MENTAL HEALTH OF WOMEN WORKERS IN STUDY: CONTRIBUTIONS TO THE GENDER DEBATE ¹

ABSTRACT.

The article sough to analyze considerations on the mental health of women workers as a theme in the Brazilian academic productions (2000-2016), in order to enhance contributions to the gender debate in the context of work relations and illness. Therefore, we performed a mapping of the Brazilian academic literature published from 2000 to 2016, available on the Virtual Health Library - Brazil, on the subject of woman worker health. From the total universe of articles located and analyzed throughout the research, mental health was the focus of a considerable number of studies, which showed, in general, the relationship between the sexual division of labor and the prevalence of illness among women in different contexts. In the direction of the proposed debate, 14 articles were selected because they relate the topic of mental health to professional contexts produced as female/male territories in which they operate and, above all, because they made it possible to problematize gender inequality as the basis of the sexual division of labor and prevalence of mental illness of women workers.

Keywords:
Mental health; labor; gender

RESUMO.

O artigo busca apresentar considerações sobre a saúde mental de trabalhadoras como tema em produções acadêmicas brasileiras (2000-2016), de modo a potencializar contribuições ao debate de gênero no âmbito das relações de trabalho e do adoecimento. Para tanto, fizemos um levantamento da produção acadêmica brasileira, publicada de 2000 a 2016 e disponível na Biblioteca Virtual em Saúde - Brasil (BVS), sobre a temática saúde da trabalhadora. Do universo total de artigos localizados e analisados ao longo da pesquisa, a saúde mental foi foco de um número considerável de estudos, os quais evidenciaram, de modo geral, a relação entre a divisão sexual do trabalho e a prevalência do adoecimento de mulheres em diferentes contextos laborais. Na direção do debate proposto, 14 artigos foram selecionados pelo fato de relacionarem o tema da saúde mental a contextos profissionais produzidos como territórios femininos/masculinos de atuação e, sobretudo, por possibilitarem problematizar a desigualdade de gênero como base da divisão sexual do trabalho e da prevalência do adoecimento mental de trabalhadoras.

Palavras-chave:
Saúde mental; trabalho; gênero

RESUMEN.

El artículo busca presentar consideraciones sobre la salud mental de trabajadoras como tema en producciones académicas brasileñas (2000-2016), de modo a potenciar contribuciones al debate de género en el ámbito de las relaciones de trabajo y de la enfermedad. Para ello, realizamos un mapeo de la producción académica brasileña, publicada del período 2000 a 2016, disponible en la Biblioteca Virtual en Salud - Brasil (BVS), sobre la temática salud de la trabajadora. En el universo total de artículos localizados y analizados a lo largo de la investigación, la salud mental ha sido foco de un número considerable de estudios, que evidenciaron, en general, la relación entre la división sexual del trabajo y la prevalencia de la enfermedad de las mujeres en distintos contextos laborales. En la dirección del debate propuesto, 14 artículos han sido seleccionados por el hecho de relacionar el tema de la salud mental a contextos profesionales producidos como territorios femeninos/masculinos de actuación y, sobre todo, por posibilitaren problematizar la desigualdad de género como base de la división sexual del trabajo y de la prevalencia de la enfermedad mental de las trabajadoras.

Palabras-clave:
Salud mental; trabajo; género

Introduction

The article seeks to present considerations on the mental health of women workers as a theme in the Brazilian academic production (2000-2016), in order to enhance contributions to the gender debate in the context of work relations and illness. This analytical focus emerged from a broader investigation that had as its general objective to map the theme of woman worker health in the Brazilian academic literature in the period 2000-2016 on the Virtual Health Library - Brazil. The selected literature makes it possible to expand reflections on work and gender relations, in urban and rural labor contexts, which guide the authors’ research interest in recent years. In a limited way, referral presupposes considering the sexual division of labor and gender inequalities from aspects that reveal constructions of femininities/masculinities in the world of work, as a possibility to shift the focus of possible causes in a linear function with the illness.

