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Gender and Health
Introduction
As a statewide health promotion agency Women's Health Victoria specialises in the translation of women's health knowledge into practice. Active consideration of gender as a determinant of health has led to a better understanding of many areas of health and wellbeing including policy approaches to planning and provision of health services.
There are many examples of existing policy that focus on women. These are important. There is however a perception and concern that, although women's issues generally, and women's health in particular, are acknowledged, these factors remain essentially cast as a separate stream within departments and government.
There is presently no framework on which to build a comprehensive, mainstreamed approach to gender across the span of department and government responsibilities. An ability to visualise and measure the many and varied ways in which policies and programs can cause or lead to discriminatory effects is essential in effective scoping and assessing gender impacts around existing and new policy initiatives.
WHV is advocating that an across government gender and health framework be developed and implemented.
For more information see the following resources:
- A gender agenda: planning for an inclusive and diverse community
Bishop, Avega. Footscray, Vic: Women's Health West, July 2002
- Gender and diversity: a workbook for an equity approach to practice
Dyson, Sue. Frankston, Vic: Women's Health in the South East, 2001
These resources are available through the Women's Health Victoria Clearinghouse. The clearinghouse can be contacted on 9662 3755 or by email at clearinghouse@whv.org.au.
Social view of health
A social model of health underpins the activities of Women's Health Victoria. A social view of health is one that concentrates on improving the health and wellbeing of a population through addressing the social and environmental determinants of ill health concurrently with the biological and medical factors which influence health and wellbeing.
A social view of health draws on key social factors or social determinants that influence broader patterns of health and illness within any given population. Key social determinants include socio-economic status (of which income is an indicator), race, ethnicity, gender and geographic location.
This view of health draws on key international documents on the World Health Organisation's Ottawa Charter (1986) and Jakarta declaration (1997) both of which place health within the broader social context of wellbeing.
The Ottawa Charter resulted in new public health thinking that emphasises solutions through community participation, equity in health, collaboration and co-operation of service providers and improved ecological management.
Locally, the Victorian Government has used this model to identify patterns of health inequalities across the state and to focus on the needs of marginalised and disadvantaged groups within the Victorian population as a whole.
Absent from this list of social determinants of health are culture (in its broadest understanding), disabilities and sexuality. There is evidence that poor outcomes as a result of discrimination and marginalisation occur within all of the determinants.
Women's Health Victoria recognises the importance of all health determinants. Our particular concern is with understanding the impact of gender on health and well being in diverse populations of women.
For more information on gender as a determinant of health, visit the Women's Health Victoria Clearinghouse resource collection database. Search the database using the subject headings: health determinants or health equality.
() This explanation of a social view of health has been adapted from: Banyule Nillumbik Primary Care Alliance & "What's the Difference" produced by the Victorian Ministerial Advisory Committee on Gay and Lesbian Health, 2002.
Why women's health?
When we speak about gender, we are referring to the experiences of both men and women.
Women and men experience health differently. Biological sex differences are responsible for health issues traditionally regarded as men's health or women's health issues, like reproductive health and sexuality. Gender refers to the different social and cultural roles, expectations, and constraints placed upon men and women by virtue of their sex. When analysing the different experiences and impacts of health on men and women, differences relating to gender, in addition to biological sex, need to be considered.
Historically, men have been the investigators and participants of health research and the data arising from this work has been extrapolated to represent the experiences of both sexes. Due to biological, genetic, socio-economic and behavioural differences between men and women, this extrapolation has resulted in policies and programs that may be unsuitable or even harmful.
Neither women nor men should be treated as another special interest group. Nevertheless it is indisputable that there are substantial differences in the lives of women and men, even within the same cultural, ethnic, age, and religious groupings.
Gender differences in our society can influence both women's and men's:
- Exposure to risk factors;
- Access to and understanding of information about disease management, prevention and control;
- Subjective experience of illness and its social significance;
- Attitudes towards the maintenance of one's own health and that of other family members;
- Patterns of service use;
- Perceptions of quality of care.
Policies and programs that do not account for gender differences may have a detrimental impact on both men and women. Given the social context of women's lives, women are more likely to experience more significant detrimental consequences as a result of policies that ignore potential gender impacts.
For more information see the following papers:
Defining the terms
Gender
Refers to the differences and relations between men and women that are learned, vary widely within and between cultures and which are changeable over time.
Gender-neutral policy
Policy that has no differential impact, either positive or negative, for equality between women and men.
Gender blindness
Where the gendered aspect is either ignored - or deliberately not addressed, on an assumption that no gender-based differences apply.
Gender mainstreaming
The (re)organisation, improvement, development and evaluation of policy processes so that a gendered perspective is incorporated in all policies at all levels and at all stages, by those normally involved in policy making. In practice this means a consideration of the differences between the conditions, situations, needs and priorities of women and men in all policies, planning and actions, as part of the core business and decision making of an organisation. As a process, mainstreaming gender may be expected to:
- Expand an organisation's knowledge of and connection with its 'market' and publics;
- Reduce unintended adverse consequences of policy implementation;
- Extract better value from investment in programs and services;
- Provide a framework for championing learning opportunities within organisations and in relation to other external partners and stakeholders, and for the achievement of gender equity and equality.
