I became interested in this book as the story of a profession that started from scratch in the 20th Century, whose ranks grew from a population of a social minority – women in the workplace. In many ways, the story of flight attendants parallels the stories of other health professionals, including physicians and nurses. In my own medical school, which opened for business in 1967, you could walk along the “wall of fame” and at a glance see how the number of women in each class grew from year to year. It was only in the year after mine that there were as many women as men in the entering school class.
I have also grown up in the Jet age, and in an era where a lot of legal rights that minorities now have, have been in place. I recently visited the National Partnership for Women and Families, where I saw legislation that that group helped to enact, including the Pregnancy Discrimination Act and the Family Medical Leave Act. When I saw the physical representation of these laws, and the years that they were enacted, it was a powerful reminder to me that a lot that we take for granted today took a lot of work by dedicated individuals to make them part of society.
It was with this interest that I learned about the history about the flight attendant profession.
The airlines were an industry borne out of technological advancement and a less than stellar safety record. In creating an image and a differential for the white male business travelers who would patronize this transportation medium, the idea of single, white, young women as hostesses was developed. First, this group was composed of registered nurses, but eventually this requirement was dropped. What happened over the next 70 years was something of a struggle between the role of glamour, safety, and femininity in supporting the livelihood of this mostly female group. Significant changes in airline work included the introduction of alcohol on board, and the jet age, with expanding cabins and reduced flight times. In the 70’s, many airlines further sexualized the role in marketing campaigns, all while maintaining weight, age, and marriage limits.
American carriers had invested millions of dollars over the years in creating a marketable image of stewardesses as uniformly “young, attractive, and unencumbered,” as one executive put it. Perhaps no less important, they had grown accustomed to the cost-effectiveness of employing young, single, healthy women for a short term at moderate wages.
The story talks about the danger of a status quo that causes people to stop asking important questions, and the amount of energy that an industry will create to keep things as they are. Even after the passage of Title VII of the Civil Rights Act of 1964, which ended tolerance for discrimination based on sex, there was much work to do to change attitudes and ultimately behavior. In 2008, we cannot imagine supporting employment practices such as termination due to pregnancy, marriage, or the reaching of age 32. It is hard for me to believe that there was a time in my lifetime when this was business as usual.
The book was an enjoyable read for someone who is interested in reducing disparities by learning how we got here, so we can know how to proceed in the future. The medical profession enjoys more integration and acceptance of differences than ever; at the same time, many parts of our medical system are challenged in reducing disparities, as landmark studies by the Institute of Medicine have shown.
What will we do to create a health system where practices that are status quo today will seem unreal in 10 years? The first thing is to never stop asking, “How are we doing?” and “How can we improve?”