Gender, Health, andGender, Health, and Equity:Equity:

The IntersectionsThe Intersections

Presented by: Beverly Hill, M.Ed.Presented by: Beverly Hill, M.Ed.

By Piroska Ostlin, Asha George and Gita Sen

Gender vs. SexGender vs. Sex GenderGender – perceptions, social roles, and – perceptions, social roles, and

interactions with other social features to interactions with other social features to produce certain power relations/differentialsproduce certain power relations/differentials

Sex Sex – the biologically recognized differences – the biologically recognized differences between females and malesbetween females and males

Males, females, transgender and Males, females, transgender and transsexualstranssexuals

A Bio-cultural ApproachA Bio-cultural Approach“…“…although gender and sex are conceptually although gender and sex are conceptually

distinct, in practice, variations of distinct, in practice, variations of interactioninteraction between the two exist. Biological differences between the two exist. Biological differences between the sexes may be in part between the sexes may be in part sociallysocially determined, while social differences arising determined, while social differences arising from gender relations may also have a from gender relations may also have a biologicalbiological element” (p. 133).element” (p. 133).

(Hammarstrom et al., 2001; Krieger and Zierler, 1995)(Hammarstrom et al., 2001; Krieger and Zierler, 1995)

Systematic Gender Systematic Gender DifferencesDifferences

Division of laborDivision of labor Education/literacy Education/literacy Medical care Medical care

accessaccess Social liberties Social liberties

associated with associated with income, resources income, resources and benefitsand benefits

*Photo accessed at http://www.mediarights.org/search/fil_detail.php?fil_id=02034.

Measures of Gender Measures of Gender InequalityInequality in Health: in Health:

MortalityMortality MorbidityMorbidity Health care Health care

access and access and qualityquality

Clinical researchClinical research Health outcomesHealth outcomes

For discussion…For discussion… What are some What are some

BIOLOGICALLY BIOLOGICALLY SPECIFIC SPECIFIC health health needs of men and needs of men and women that are not women that are not fairly accommodated fairly accommodated in the U.S. health in the U.S. health care system? In care system? In developing developing countries?countries?

What are some What are some examples of examples of inequalities in health inequalities in health and health care and health care arising from unfair arising from unfair GENDER RELATIONSGENDER RELATIONS, , not associated with not associated with biological biological differences?differences?

Structural Violence?Structural Violence? Medical Anthropologist & Medical Medical Anthropologist & Medical

Doctor, Paul Farmer, informs us that many Doctor, Paul Farmer, informs us that many health conditions are health conditions are socially-derivedsocially-derived and and are hence a result of ‘structural violence’ are hence a result of ‘structural violence’ that is perpetuated by inequitable policies that is perpetuated by inequitable policies that are that are political-economic in naturepolitical-economic in nature..

He warns that when we do not He warns that when we do not respond to such policies explicitly, we run respond to such policies explicitly, we run the risk of becoming the risk of becoming “m“managers of anagers of inequalityinequality.”.”

DO YOU AGREE …DO YOU AGREE … OR DISAGREE? OR DISAGREE?

Policy Development for Gender Policy Development for Gender EquityEquity

Access to goods and services:Access to goods and services: Comprehensive Comprehensive promotion of self-help, reproductive health and promotion of self-help, reproductive health and sexuality, violence prevention and care for victims sexuality, violence prevention and care for victims of violence, mental health, and occupational health of violence, mental health, and occupational health across age and cultural groups (inclusive of across age and cultural groups (inclusive of primary, secondary and tertiary prevention efforts).primary, secondary and tertiary prevention efforts).

Education & Empowerment:Education & Empowerment: Implement at the Implement at the community and individual levels, for both men and community and individual levels, for both men and women. Base on sound theoretical perspectives.women. Base on sound theoretical perspectives.

Political and Economic Equity:Political and Economic Equity: Provision of Provision of opportunities that are made equally available to opportunities that are made equally available to men and women at all ages and cross-culturally, men and women at all ages and cross-culturally, and for the same rate of pay. and for the same rate of pay.

Theory to Practice: Theory to Practice: Lessons from the fieldLessons from the field

Improvements can be made to combat gender Improvements can be made to combat gender inequitiesinequities

in health by:in health by:

Addressing Addressing barriersbarriers to health care services to health care services Working toward greater Working toward greater cultural sensitivity, cultural cultural sensitivity, cultural

competency, & cultural proficiencycompetency, & cultural proficiency Establishing means for developing, implementing and Establishing means for developing, implementing and

evaluating programs that will be evaluating programs that will be sustainablesustainable over time over time Make the embodiment of Make the embodiment of “health as a human right”“health as a human right”

central to all health promotion endeavorscentral to all health promotion endeavors Improving Improving data collection methodsdata collection methods to include more to include more

effective tracking and monitoring of health outcomes effective tracking and monitoring of health outcomes through time and space for through time and space for all all genders.genders.

Parting thought…Parting thought… Until we explicitly account Until we explicitly account

for the for the interacting social interacting social factorsfactors that serve as health that serve as health

determinants along with determinants along with differential differential biological biological

markersmarkers in in locallocal health health care provision, policy-care provision, policy-

making and community making and community praxis, we will not be able praxis, we will not be able to adequately address the to adequately address the issues surrounding issues surrounding gender gender

inequityinequity in health. in health.*References for this presentation have been made available on your handout.