For the composition of the text, conceptions of work and mental health are mobilized that enable the understanding of singular and collective dimensions of illness. In the process of capitalist production, from the studies of Karl Marx (2013), a certain conception of work is envisaged that allows to understand it as an activity that produces the objective and subjective conditions of human existence. Therefore, the activities carried out by workers are not limited to the production of goods or services as a reflection of merely economic activities, but, at the same time, they constitute conditions for the possibility of social relations and the meanings that the subjects attribute to their own doing.

In the same direction, there is a need for an understanding of mental health that can encompass forms of existence produced in/by the relationship with work, in order to problematize how working conditions, in the interface with gender relations, can be constituted as places of illness of workers. In this case, regarding the occurrence of certain pathologies and their associations with characteristics of their own work in the field of mental health, Codo (2004) guides in the direction of a possible reading of the subject-work relationship in illness processes, as far as in which they indicate the need to transpose the understanding of a psychopathology through the individual and direct relationship of factors.

Regarding the gender debate in the scope of work relations and illness, Codo (2004) instigate questioning the distribution of workers by different attributions, functions and/or areas of work, above all, their effects on conditions and labor relations as promoters of gender inequalities. Without such questioning, it is argued that the investigation of mental illness processes in the field of work and gender relations is fruitless. Likewise, it is necessary to take into account that “[…Α mental illness is characterized by a complex determination that involves economic, social, political and cultural dimensions, expressing itself differently in social classes and in gender relations” (Ludermir, 2008, p. 452).

As for gender relations in the constitution of subjects, it is important to highlight that, for feminist and gender studies, coming from the second half of the 20^th century, the naturalization of positions attributed to women and men, as a biological destiny and as a social organizer, was questioned; one of the emphases of the feminist theoretical field was to reveal the historical and sociocultural character of the positions occupied by women and men, in order to demonstrate the construction of female and male subjects, as well as the social inequalities produced in and by the assumed differentiation (Scott, 1995).

Therefore, based on temporal and socio-cultural norms, gender constructions produce the sexual difference and social positions of women and men, which are affirmed by the necessary and recurrent conformation of bodies and experiences (Butler, 2016). Such conformation mechanisms can be subverted, insofar as it is assumed, according to Butler (2017, p. 695), that “[…Α gender is the mechanism by which notions of masculine and feminine are produced and naturalized, but it can also very well be the apparatus by which such mechanisms are deconstructed and denaturalized”.

Nevertheless, the naturalization of positions occupied by men and women, based on biology as a destination, has not been overcome, as highlighted by Saffioti (2016, p. 385, emphasis added): “[…Α although it was thought outdated, the historical phase of ‘biology is a destination’, which emerged in the 1980s and continues today to see a frightening return to essentialist positions, linking women to nature and men to culture”.

Thus, as one of the possible effects of gender constructions, there is the institution of a certain sexual division of labor that acts in the reproduction/conduction of the working lives of women and men. As a powerful category of analysis of gender inequalities, the sexual division of labor represents a division of social work, governed by principles of separation and hierarchy, historically and socially constructed, which stratify and attribute different values to the work done by women and men (Hirata & Kergoat, 2007).

The pioneer study by Saffioti, entitled A mulher e a sociedade de classes, originally published in 1969, shows a certain sexual division of labor, insofar as, when dealing with the theme ‘Woman and capitalism’, the author discusses how the female labor force “[...Α sometimes is put on the market as a commodity to be exchanged, sometimes is put at home as a mere use value that, however, has a connection with determination as a commodity of the force work of the head of the family” (Saffioti, 2013, p. 96).

From the pioneering study by Saffioti to studies on the theme of the sexual division of labor, produced in the last five decades, there is an exposure of gender inequalities that are expressed and have repercussions on the growing, however, difficult participation of women in different paid contexts of work, marked by precarious jobs, unhealthy working conditions and wages lower than those of men. As representative of this scenario, the dossier entitled Economy, Human Rights and Gender Equality: a new agenda?, published by Revista Estudos Feminista, in 2016, which brings together a set of articles with the “[…Α objective of stimulating the debate on the important UN-Women report entitled Progress of the World’s Women 2015-2016” (Sorj, 2016, p. 587).

In the aforementioned dossier, Alves (2016) points to important advances and achievements by women in recent decades, but also indicates the maintenance of a certain sexual division of labor on the basis of the unequal distribution of activities between women and men (production and reproduction activities, for example), which, among other issues, hinder gender equality.

