model which acknowledged the personal experiences of women and the social, historical, political, cultural, economic, emotional, as well as physical determinants of health. This social perspective on health argues that women's health needs and concerns are entirely incompatible with the conventional medical model, which ignores widespread inequalities in society and depends simplistically on morbidity and mortality statistics.

‘Women's health’ is defined in this chapter in relation to this holistic model, and in choosing our ‘feminist’ perspective, we are in agreement that ‘to promote women's health is to facilitate choice’ (Pattenson and Burns, 1990:40). Although women may share certain health concerns, it is also important to challenge approaches to women's health which consider women as an homogenous group. A woman's age, her social class, ethnic background, sexual identity, religion, and level of education and experience all affect how appropriate certain definitions of ‘health’ may be to her, and how possible it is to incorporate certain health strategies into her way of life. It is necessary to ‘empower all women to understand their own bodies and for them to have access to appropriate (language reading level, relevant to own issues) information for the “choices” they face’ (Worcester and Whatley, 1992:23).

Theories of Health Promotion and Parallels with Feminist Activism

In 1981, P. Reagan made explicit the connections between the actions of the women's health movement and good practice in health promotion:

When one reads of preventive health concepts, self-awareness or personal control, the likelihood is that one would think these to be definitions of health education. Interestingly, these terms also describe the rebirth of another important program, the women's health movement. The rejuvenation of the women's health movement and the growing credibility of the self-care movement deserve to be viewed for what they are— important, although neglected, parts of health education … above all, health education can do for women what it does best for all. It can help people feel good about their ability to be themselves, … to have a sense of self that allows for positive decision-making and self-actualised behaviour.

(Quoted in Pattenson and Burns, 1990:39–40).

Reagan refers to health education here because she is writing before the aims of ‘health education’ and ‘health promotion’ became distinct. ‘Health promotion’ as a specific practice received definition in the early 1980s with the growing recognition that determinants of ill health are often found in social, economic and environmental conditions such as poor housing, unemployment, poverty and disadvantage. Health education, while an integral part of health promotion, has been found to be largely ineffective on its own. The action and aims of the women's health movement clearly have much in common with the philosophy of health promotion. Health promotion is defined by the World Health Organization (1984) as ‘the process of enabling people to increase control over, and to improve, their health’. Ewles and Simnett (1992) understand health promotion as an umbrella term which includes health education programmes, preventive health services, economic and regulatory activities, environmental health measures, organizational development, healthy public policies and community-based work. Health promotion can ideally operate on many levels, empowering individuals and communities to clarify and meet their own health needs, including emotional issues and interpersonal relationships (Evans et al., 1994).

Health promotion can be divided into policy development and health education. Three techniques of health education are information giving, self-empowerment, and collective action (French and Adams, 1986); but these are not adequate on their own. The role of health promotion in policy development emphasizes how it is necessary to alter environmental, economic and social structures in order to promote health, a view supported by Townsend and Davidson's (1982) research into inequalities in health.

The information giving approach has developed in relation to psychological models which explain and predict behaviour. Most important is the Health Belief Model (French and Adams, 1986) which states that for behaviour change to occur, individuals must have sufficient concern about health issues and believe that (1) they are susceptible; (2) behaviour change can remove the threat of illness; and (3) behaviour can be changed at an acceptable cost.

The self-empowerment approach is described as ‘a process by which one increasingly takes greater charge of oneself and one's life’ (Hopson and Scally, 1981). Self-empowerment aims to encourage considered decisions about health according to the priorities and interests of the individual. This often involves training in life skills to equip the individual with the information, opportunity and skills to make appropriate decisions.

It therefore involves participatory methods of learning, and aims not only to raise levels of awareness but also to enable the mobilization of such knowledge through assertiveness training.

The collective action approach aims to enact a change in external environments, not through policy development within existing structures but through change emerging from grass-roots activity. This can be brought about by community groups or individuals acting in their own interests. Collective action seeks to mobilize people against stigmatization and misinformation. Here, the physical, social and political environment is seen as the key determinant of health.

Self-empowerment and collective action approaches are appropriate models for feminist health activists because they can be viewed as stages toward a fourth social transformatory model of health education. Interaction with community groups, where individuals are involved as active participants rather than passive receptors of information, reflects a move towards a more sophisticated appreciation of the social factors affecting health, and insight into the ways in which concepts of ‘health’ and ‘well-being’ are socially constructed. In 1990, the Health Education Authority (HEA) published its rationale for the use of assertiveness training in promoting women's health (Pattenson and Burns, 1990). This presented a strong argument for an ongoing and wideranging campaign around women's health which could feed into all health promotion programmes and settings.⁴ The 1990 rationale also interpreted health promotion for women within the history of the women's health movement. Pattenson and Burns list four levels which build upon each other and combine to improve women's right to choice and control over their own health:

1.to be aware of choice and information about options available;

2.to have the decision-making skills required to set goals and ascertain appropriate courses of action to achieve them;

3.to have the self-confidence and self-esteem to believe one has the right to make such choices;

4.to have the ability to carry out these choices, which usually involves making them known to, understood and respected by and adhered to by others (p. 40).

We take these points as a model for feminist activism within health promotion work with women, but also recognize that change cannot be facilitated simply through individual self-empowerment. It is important to acknowledge that individual ‘choices’ about health may not be choices at all, influenced as they are by wider social and material contexts and interactions with one's peers.

Unfortunately, the UK Government has mainly backed the information-giving model, where health educators decide what it is that people need to know (usually without consultation) and make information available through the media. Information is delivered to the public on particular diseases, how to avoid them, and how to get well. Conventional health education is therefore firmly set within the medical model founded on the principles of behaviourism and individualism. The emphasis here is on individual behaviour change, with little acknowledgement of the structural constraints which limit people's power and ability to effect change and to make ‘healthy’ choices. Similarly, when initiatives such as breast and cervical screening are evaluated, there is a tendency to concentrate on individuals' attitudes and behaviours and to neglect social or collective responses.

Public health policy and reforms developed in the 1990s have given greater emphasis to health promotion and the need for preventative health care (Health of the Nation, 1992). However, the Government has not released any additional funds to help facilitate such efforts, and also continues to prioritize specific diseases and medical conditions, thus ignoring wider social contexts and inequalities. This has significant implications for future health promotion activities around the health of women. We consider below some ...

Table of contents

• Cover
• Half Title
• Full Title
• Copyright
• Contents
• Acknowledgments
• Introduction
• Part I Fighting for Women's Health
• Part II Women's Rights
• Part III Black and Asian Women's Activism
• Part IV Young Women
• Part V Lesbians Organizing Together
• Part VI Women Working for Change
• Contributors
• Index