The concept of gender mainstreaming must become an ordinary part of the way things are done across all government departments and instrumentalities. This requires the process to be championed from top down; that is, the expectation that gender awareness and valuation objectives will be routinely present in:
- All levels of State and organisational planning (e.g. mission and strategic planning, annual reports, business plans and performance targets at departmental and divisional levels);
- The organisation's work culture (e.g. policies around work/domestic life balance, awareness training, staff participation and consultation, etc); and
- The range and imagination shown in their engagement with external partners and communities.
For more information see the following papers:
International work in gender mainstreaming
Cases involving the development and progressive critiquing of approaches in mainstreaming gender have been initiated over the last several years, notably in Europe, Ireland and Canada . The United Nations also has several programs aimed at integrating gender in policy and planning. There is a significant collection of this work in Women's Health Victoria's clearinghouse. From these initiatives, a body of knowledge with considerable consensus has emerged about the conditions, tools and processes required in embedding gender considerations in policy and planning.
Gender and health framework
A gendered policy framework is a tool that enables the development of policy that takes account of and is responsive to gender. It is predicated upon the following:
- All policies have an impact on men and women;
- Policies and programs affect women and men differently;
- Women and men are heterogeneous groups of and within themselves.
A gender and health framework can be applied at the macro and micro level to any policy or program that is being developed or implemented. There are three elements to a gender and health framework. They are:
- Gendered data
- Gender impact assessment and
- Gender awareness raising
Gendered data
Gender monitoring is an essential tool in mainstreaming; initially in the scoping and collection of baseline data, then in the setting and measurement of progress towards targets.
Gender disaggregated statistics are critical in gauging the extent to which men and women benefit differently from policies, however gender statistics need to be cross-referenced with other variables in order to distil clear meanings and meaningful extrapolations.
Raw data is not enough. For instance, a cluster of unusually favourable or adverse outcomes of a small segment among a much larger grouping will often require further enquiry to become meaningful. For instance, what characteristics gave rise to an atypically high presence of women in management, or the high turnover of women on the board, of a particular organisation?
Data collecting needs also to encompass a wider range of circumstances than immediately obvious or related to a particular policy area; for instance, gender disaggregated data on use of unpaid time, on household routine, etc.
Women's Health Victoria has undertaken several projects that highlight issues in gendered data and advocate for their use in policy and planning.
One project was an analysis of the Victorian Burden of Disease data and its use in service delivery planning. Through discussion papers, forums and direct advocacy, Women's Health Victoria demonstrated problems using such data for resource allocation, raised awareness of other related issues and were able to influence the quantifying of the burden of disease attributable to violence against women.
For more information see:
The Burden of Disease case study (under Gender Impact Assessment below) also provides more information about this advocacy.
Victorian gendered data directory
Another project, in collaboration with the Department of Human Services, has been the development of a directory of Victorian data that identifies gender specific information on a wide variety of health and wellbeing indicators. Access to the directory is available here.
Gender impact assessment
Monitoring of new and existing policies for their gender impact requires developing research and auditing methodology for gauging the differences experienced by women and men, in terms of:
- Their respective levels of representation and participation in decision-making
- The distribution and their effective access to the resources
- Norms and values influencing their roles, attitudes, behaviours and others' expectations
- Rights, freedoms and access to justice
The purpose of such examination is to inform and galvanise a process of adapting existing or proposed policies so as to neutralise any discriminatory effects, and to enhance those aspects that promote gender equity as an outcome of policy and planning implementation.
Gender impact assessment papers
Part of WHV's knowledge translation work is the collation of topic-based gender impact assessment papers to demonstrate the disconnection between gendered evidence and policy and practice. The elements of the gender and health framework within which this work fits are gendered data, gender impact assessment, gender analysis training and capacity building from which improved policy and practice flows.
The gender impact assessment papers examine existing policies and programs from an evidence-based gender perspective. They are a clear, concise tool in highlighting the prevalence of both gender differences and absence of gender responsive policy and practice.
Gender impact assessment papers currently available are on the following topics:
If you are interested in contributing to the gathering
of these papers, to support ongoing advocacy, further
information is
available here.
Gender awareness raising
Raising the profile of gender awareness requires knowledge, conceptual and technical skills as well as persistence! This can be achieved at many levels using various tools such as:
- Training delivered through seminars and conferences
- In-house training within an organisation
- Cross - sectoral information sharing and
- Bench marking with others in the same or varying areas of work and policy
Below are examples of some resources that have been used in gender awareness raising:
These resources are available through the Women's Health Victoria Clearinghouse. The clearinghouse can be contacted on 9662 3755 or by email at clearinghouse@whv.org.au.
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