On the reproductive care activities, largely performed by women, the work entitled Gênero e trabalho no Brasil e na França - perspectivas interseccionais, organized by Abreu, Hirata and Lombardi (2016), brings a set of articles that problematize the gender relations and work within the scope of care activities, among other issues. Certainly, substantive equality in the scope of work and gender relations is an outstanding issue, so that, in line with the aspects already punctuated in the relationship with the mental health of women workers, they update and corroborate the relevance of the gender debate.

Procedures

In order to address the emergence of the mental health theme of female workers, it is worth detailing the methodological procedures that guided the original research on the theme of woman worker health in the Brazilian academic production in the period 2000-2016. The research was carried out on the Virtual Health Library - Brazil (available at http://brasil.bvs.br/), in the period from August to October 2016. The choice for the Virtual Health Library - Brazil is justified by the thematic focus, scope and scientific relevance of the Database.

In the search process, using keywords, the following filters were used: articles (types of document); Complete text; portuguese (language); 2000-2016 period (year of publication). The delimitation of the period was attributed to the growing number of scientific journals and the availability of complete articles in electronic format that are freely accessible in the last two decades; and the growing academic interest in gender studies in the Brazilian context (among other aspects, the growing interest in the gender debate can be seen in a brief consultation to two important academic journals entitled Revista Estudos Feministas and Cadernos Pagu).

Three combinations of keywords were used, namely: ‘health of the woman worker’, ‘health, work and women’ and ‘health, work and gender’. In the search using the first combination of words, 16 articles and 49 were selected in each of the last two. The inclusion and exclusion criteria of the studies were applied according to the thematic delimitation of the research, through the keywords and reading of all abstracts.

For each set of selected articles, using the keywords, an individual table was created based on the following organization: title; authors; keywords; year of publication; name of the journal; electronic address of the publication; complete reference. Subsequently, all repeated articles were excluded and the individual tables were integrated into a general and chronological table with the same organization (title; authors/keywords; keywords; year of publication; name of the journal; e-mail address of the publication; complete reference), totaling 77 articles directly related to the theme of woman worker health.

Subsequently, the full articles were retrieved and read in their entirety, grouped by the emergence of thematic scopes and by the interest of the researchers in deepening relevant topics in the social/academic context. The theme of woman worker mental health emerged in the analytical process described as it became the focus of a set of 21 articles. In view of the academic interest of the present researchers in fostering discussion in the field of gender studies and the sexual division of labor, a new reading of the texts made it possible to select a set of 14 articles: Ludermir (2000); Fernandes, Ferreira, Albergaria and Conceição (2002); Elias and Navarro (2006); Souza, Franco, Meireles, Ferreira and Santos (2007); Wai and Carvalho (2009); Amato, Pavin, Martins, Ronzani and Batista (2010); Silva, Costa and Nascimento (2010); Thomé and Meyer (2011); Oliveira, Garcia, Gomes, Bittar and Pereira (2012); Pinho and Araújo (2012); Bezerra, Minayo and Constantino (2013); Vidal et al. (2014); Costa, Dimenstein and Leite (2015); Silva et al. (2015).

The articles were selected because they relate the theme of mental health to professional contexts produced as female and male territories in which they operate, in addition to contributing, to a large extent, to updating the debate on the double workday of women (in/by the reconciliation of paid and domestic work) as one of the conditions involved in the illness of women workers. In the subsequent topics, a possible reading and contributions to the gender debate are presented.

Mental health of women workers as a subject of study

In the set of selected productions, regarding the methodological procedures, there was an expressive number of empirical studies. Studies were conducted through individual interviews, group interviews, focus groups, observation, case study, questionnaires - with emphasis on the Self Reporting Questionnaire (SRQ-20), questionnaire on work stress (SWS Survey), Quality of Life Inventory, Lipp's Stress Symptom Inventory, Maslach Burnout Inventory, among other instruments; in view of the maximum page limit, in this article, the instruments will not be detailed and such information can be found in the original articles cited.

