Gender Inequality as a predictor of Hunger: Evidence from a cross-country analysis

This longitudinal evaluation of gender inequalities and economic growth addresses key questions in the evolving debate over the character of gender differentiation and the goals of womens empowerment. These questions include: 1) whether the impact of strategies of economic growth served to enhance or undermine the status of women; 2) whether changes in the status of women were accompanied by significant changes in gender inequality; and 3) the implications for existing debates. Section I reviews several sets of literature pertinent to the questions using three general approaches: modernization-neoclassical women in development and gender and development. Section II presents the data and methods used in the evaluation. The research assessed the contending interpretations reviewed in the first section by combining another set of cross-sectional and longitudinal data on womens status and inequalities between men and women with other existing indicators. Section III discusses the results in the following order: 1) cross-sectional patterns in womens status; 2) trends in womens status; 3) cross-sectional patterns in inequality between men and women; 4) trends in inequality between men and women; and 5) conclusion. Finally section IV presents an overall discussion of the findings of the whole longitudinal evaluation.

Purpose This paper aims to suggest that gender inequality plays a significant role in explaining the prevailing magnitudes of food insecurity in the countries of Sub-Saharan Africa. It provides empirical evidence for the underlying hypothesis that removing discrimination against women, particularly, with respect to their reproductive health and rights, depicted in high adolescent fertility rates and maternal deaths, will be an important pre-condition for addressing the hunger and undernourishment challenge in the region. A theoretical linkage has been conceptualised and supported through findings from panel data analysis of a set of 20 countries in the region, over a period of 16 years (from 1999 to 2015). The key result is that the relative impact of health inequality on food insecurity is higher and significant, in comparison to disparities in education and economic participation of women. A unit increase in adolescent fertility rate leads to an increase in undernourishment by 19.4 per cent, depth of food deficit by 1.15 per cent and a decline in average dietary energy adequacy by 0.21 per cent. Design/methodology/approach In the paper, time series data set for 20 countries of Sub-Saharan Africa is generated by using world development indicators (World Bank) of gender inequality and food security statistics of Food and Agriculture Organisation (FAO). Data set involves trends in variables over a period of 16 years (1999 to 2015). A panel regression analysis with fixed effects is undertaken for testing the underlying hypothesis. To capture the linkage in a detailed manner, the author has fitted four models for each of the three measures of food security. First model captures the specific impact of gender differences in secondary school enrolment on food security in the region. Second model assesses the impact of gender inequality in labour force participation, and the third model explores the impact of health inequality in terms of adolescent fertility and maternal mortality on food security indicators. In the final model, the relative impact of all the four gender inequality indicators on magnitude of food insecurity in the study region is assessed. Findings The findings from panel data analysis provide empirical support to our hypothesis that gender disparities prevailing in Sub-Saharan Africa have an adverse impact on the level of food security in the region. Individually, increase in both, gender parity in secondary education and ratio of female to male labour force participation rate, has a negative influence on prevalence of undernourishment and depth of food deficit in the region. But, when the relative impact of gender inequality in education, economic participation and health are considered together in a single model, adolescent fertility rate, followed by maternal mortality ratio became the two most important indicators negatively influencing the magnitude of food security in SSA. A unit increase in adolescent fertility rate, leads to an increase in undernourishment by 19.4 per cent, depth of food deficit by 1.15 per cent and a decline in average dietary energy adequacy by 0.21 per cent. Research limitations/implications Scarcity of continuous time series data for the countries of Sub-Saharan Africa limits the scope of analysis. Social implications Government policies and programmes in Sub-Saharan Africa must focus on successful implementation of sexual and reproductive health and rights of women, as underlined in Goal 3 of sustainable development goals (SDGs). This would require deeper levels of interventions aimed at transforming gender roles and relations through involvement of men and boys as partners. Elimination of sexual and gender-based violence against women and girls, and ensuring easy and affordable access to sexual and reproductive health services, particularly in fragile and conflict affected areas, are some of the important measures which may facilitate movement of the countries in the region, towards the target set by SDG 3. Originality/value Indisputably, women play a key role in a nation’s food economy, not only as food producers and income earners but also as food distributors and consumers. Nevertheless, they face discrimination in every dimension and phase of life, which hampers their ability to successfully fulfill this responsibility. The paper provides a theoretical linkage and empirical evidence on the underlying hypothesis that targeting various forms of gender disparities in the African sub-continent, particularly those relating to reproductive health and rights of women will pave the way for reducing the magnitude of hunger and food insecurity in the region of Sub-Saharan Africa. Few papers in my knowledge have explored the linkage between gender inequality and food insecurity, but none have empirically emphasised the reproductive health dimension of this association.

