Women schoolteachers ’ health , gender issues , and work in elementary education

Mesmo reconhecendo um avanço na produção de conhecimento no que tange à visibilidade do trabalho como prática sexuada 1, observa-se que a compreensão desta questão como transversal nos estudos dos mundos do trabalho e especificamente no campo da Saúde Coletiva 2 ainda não se encontra suficientemente sedimentada. Dessa forma, este texto se propõe a refletir como a convocação da ótica das relações sociais de gênero e da divisão sexual do trabalho pode contribuir para estudos mais pertinentes acerca da atividade de trabalho e saúde de professoras de escolas do Ensino Fundamental, trabalho desenvolvido majoritariamente por mulheres 3,4,5,6. O conceito de relações sociais de gênero permite colocar as relações de poder entre os sexos em análise, assinalando que a persistente divisão desigual e hierárquica do trabalho existente entre homens e mulheres é um problema que exige atenção, tendo em vista possíveis mudanças 1,2,3. Além disso, como enfatiza Kergoat 7, as relações entre os sexos e as relações entre as classes não devem ser hierarquizadas, conferindo-se maior importância a uma delas. Tais relações não apenas coexistem: são coextensivas, isto é, elas se produzem e se reproduzem mutuamente. Ambas estruturam e estão presentes nas duas esferas de atividades: a doméstica e a profissional. Portanto, seria um equívoco desconsiderar a questão do trabalho e das relações de classe nos estudos que tratam da vida no âmbito familiar (por exemplo, em estudos sobre violência doméstica), bem como seria ignorar o problema da opressão das mulheres nas pesquisas que abordam o mundo da produção. A questão da consubstancialidade das relações sociais ilumina outro aspecto a ser considerado: há um cruzamento dinâmico do conjunto de relações sociais, pois cada uma delas imprime uma marca sobre as outras 7. Observa-se historicamente que dentre as alternativas possíveis para determinados segmentos de classe do sexo feminino, a inserção no mercado formal de trabalho ocorrerá especialmente em profissões que guardam similaridades com a esfera doméstica. É o caso das atividades de “cuidados” e responsabilidades relativas à casa e aos familiares, que favorecerão a concentração de mulheres em determinados tipos de trabalho, como o magistério 3.

Cad. Saúde Pública 2019; 35 Sup 1:e00189617 feminine), of perceiving and practicing the work of teaching, thereby consolidating a given way of performing the work 3,6 .
Becoming a schoolteacher, especially in elementary schools, more than a professional choice, is perceived socially as a possibility women generally encounter to practice certain skills and competencies not acquired only in formal establishments, and thus not seen as qualifications, but as inherent qualities of women, who are purported to be naturally dedicated, attentive, patient, affectionate, and abnegated, attributes that are considered important in the act of educating children 3,6 .This shows that the coextensive consubstantiality of social relations materializes in the symbolic and economic disqualification of the work performed by women 7 .
This underscores the deterioration of teaching salaries in Brazil, leading to increasingly precarious living conditions for women schoolteachers.Although teaching was initially occupied by middleclass women (after men gradually left it), the profession underwent profound changes terms of class origins, and it was thus later occupied mainly by working-class women 3,6 .