In line with the data collection procedures, the studies combined qualitative or quantitative, qualitative and quantitative analytical approaches. In and through the articulation of knowledge from the health, human and social sciences, there was an interest in analyzing the relationships between mental illness and work contexts, comparing illness rates between men and women in different occupational areas, formal and informal employment, in different regions and Brazilian cities, in order to support the discussion about the prevalence of illness of workers.

The research subjects were health professionals (nursing professionals, community health agents, higher education professionals linked to the Primary Health Care Network, among others), civil and military police officers, firefighters, bank employee, female teachers of higher education in the health area, workers at a public university, women in rural settlements, sex workers, women caregivers for men with chronic kidney disease, among other workers.

Based on research with workers of different work contexts, studies by Ludermir (2000), Pinho and Araújo (2012), Vidal et al. (2014), Costa et al. (2015) addressed the occurrence of Common Mental Disorders (CMD). Regarding the conceptualization of the referred group of mental disorders, it is worth mentioning the use, as a central reference, of the work ‘Common mental disorders: a bio-socialmodel’, by David P. Goldberg and Peter Huxley, published in 1992. The authors created the category ‘Common mental disorders’ to describe: “[…Α cases that present non-psychotic symptoms, such as insomnia, fatigue, depressive symptoms, irritability, forgetfulness, difficulty concentrating and somatic complaints, which produce functional disability of people, but which do not meet the requirements for diagnoses of the DSM-IV” (Moreira, Bandeira, Cardoso & Scalon, 2011, p. 222).

The study by Costa et al. (2015, p. 16-17) aimed “[…Α to investigate the psychosocial care and support strategies offered to women living in a rural settlement in Northeastern Brazil, especially for those who have CMD indications”. Through a cross-sectional study conducted in Olinda (state of Pernambuco), Ludermir (2000, p. 649) aimed to investigate “[….Α the association of unemployment and informal work with common mental disorders (CMD)”.

The study by Pinho and Araújo (2012, p. 562) “[…Α aimed to assess the association of domestic overload with the occurrence of common mental disorders in women living in urban areas in Bahia, Brazil”. Vidal et al. (2014, p. 2006), in a cross-sectional study, from November 2012 to May 2013, reported “[…Α the prevalence of probable CMD in women workers registered in the Associação de Prostitutas de Minas Gerais (Aprosmig)”.

The studies by Wai and Carvalho (2009), Bezerra et al. (2013), Silva et al. (2015) addressed the themes of stress and Burnout Syndrome and their effects on different diverse work contexts. The article by Bezerra et al. (2013, p. 658) “[…Α aimed to present and discuss occupational stress experienced by female military police officers, based on a study performed by this corporation in the state of Rio de Janeiro”. The studies by Wai and Carvalho (2009) and Silva et al. (2015), in a more specific scope, were carried out with health workers and address aspects of the implications of activities that involve caring for others. Silva et al. (2015, p. 3012) evaluated “[…Α the prevalence of Burnout Syndrome and associated factors in higher education professionals linked to Primary Healthcare Network (Rede de Atenção Primária à Saúde - REAP) in the municipality of Aracaju/SE”. In the study by Wai and Carvalho (2009, p. 564), with Community Health Agents (CHA), “[…Α the objective was to identify, through the perceptions of CHA, events that cause overload and the coping strategies they use”.

Concerning stress and Burnout Syndrome, some conceptual considerations are appropriate. In a text that deals with the basic concepts of stress, Lipp (2001, p. 20) notes that it is important to consider it as a process and reaction of the organism, involving “[…Α physical and/or psychological components, caused by the psychophysiological changes that occur when a person is confronted with a situation that, in one way or another, irritates, frightens, excites or confuses them, or even makes them immensely happy”. According to clarifications of the author, the study of responses produced by stress process must take into account physical and psychological aspects, as a way of including physical and emotional manifestations. The symptoms of stress can be identified and contribute, according to Lipp, to the etiology of more serious diseases, affecting individual quality of life and specific populations. For the reflection in the scope of work relations and illness from the contributions of gender studies, at an opportune moment, it will be central to problematize symptoms of stress and diseases related to specific professional groups.

The use of the term burnout, in the field of psychology, according to Pereira (2016, p. 60), started to be used “[…Α to express the lack of energy and discouragement in relation to work by some professionals, especially those from Health and Education, together with cold, inhuman, impersonal attitudes with which they started to treat people”.

