From Jane to the Journal of Women's Health: Women's health as an emergent body of medical knowledge

Proliferating most publicly since the June 18, 1990 GAO Report to Congress, but present since the 1981 opening in Chicago of the first hospital-based primary care women's health center--Illinois Masonic Medical Center's Women's Health Resources--a discourse has emerged within medicine that defines "women's health" as being "more than" a woman's reproductive organs. Of particular significance is the popular and institutional support which this discourse has garnered, from the establishment of over 1200 hospital-based women's health centers to the creation since 1990 of an Office of Research on Women's Health at N.I.H., a Congressionally mandated survey of women's health in medical education, and the academic medical Journal of Women's Health.While this discourse relies upon the critiques and goals of the women's health movement, it also refigures them. This dissertation provides a history of this discourse's emergence within the institution of medicine from 1965 (the eve of the woman's health movement) through 1995 (five years after the "watershed" GAO Report to Congress). It argues that this discourse has attempted, in de Lauretis' (1987) words, to "de-re-construct" medical understandings of gendered difference. Using feminist theories of discourse and social change in conjunction with Gramscian ideas of articulation and hegemony, this project examines how this discourse--at specific institutional sites where it has emerged--has (and has not) succeeded in changing the production of medical knowledge and practices. As a feminist cultural studies project, it especially assesses how successfully these changes have contested the gender, race, class, and age differences that have traditionally structured discourses of women's health.The dissertation first examines how women's and community health movement critiques traveled into the materials available to physicians and women from 1965-1995. It then analyzes the changes that this emergent discourse of women's health has secured at three different conjunctures: the women's health movement in the 1970s; hospital-based women's health centers in the 1980s; and women's health policy, medical education, and research initiatives in the 1990s.This dissertation uses interviews, on-site observations, archival materials, policy documents, health-care statistics and marketing reports, and mass and popular media stories to construct and analyze this history.U of I OnlyETDs are only available to UIUC Users without author permissio