Human development and gender inequality are associated with cardiorespiratory fitness: A global systematic review of V̇O2peak.

ROLE OF SEX AND GENDER IN ACCESS TO CARE AND CARDIOVASCULAR COMPLICATIONS OF INDIVIDUALS WITH DIABETES MELLITUS

BackgroundGender inequality varies across countries and is associated with poor outcomes including violence against women and depression. Little is known about the relationship of source county gender inequality and poor health outcomes in female immigrants.MethodsWe used administrative databases to conduct a cohort study of 299,228 female immigrants ages 6–29 years becoming permanent residence in Ontario, Canada between 2003 and 2017 and followed up to March 31, 2020 for severe presentations of suffering assault, and selected mental health disorders (mood or anxiety, self-harm) as measured by hospital visits or death. Poisson regression examined the influence of source-country Gender Inequality Index (GII) quartile (Q) accounting for individual and country level characteristics.ResultsImmigrants from countries with the highest gender inequality (GII Q4) accounted for 40% of the sample, of whom 83% were from South Asia (SA) or Sub-Saharan Africa (SSA). The overall rate of assault was 10.9/10,000 person years (PY) while the rate of the poor mental health outcome was 77.5/10,000 PY. Both GII Q2 (Incident Rate Ratio (IRR): 1.48, 95% Confidence Interval (CI): 1.08, 2.01) and GII Q4 (IRR: 1.58, 95%CI: 1.08, 2.31) were significantly associated with experiencing assault but not with poor mental health. For females from countries with the highest gender inequality, there were significant regional differences in rates of assault, with SSA migrants experiencing high rates compared with those from SA. Relative to economic immigrants, refugees were at increased risk of sustaining assaults (IRR: 2.96, 95%CI: 2.32, 3.76) and poor mental health (IRR: 1.73, 95%CI: 1.50, 2.01). Higher educational attainment (bachelor’s degree or higher) at immigration was protective (assaults IRR: 0.64, 95%CI: 0.51, 0.80; poor mental health IRR: 0.69, 95% CI: 0.60, 0.80).ConclusionSource country gender inequality is not consistently associated with post-migration violence against women or severe depression, anxiety and self-harm in Ontario, Canada. Community-based research and intervention to address the documented socio-demographic disparities in outcomes of female immigrants is needed.

Access to ART treatment and gender equality

BackgroundGender inequality weakens maternal health and harms children through many direct and indirect pathways. Allied biological disadvantage and psychosocial adversities challenge the survival of children of both genders. United Nations Development Programme (UNDP) has recently developed a Gender Inequality Index to measure the multidimensional nature of gender inequality. The global impact of Gender Inequality Index on the child mortality rates remains uncertain.MethodsWe employed an ecological study to investigate the association between child mortality rates and Gender Inequality Indices of 138 countries for which UNDP has published the Gender Inequality Index. Data on child mortality rates and on potential confounders, such as, per capita gross domestic product and immunization coverage, were obtained from the official World Health Organization and World Bank sources. We employed multivariate non-parametric robust regression models to study the relationship between these variables.ResultsWomen in low and middle income countries (LMICs) suffer significantly more gender inequality (p < 0.001). Gender Inequality Index (GII) was positively associated with neonatal (β = 53.85; 95% CI 41.61-64.09), infant (β = 70.28; 95% CI 51.93-88.64) and under five mortality rates (β = 68.14; 95% CI 49.71-86.58), after adjusting for the effects of potential confounders (p < 0.001).ConclusionsWe have documented statistically significant positive associations between GII and child mortality rates. Our results suggest that the initiatives to curtail child mortality rates should extend beyond medical interventions and should prioritize women’s rights and autonomy. We discuss major pathways connecting gender inequality and child mortality. We present the socio-economic problems, which sustain higher gender inequality and child mortality in LMICs. We further discuss the potential solutions pertinent to LMICs. Dissipating gender barriers and focusing on social well-being of women may augment the survival of children of both genders.