With regard to the recognition of mental disorder, within the scope of the Brazilian legislation, Decree 3048, of May 6, 1999 (approves the Social Security regulation and provides other measures), in the detail entitled ‘Mental and behavioral disorders’ - ‘Work-related (Group V of the ICD-10)’ (according to Annex II), presents the following definition: “XII - Feeling of being finished (Burnout Syndrome, Professional Burnout Syndrome) (Z73.0)” (Brasil, 1999).

Still, in the scope of the health and mental illness of health workers and health care workers, stand out the productions of Fernandes et al. (2002), Elias and Navarro (2006), Thomé and Meyer (2011). The study by Elias and Navarro (2006, p. 518) addressed the “[…Α work of nursing professionals at the Hospital of Clinics of the Federal University of Uberlândia, MG […Α” and aimed

[…Α to investigate the relationships between this activity and the health of the professionals who perform it, what are the negativities and positivities present in their daily work, as well as knowing the extent to which this affects the living conditions of these women.

Fernandes et al. (2002, p. 200) present a research that “[…Α arises from the perspective of building knowledge about the relationship between mental health and women work, through the images and representations of nurses, a category mostly made up of women, whose object, care, it is characterized as feminine”.

With emphasis on the physical and mental health of women caregivers, the article by Thomé and Meyer (2011, p. 504), produced from a research carried out at the Hemodialysis Clinic of the Hospital of Clinics of Porto Alegre-RS, aimed at “[…Α describing and problematizing, from the point of view of cultural studies and post-critical gender studies, some of the cultural learning carried out by these women in the process of ‘becoming caregiver’ for men with chronic kidney disease”.

Likewise, mental health was configured as an investigation topic with military and civil police in the productions of Souza et al. (2007) and Amato et al. (2010). The research by Amato et al. (2010, p.105) “[…Α aimed to evaluate the mental health indicators of firefighters and the factors that influence them, highlighting the differences between women and men”. Souza et al. (2007, p. 106) investigated “[…Α how psychic suffering is expressed among civil police in Rio de Janeiro, from the perspective of gender”.

The suffering and mental illness of sex workers were the object of study by Silva et al. (2010, p. 111) in an article that “[…Α presents the differences and singularities of the work situations of sex workers at the central fair and bars in the city of Campina Grande-PB”. The study by Oliveira et al. (2012, p. 742) aimed “[…Α to evaluate the working conditions on health and perceived quality of life of women teachers of higher education in the area of health, in the city of Vitória - ES”.

Paying attention to the singularities of the methodological procedures and the interests of each study, the set of productions gathered demonstrates that the mental health and illness processes of workers, in addition to being related to each activity and to specific work conditions, allow problematize gender inequalities in different work contexts, especially in and through the materialization of a certain sexual division of labor, as well as its effects and norms on the production/regulation of subjects and subjectivities. In the next topic, some considerations about this possibility are presented due to the intertwining of sexual division of labor, gender inequalities and woman worker mental illness.

Sexual division of labor and gender inequalities in the genesis of worker mental illness: possible threads and entanglements

The interests of studies, summarized in a previous topic, demonstrated that investigations on the mental health of workers require the analysis of labor relations and the technical factors of each activity, as well as the social and subjective meanings attributed to the work process. Indeed, the studies analyzed indicate the need to understand this process from a class perspective and to problematize, among other aspects, the sexual division of labor and gender inequality in the genesis of worker mental illness. Although not all selected studies deal with the categories of sexual division of labor and gender, the different referrals and analytical scopes produced allow them to be problematized.

Therefore, as explained in the article selection process, we decided to emphasize aspects that allow problematizing the mental health related to territories of operation considered to be female and male, as well as the double workday of women in the interface with illness of women workers. This comprehensive analytical perspective allows to trace the sexual division of labor through the bias of activities historically attributed to women and men, which contributes to demonstrate the correlation between activities considered productive and reproductive in the analysis of the illness of women and men.

