Gender inequality is a prevalent issue and a reoccurring theme within Catching Homelessness. Gender bias in education, the wage gap, healthcare, and the lack of representation of women in leadership roles are just a few examples of how gender seeps into society and creates inequality. Gender inequality can set women back in several aspects of life. Unequal job opportunities and wage gaps can prevent women from acquiring the income needed for housing, food, or healthcare. A report done by the Global Gender Gap found that "it will take another 132 years to close the global gender gap." (WEF, 2022). There are also significant risks within the healthcare world due to gender. Several women have reported having stories of being ignored or dismissed by medical professionals. A survey done in 2019 found that "Twenty percent of women reported feeling ignored or dismissed by a healthcare provider while 17% feel they have been treated differently because of their gender" (Dr.Alibadi, 2022). Ignoring a patient's needs is very dangerous and causes serious health complications leading to healthcare disparities and different outcomes.

Josephine Ensign, the author of Catching Homelessness, discusses the sexism she experienced within her workplace. Being a woman in the healthcare industry during the 1980s, Ensign describes it as a predominantly white, male-dominated field. At one point in the book, Ensign gets invited to dinner with her colleagues. She writes, "Clearly I did not belong. I was the only female inside a boys' club: a rich, exclusive boys' club. A rich, exclusive, white boys' club." (Ensign, 2016, p.104). She then discusses how poorly she was treated by her colleagues as if she were too incompetent to manage the job she had. She says, "I felt simultaneously embarrassed, flattered, -- and suspicious. Several of the older men seemed particularly interested in my role as a nurse practitioner. Did I diagnose health problems? Did I prescribe medications, and if so, which ones? And how exactly did I prescribe them?" They asked these questions in a manner of court cross-examination in front of a jury, darting brief, knowing glances at each other, smiling sardonically." (Ensign, 2016, p.106). Ensign has to constantly prove her knowledge and be judged by her male counterparts because of their bias'. She finds herself working harder than those around her so that she isn't seen as less than others. This causes her to burn out faster and lose her identity. Throughout the book, Ensign notes societal expectations, often referring to herself as "playing the role of pious, Southern Christian wife" (Ensign, 2016, p.40). She even believes the reason she was hired was that she has motherly. She is afraid that if she loses that identity, she will lose her job.

Several systems influence and shape this SDOH. Politics is one of the most prominent systems that shape and directly impact women. The most important example is the overturning of Roe v. Wade. This disappointing decision was made to control women by telling us what we can and cannot do with our own bodies. The overturning of Roe v. Wade will have serious negative consequences leaving women in vulnerable positions such as unsafe abortions and not being ready financially or mentally for a child. In class, we read about Olivia Julianna, a Texas teen who has raised thousands of dollars for abortions after being mocked by a Florida Representative (Jones, 2022). This shapes gender and gender inequality because it further supports the idea that women should not be in charge of their bodies.

Moreover, it perpetuates the idea that women must be controlled. Another system that influences gender and gender inequality are the media. The media is known to have a considerable wage gap between female and male costars/female and male athletes. In this course, we also read an article that discussed the U.S. Women's National soccer team reaching a settlement agreement. The article reported, "Twenty-eight players sued U.S. Soccer in March 2019, alleging that female players were consistently paid less than their male counterparts despite superior performance on the field" (Treisman, 2022). The media can further influence unfair wage gaps between men and women. History also plays a massive role in gender inequality because, throughout history, women have been told what to do. Furthermore, their roles have been deemed the inferior gender; this contributes to the systemic oppression of women.

A theory that applies to this is the intersectionality theory. The theory states that systems of inequality intersect with one another and create unique experiences; this means gender, race, ethnicity, social status, sexual orientation, etc. can overlap and create multiple forms of oppression. For example, I am a brown desi woman. These identity markers do not exist independently. I am never just a woman; avoid the single story and label (Adichie, 2009). This theory reflects the SDOH because there is a lot more than just gender that we need to think about. We are multifaceted beings and have multiple identities that makeup who we are. Ensign even mentions how she is more than just a woman. She brings up her religious affiliation, race, and gender by letting readers know she is a white Christian woman. If we try to look at human beings with a simplistic approach, we will never be able to understand why someone is the way they are. Therefore, we must recognize that our experiences and identity markers do not exist separately. We read an article on the intersectionality theory, which gave a good example related to the gender wage gap. They mentioned how a white woman makes $0.78 for every white man's dollar while a black man makes $0.74. A black woman, faced with multiple forms of oppression, only makes $0.64. (Chandler, 2020). Ensign was mistreated by her male coworkers; a WOC working within the field could have dealt with sexism and racism too.

To help resolve issues with gender inequality, we must look at ways of intervention via the Public Health Intervention Wheel. Policy development and enforcement could ensure laws and systems are in place that prevent inequality in the workplace (wage gap, harassment, equal representation, etc.). Laws should protect the health and rights of women as well.

Physical environment is a recurring theme throughout Catching Homelessness. The historical landscape of Richmond, VA, tells a story of its Confederate heritage. According to A Guide to the Richmond (Va.) Free Negro and Slave Records ( n.d.) Richmond was named by William Byrd (1674-1744), who envisioned the development of a city at the falls of the James River. It served as the capital of the Confederacy from mid-1861 to April 1865. Ensign describes Richmond as "a landscape of ghosts and half-buried violence, blanketed in violets, punctuated by deep, abandoned wells" (Ensign, 2016, p.31).

In the first chapter, Ensign talked about one of her patients named Lee, who had died of AIDS. Lee was a homeless man she had grown close to through her work at the clinic. At one point in the book, when Lee had not come in to receive his shots, Ensign visited him at the new place he was staying. The building had no electricity and running water; there were liquor bottles and fast-food bags all over the floors of the building. The railings were crumbling to pieces inside, and Lee's room was the size of a walk-in closet where a cot and heater was the only thing that fit (Ensign, 2016, p.15). Ensign wondered how it was possible for someone to live here and even pay to live there, especially when she had seen homeless camps outside in better condition. Another patient of hers, Louie, had lived in the dumpster in the street center parking lot with old discarded wooden doors used as his shelter. Louie had been living in such bad conditions in the dumpster that he was covered with lice from head to toe (Ensign, 2016, p.35). His poor living conditions and his untreated schizophrenia had allowed him to become covered with lice because it was dirty, and he was unable to clean up.

Throughout the book, Ensign talks about the Street Centers' appearance. She had described it as having a "cold" look. The street center was located in the "armpit" of town and had been built on an old city dump (Ensign, 2016, p.5). City officials were trying to hide the homeless problem by getting them out of sight, so they donated the building to get the visible homeless living on the streets out of the public eye (Ensign, 2016, p.5). Ensign describes the landscape around the street center as empty lots surrounding the building, and kudzu vines draped over the telephone poles that acted as a "convenient curtain to block the public's view of the ugly, forbidding-looking building" (Ensign, 2016, p.5).

Towards the end of the book, when Ensign fell into her depression after she and her husband had split, she described the place that she rented out as a prison. Her first rental place had a dead furnace causing it to be cold inside, and she lay in bed alone with her death list while being so cold that she was past the point of shivering (Ensign, 2016, p.119).