The importance of the gender perspective in health

 The importance of the gender perspective in health

The importance of the gender perspective in health

The importance of the gender perspective in health

Gender equality in health is essential in order to provide equitable care for all people. However, it is not always, and in all areas recognized as a goal to be achieved. In part, this is due to the lack of recognition of many of the problems that the traditional healthcare model entails in its very practice. Perhaps the most important of these problems is the lack of a gender perspective in the design and analysis of healthcare structures, research, and strategies. Analyzing these issues in detail serves to show the need to promote changes in the area to achieve a fairer model for everyone.

gender and health

The social determinants of health can be defined as the circumstances in which people are born, grow, work, live and age. They include the set of forces and systems that influence the conditions of everyday life. In short, different sociopolitical, economic, and cultural circumstances (such as access to drinking water, decent housing, and care in quality health centers, among others) have a great impact on people’s health. The  main causes of health inequities can be explained through these determinants, and the vast majority can be avoided.

It is important to include the gender perspective in health analyses because, like the other factors we mentioned,  gender is a key structural determinant: it establishes the existence of different opportunities for girls and boys, women and men to enjoy optimal health and plays a decisive role both in the way in which women and men contribute to health development and also in the way in which they receive its benefits.

A gender approach to health differs from a purely sex-focused analysis  (focused on biological differences) in that it seeks to identify the social and cultural differences experienced by women, men, and other identities, and the impact they have on their relationship to health. Health. Thus, while sex can indicate different risk factors or the need for another treatment for the same pathology, gender can determine different possibilities of access to health care, adherence to treatments or the impact of social and economic determinants of health.

The gender paradox in health

In the 1970s, the existence of a paradox that is known today as “ the paradox of gender in health ” was revealed. From the reviews of the literature on the differences between the sexes in getting sick and dying, the existence of differential mortality and morbidity between men and women became evident: worldwide, women have a longer life expectancy than men. men ( around 73 years for the former and around 69 years for the latter ), a fact that has led some to defend the idea that it is men, not women, who are in a more vulnerable health situation. However,  while women live longer, they suffer from poorer health. This difference cannot be explained by appealing to a single reason: it is due to multicausal factors in relation to differences in risks related to lifestyles, biological risks, health and disease behaviors, differences in the use of health services, etc.

Subsequent investigations also showed cases in which men suffer from poorer health, but with better survival than women, but these are specific cases in which the comparison is limited to a particular age group or a determined territory or, also, to the socioeconomic conditions that cross them. However, globally, the mortality/morbidity paradox (that women live longer than men, but have worse health) holds, despite some differences in isolated cases.

It should be noted that gender is one of all the determinants of health, although structurally it is one of the most important. Therefore, when analyzes are carried out within the different groups, differences are also observed among all women with respect to race, ethnicity, age, socioeconomic level, education, the place where they live, sexual orientation, and more.

Gender biases in research and healthcare

High maternal mortality rates (especially in developing countries), lack of access to contraception and family planning advice, teenage pregnancies, the rise in HIV infection among young women in many peripheral countries, and High rates of cervical cancer make it urgent to implement public policies with a gender perspective in health.

Throughout the world, women continue to suffer from social and economic disadvantages, with consequent health consequences. Despite having higher levels of formal education (exceeding men in many regions),  this progress is not reflected in their economic situation:  formal income and employment rates are still lower than those of men and they work mainly in the informal sector of the economy. This situation of inequity limits women’s access to quality health care, in some cases because they are in countries where there is no free care, in others because they do not have health insurance, as they do not have the possibility of accessing a job. formal.

Gender-related health inequities disproportionately affect poor, young, and ethnic minority women. In some countries, where maternal mortality rates are high (especially among the poor),  the gap in life expectancy between women and men is also smaller, which marks a difference with women who have access to better conditions of health and development.

The gender bias in the sphere of health care is manifested in the slow (and sometimes non-existent) recognition of health problems that affect women in particular. Perhaps the greatest example of this neglect is that of violence against women, its prevalence, and its consequences for the physical and mental health of women. It is estimated that one in three women experiences some form of gender-based violence throughout her life, which has a substantial impact on her health. Intimate partner violence, for example, is a major cause of death worldwide,  accounting for 40 to 60% of homicides of women. in many countries, and is also responsible for a large percentage of maternal mortality in countries such as India, Bangladesh, or the United States.

Those who work in the health field (from medical to administrative) rarely have the necessary training to identify situations of violence and articulate strategies to address the problem. And they are often the first (and sometimes only) contact the victim has with someone outside of their environment. For this reason, they should be able to count on the means to detect and prevent new occurrences, especially in the services that women are more likely to use, such as those related to sexual and reproductive health in young people and adults, and pediatrics in the case of women. the girls. These spaces are strategic for providing care, support, and referral to other services.

But not only gender issues are little worked in the field of health care, the same happens in the field of research. Despite the recognition by international organizations of the importance of including the gender perspective in health research,  much of the statistical data on health is not yet disaggregated by sex.

Added to this, the frequent absence of women in clinical trials does not allow the correct generalization of their results to the entire population, with negative consequences for the health of those who are excluded: between 1997 and 2000,  80% of the drugs that were withdrawn from the market in the United States was due to the side effects that its use had in women. And research showed that the vast majority of clinical trials testing its safety and efficacy had not included women.

An additional problem can be seen in the composition of the health structures in the world. From international organizations to ministries, from large hospitals to small health providers,  women are underrepresented in the most renowned specialties and almost absent from positions of power  (with the exception of some specialties considered “feminine” such as gynecology and obstetrics, dermatology, and pediatrics, among others). The latest issue of the prestigious medical journal The Lancet has drawn attention to discriminatory work environments and unequal pay for women in the medical field., decrying the dearth of women in institutional leadership despite overrepresentation among medical graduates and in the global health workforce.

Health should not be considered without gender

For decades there has been sufficient evidence to support that the lack of gender equity in health has a negative influence on the health of women and girls. For this reason, it is necessary to integrate the gender dimension in professional training programs in health careers, in the design of research, in the structures of health services, and, especially, in public health policies, to combat unequal gender relations. the power that exists between women and men in the world. The well-being of women and girls, who make up half the population, directly affects the well-being of the entire global community.

Gender analysis in health —that is, attention to the interaction of biological and sociocultural factors— must always be accompanied by the search for gender equity, to guarantee equality between women and men in relation to their health status, access to health care and labor participation in the field of health, thus eliminating barriers that are unfair, unnecessary and avoidable.

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