Studies by Ludermir (2000), Pinho and Araújo (2012), and Costa et al. (2015) regarding Common Mental Disorders (CMD) are representative of the mentioned integration, since they showed aspects of illness related to the specificities and requirements of each activity, bring questions that demonstrate the effects of domestic work and gender inequality in the occurrence and diagnosis of the aforementioned disorders. In the study of women living in the Brazilian rural settlements, Costa et al. (2015, p. 23) explain that work as a ‘mental health support strategy’, in addition to generating benefits, “[…Α especially insofar as it can generate a gain in financial autonomy, also appears as an important factor to be taken into account when referring to the health of these women”. In the context of rural settlements and family farming, according to the authors, in the process of becoming ill, it is necessary to consider the burden resulting from the ‘triple working hours’ of women due to the sexual division of labor.

On the sexual division of labor and gender inequalities related to the occurrence of CMD, Ludermir (2000, p. 656) explains that, in relation to men mental health, “[…Α unemployed women and informal women workers presented an increased risk for CMD”. Moreover, the fact that they perform economic activities does not exempt women from activities in the domestic sphere: “[…Α when performing an economic activity, they also assumed the responsibilities of wife, mother and worker and did two jobs: paid and unpaid, usually not recognized at home” (Ludermir, 2000, p. 656).

The association of the burden of domestic work with Common Mental Disorders in women was also reported by Pinho and Araújo (2012). In the survey conducted with women living in urban areas in Bahia, a high prevalence of CMD was identified, at the rate of four out of 10, “[…Α which reveals a serious health problem in the population studied, especially when compared to the estimate of the World Health Organization (2000), which reports an average prevalence of 24% in the population” (Pinho & Araújo, 2012, p. 570).

As seen, the discussion about domestic work and how it regulates the participation of women in the labor market is not recent in the feminist debate, commonly problematized as an effect of gender inequality that acts in the production of the sexual division of labor. The results analyzed by another set of articles reinforces the problem of the overload of domestic work for which women are responsible, providing an opportunity for a debate on the relationship between the sexual division of labor, gender inequality and illness when investigating professions considered to be female and male. The professions historically attributed to women begins with those that combine care activities in the field of nursing.

As a professional field of female predominance, the study by Fernandes et al. (2002) exposes the impaired mental health of professionals in the face of daily life that requires reconciling professional care activities with the activities of the domestic space. In the study by Elias and Navarro (2006), with nursing professionals, stand out the numerous presence of women in hospital work and the fact that the completion of the workday at the hospital is followed by domestic chores. Among the important analytical considerations of the study, the authors observe the non-recognition of the illness by the interviewed professionals and raise awareness to a dimension of the research results that

[…Α revealed heterogeneity in the distribution of the overload, confirming that it is not possible to talk about a woman daily life but rather about various women daily lives, in a plurality that contains the differences of social class, as well as ideological, cultural and social differences (Elias & Navarro, 2006, p. 524).

Likewise, in the study by Silva et al. (2015, p. 3012), with “[…Α higher education professionals linked to the Primary Health Care Network (Rede de Atenção Primária à Saúde-REAP) of the municipality of Aracaju /SE […Α”, ‘gender differences’ were not identified in the prevalence of Burnout syndrome. However, it is worth emphasizing that, “[…Α in the present study, REAP professionals were a mean age of 44.9 ± 10.5 years, the majority of whom were women (83.5%), married (65.5%), with children (70.6%) and graduate program (68%)” (Silva et al., 2015, p. 3016). Thus, it is emphasized that it is important to consider that it is a professional universe of care, with the prevalence of women.

Similarly, the illness of health professionals due to the burnout syndrome was observed in the study carried out by Wai and Carvalho (2009), with community health agents (CHA). The study focused on overload and coping strategies as central themes for analysis. The gender category was related to “[...Α the CHA’s difficulty when male and faces the difficulty of creating a bond, of entering the homes where only the hostess is present […Α” and the need to present “[...Α guidelines regarding gynecological exams and breast self-exams” (Wai & Carvalho, 2009, p. 565). On this aspect, the authors mention and suggest the gender perspective as a possibility of analyzing the difference and inequality between women and men in the professional field.