Teaching work and schoolteachers' health
A series of intervention-studies conducted by the current authors (from 1999 to 2017) analyzed the relations between work in teaching and schoolteachers' health in the public school system in the state of Rio de Janeiro and in the city of João Pessoa, Paraíba State, from the perspective of social gender relations and activity theory 8,9 .To understand and transform the teachers' work, life, and health, the premise was that the construction of knowledge on this activity and its relationship with health should result from experimentation developed jointly by professional researchers and the teachers themselves, since they have the hands-on experience of teaching 6,10,11,12 .Thus, the concepts of gender relations and sexual division of labor were tools that dynamized this collaborative work, mobilized in debates and reflections on the increasingly precarious conditions in teaching, partly a result of the value assigned to women's teaching activities.Such instrumental concepts also allowed a critical analysis of the schoolteachers' health-disease process, an analysis by which this process was no longer taken for granted 3,10,12 .
Likewise, from the perspective of activity theory 8,9 , it was possible to identify that these women workers engendered a substantial process of daily reinvention in the face of the limits and impositions of ever-present prescribed rules, variabilities, and chance events.Under these conflicting forces, a set of events develops that shapes life at work -an unrelenting struggle to deal with the stress and strain from the work itself, to avoid illness and pursue a minimum of psychosomatic equilibrium (always unstable).
The studies in the city of João Pessoa 6,12 focused not only on the possible illness processes, but also on the schoolteachers' experiences with pleasure and psychological distress, besides the ways by which they build and rebuild the meaning of (and in) work under such adverse conditions.Their experience with illness relates primarily to problems with their voice and eyesight, besides allergies, back pain, and varicose veins.Psychosomatic complaints also appear, expressed as digestive and sleep disorders and headaches.Given the various situations of embarrassment, the schoolteachers identify various of signs of psychological distress, expressed as despondency, fatigue, frustration, depression, impotence, manifestations of helplessness, irritability, anguish, and even a "feeling of insanity".Such distress has been associated with factors like conflicting hierarchical relations, long and poorly structured work hours (added to their invisible domestic work), difficulty in operating what they have discovered is a golden rule of the trade -"control over the class", discomfort from classroom heat and noise (in synergy with problems with unruly students), deteriorating wages, contamination of family relations, and especially the steady devaluation and lack of social recognition for their work.The greatest source of pleasure is the relationship they develop with their students.
The studies in the state of Rio de Janeiro 10,11 focus their analysis on factors that contribute to the work overload.Importantly, the work actually done by schoolteachers extends well beyond their workday.According to the rules, the schoolteachers have to meet a certain number of hours per week in the classroom, plus another stretch reserved for preparing classes and other activities.However, due to the precarious conditions -like large classes (which means excessive teaching work, Cad.Saúde Pública 2019; 35 Sup 1:e00189617 proportional to the amount of exercises and tests they have to correct and the resulting lack of time for adequate individual attention to students), poor working conditions (noise, shortage of teaching supplies and resources...), urban violence and serious public security problems increasingly invading the schools' walls, etc. -, teachers end up occupying their leisure time with these activities, thus invading their domestic lives, with greater implications for women schoolteachers, who are the ones that traditionally take on the work done in the home 11 .Adopting a perspective of cross-application of research methods, the studies also analyzed official data on sick leave and "work rehabilitation".There was a relevant increase in sick leave rates due to psychological disorders and voice problems, evidencing changes in work conditions and organization that made teaching more harmful over the years studied 10 .
As discussed above, these intervention studies evidenced processes of devaluation of teaching work marked by social gender and class relations, producing dynamics of illness and psychological distress in the women schoolteachers.Likewise, as in other studies 4,5,13 , the research did not point to just a single harmful factor in the health-disease process in these women workers, but to a complex and synergistic set of factors, even more harmful, although scarcely visible.
The studies also showed that gender relations produced different ways of constructing meaning in and about the work, due to the distinct ways that men and women conceived their work in the school.For women, constructing this meaning was intensely permeated by affectivity, with the profession and motherhood echoing each other.The women assume the variabilities -and precarious conditions -of the daily routine as an integral and even fundamental part of their work, indicating a great willingness to cope with the predictable and the unpredictable, particularly in relation to the affective nature of care and attention.However, while they build meaning on the basis of affective aspects, their dedication leads paradoxically to work overload and physical and psychological strain in these women workers.
Finally, the contribution by the perspective of social gender relations to studies on schoolteachers' work and health is not limited to the possibility of better describing the problems encountered (which is quite relevant in itself), but it also provides a comprehensive qualitative analysis of its various aspects.In this sense, the social gender relations perspective involves questioning the prevailing ways of life and power relations and can thus help leverage changes in the working conditions in schools and strengthen the emancipation of women schoolteachers.

Contributors
All the authors contributed equally to all stages of the article.