The power of the gender perspective in the analysis of the position of ‘caregivers’, historically and culturally learned and occupied by women, was demonstrated in the study of Thomé and Meyer (2011). To address the theme involving “[…Α women in the process of ‘becoming caregiver’ for men with chronic kidney disease […Α”, the authors are based on cultural studies and post-critical gender studies (Thomé & Meyer, 2011, p. 504, emphasis of the authors). For a chronic kidney disease that requires a specific, daily coexistence of specific care, the study revealed the importance that men attribute to caregivers. However, as the authors bring, “[…Α this coexistence, which for some can help in understanding the situation of their ‘dependents’, for others it can generate great anxiety, precisely because of the identification and judgment common to the situation triggered by the disease” (Thomé & Meyer, 2011, p. 506, emphasis of the authors).

Among other contributions to the gender debate, the study evidences two aspects that deserve to be highlighted: on the one hand, the caregiver falls ill due to the unique requirement of the care process itself and the dependence that is installed, generating, in some cases, the need for psychiatric monitoring; on the other hand, “[...Α dependence that is experienced as a burden also implies changes in the gender power relations in force in some cultural contexts [...Α” (Thomé & Meyer, 2011, p. 508). As the study asserts, in/through caring, the interviewees show that ‘becoming’ a caregiver makes it possible to ‘construct other identities’, despite reproducing it as the task and destination of women.

In the repertoire of women professions, teaching stands out, the focus of investigation in the study by Oliveira et al. (2012), carried out with women professors of higher education in the health area. As it is an environment of cognitive overload, the study points out that the interviewees narrate the fact that working conditions and quality of life are affected by the lack of leisure and rest, generating stress, sleep disorders and psychic disorders. The ‘unlimited workday’ due to the coexistence of professional activities and domestic chores is evidenced by the authors, and, “[…Α when referring to women, working time seems to be an important element to determine the perception of quality of life” (Oliveira et al., 2012, p. 744). In view of the overload of demands and their implications for the mental health of the aforementioned occupational group, Oliveira et al. (2012, p. 746) suggest “[...Α the need to elaborate a project for worker health intervention, to improve the work condition of the professor in the health area, reducing the psychological suffering to which they are exposed”.

The working conditions and relationships experienced by women workers, the territory where female work predominates, were analyzed by Silva et al. (2010) and Vidal et al. (2014). Such studies raise questions about the centrality of the sexual division of labor in the analysis of worker illness and, considering the complexity of the debate about the profession in the field of feminist and gender studies, the burden of stereotypes and prejudices as an effect of gender constructions on (de)valorization of women due to the activities they perform.

Damage to the physical and mental health of women as a result of their daily work was evidenced in two studies. Silva et al. (2010, p. 116), in the research they carried out with sex workers at the central fair and in the bars of the city of Campina Grande, state of Paraíba, report that the “[…Α violence practiced by clients against women […Α” and “[…Α the very imminence of violence causes psychological suffering, like anguish”. The study by Vidal et at. (2014, p. 208), with women sex workers registered with the Associação de Prostitutas de Minas Gerais (Aprosmig), reveals that “[…Α in the studied sample, about 60% women had symptoms indicative of probable CMD, a much higher percentage than that found in the general population”.

Another set of articles brought together studies focusing on the mental health of women workers who carry out activities in professional territories historically male, such as the civil and military police. The studies by Souza et al. (2007) and Bezerra et al. (2013) are representative of the processes of illness of police women in the exercise of their activities.

Souza et al. (2007, p. 105) investigated “[…Α the psychological suffering of civil police officers, from the perspective of gender […Α” and report that it is a labor territory considered to be male dominated (despite the evolution of female participation). The study by Souza et al. (2007) highlights the greater representativeness of women police officers in the technical (TEC) stratum compared to the administrative (ADM) and operational (OP) strata, which can demonstrate the reproduction of a sexual division of labor based on the conception of women’s work as care. The load of police activities associated with domestic chores (taking care of the home and family) were cited as factors contributing to the psychological distress of women police officers. The results show difficulties experienced by women police officers due to the characteristics of the police environment itself and the psychological wear and tear they can generate, demonstrating how women and men attribute different meanings to the profession and how such a difference implies the illness of women more intensely.

The study by Bezerra et al. (2013), specifically, dealt with the occupational stress experienced by women military police officers, their consequences in the spheres of work and domestic life. In a direction that is close to that pointed out by previous studies with regard to the sexual division of labor, most of the women studied perform “[…Α internal, administrative and health functions […Α”, since “[…Α their stress basically originates in the managerial and organizational issue” (Bezerra et al. 2013, p. 662). The study revealed that military police men and women do not deal with daily work in the same way, so that the stress-generating factors and their consequences are different. In the case of police officers, stress is associated with daily work and its symptoms affect the family relationship; psychological symptoms of stress supplant physical symptoms; among the factors producing negative stress, prejudice and gender discrimination stand out (Bezerra et al. 2013). Another issue pertinent to the gender debate refers to the fact that police officers perceive differences in the distribution and evaluation of the activities they perform in relation to men because of their ‘gender’; “[…Α in the logic of the military police about the stressors identified in their work, the fact of being a woman is a trigger” (Bezerra et al., 2013, p. 664). The study concludes that it is not a question of eliminating differences between women and men police officers, but gender inequalities.

Still, in professional territory considered to be male-dominated, Amato et al. (2010) deal with mental health indicators and the differences between the processes of illness of women and men in the Fire Department. In comparison with the health of men firefighters, Amato et al. (2010)point out the mental health impairment of women firefighters. Work overload and other negative points, involving work relationships and their effects, mainly on mental health, were perceived and reported by women. Some prejudices and judgments recorded by women and men are representative of gender inequalities, such as the notions of limited woman’s physical strength and specific functions for women in the Fire Department, prejudice against female work and the alleged superiority of men in some activities, among other issues. From the results obtained and widely detailed in the article, the authors note that it becomes “[…Α feasible to suggest that the indicators of stress, depression and general mental health, more common among female firefighters, may be linked to the conditions of female work in the institution” (Amato et al., 2010, p. 115).

Finally, the set of selected articles made it possible to outline considerations regarding the mental health of women workers in the intertwining with the categories gender and sexual division of labor, since they made it possible to demonstrate the intrinsic relationship between paid professional activities and domestic chores in the genesis of the illness, as well as particularities of professional territories considered female and male dominated. In view of the above, the relevance of the gender debate is highlighted to explain the inequalities between women and men in work contexts based on women mental health problems.

Final considerations

The selected articles brought discussions about mental health as a focus in different professional contexts, produced as female and male territories of operation, highlighting the debate on the double workday of women as one of the conditions involved in the illness of women workers. The categories of sexual division of labor and gender were mobilized to analyze the relationship between work and the woman worker’s mental health/illness. The articles, in general, compared rates of illness between men and women in different spaces and working conditions, in the different Brazilian regions, showing the prevalence of illness among women workers. A set of studies focused on mental illness in activities in the areas of health and care, to a large extent, precarious and feminized. One of the studies, for example, raised questions regarding the mental illness of university professors, highlighting the condition of full-time work that it requires. At the opposite pole, the presence of women in professions historically considered male dominated, also showed faces of illness, which say about the ‘weight’ of gender norms and the challenges of moving through such work spaces.

Common Mental Disorders have been the topic of studies that have emphasized the specifics of occupations, the relationship with domestic chores and gender inequality in work contexts as conditions for the illness of women. The analysis of the prevalence of stress and Burnout Syndrome among women workers was the focus of a set of studies. For an analysis based on the contributions of the gender debate, the symptoms of stress are largely associated with the burden generated by the multiple working hours of women, as an effect of the gender inequalities that act in the production of the sexual division of labor. Although not all studies have combined the categories sexual division of labor and gender in their analyses, they have allowed to problematize the differences in the illness processes of men and women workers, contributing to potentiate the gender debate in the scope of labor relations and illness. In summary, it is highlighted that the analysis carried out contributes to highlight the recurring need for empirical studies on women workers in different work activities, especially in the interface with issues related to health in the field of gender studies.

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  Support and funding: Research Groups Program at the Universidade do Extremo Sul de Santa Catarina - UNESC.

Publication Dates

• Publication in this collection
  12 Nov 2021
• Date of issue
  2021

History

• Received
  09 Aug 2018
• Accepted
  11 Apr 2019