Gender inequality is a complex problem with multiple interrelated indicators (e.g. underrepresentation of women in leadership roles, gender pay gaps). Our academic community has been following a three‐step ‘script’ to motivate organisations to act on gender inequality: we document the inequality, we build a business case for equality, and we advocate solutions to correct inequality. But too often, our well‐meant messages have negative consequences. We may be inadvertently presenting gender inequality as an intractable problem and creating unrealistic expectations among stakeholders about gender equality benefits and gender inequality solutions. As stakeholders become impatient with Australia’s slow progress toward gender equality, we may need to reconsider this strategy. Academic researchers may be more successful change agents if we are more deliberate about highlighting the interconnections among gender inequality indicators, identifying the organisational value of gender equality beyond financial performance, and advocating small‐scale structural changes alongside large‐scale interventions.

Societal gender inequality and a preference for male children has been shown to be detrimental to girls' health. This is despite females' innate biological advantage early in life. The negative effects of gender inequity on female health are most pronounced in resource-poor countries, where cultural norms supporting a preference for male children are strongest. However, most of what is known about gender inequality and child health comes from studies of singleton births. There is little evidence for how, or if, the disadvantages associated with gender bias and son preference extend to multiple births, a population inherently at risk for a number of health challenges. This analysis examines whether gender bias in health outcomes exists for twins. Data on live twin births from 38 Demographic and Health Surveys were compiled (n=11,528 individuals) and twins were categorized as girl/girl, girl/boy, boy/girl or girl/girl. Gender inequality was measured via the Gender Inequality Index. Multilevel logistic regression models examined associations between twin sex composition, gender inequality and eight outcomes of infant and child morbidity, mortality and mother's treatment-seeking behaviours. Twin pairs containing girls had significantly lower odds of first-year mortality. Higher country-level gender inequality was associated with higher odds of reporting diarrhoea and fever/cough, as well as an increased odds of post-neonatal mortality. Results suggest that the biological advantage for females may be stronger than son preference and gender inequality in the first year of life. Understanding these relationships has the potential to inform efforts to curb the influence of gender preference on the health of female children in resource-poor settings.

Gender inequalities are reflected in differential vulnerability, and exposure to the hazards posed by climate change and addressing them is key to increase the adaptive capacities of societies. We provide trajectories of the Gender Inequality Index (GII) alongside the Shared-Socioeconomic Pathways (SSPs), a scenario framework widely used in climate science. Here we find that rapid improvements in gender inequality are possible under a sustainable development scenario already in the near-term. The share of girls growing up in countries with the highest gender inequality could be reduced to about 24% in 2030 compared to about 70% today. Largely overcoming gender inequality as assessed in the GII would be within reach by mid-century. Under less optimistic scenarios, gender inequality may persist throughout the 21st century. Our results highlight the importance of incorporating gender in scenarios assessing future climate impacts and underscore the relevance of addressing gender inequalities in policies aiming to foster climate resilient development.

Background: Gender plays a well-recognized role in shaping health inequities. However, the population-level health consequences of gender inequalities have not been measured precisely. The goal of this study was to evaluate the association between gender inequity and health indicators in OECD countries. Methods: Ecological study based on 1990–2017 panel data for Organisation for Economic Co-operation and Development (OECD) member countries. Gender inequity was measured using the Gender Inequality Index (GII). The population health parameters evaluated were life expectancy (LE), healthy life expectancy (HALE), years of life lost (YLL), years lived with disability (YLD), disability-adjusted life years (DALYs), and specific-cause mortality. Fixed-effects linear models were used to assess the relationship between gender inequity and health outcomes. Models included potential mediating and confounding factors such as health spending, political model, and income inequalities. Findings: Greater gender inequity was associated with lower LE (-0·49%; CI 95 -0·63%– -0·31%; p-value <0·0001), HALE (-0·47%; CI 95 -0·63%– -0·31%; p-value <0·0001) and with increased premature mortality (YLL 6·82%; CI 95 3·63%–10·75%; p-value <0·0001). and morbidity measured in DALYs (1·50%; CI 95 0·48%–2·46%; p-value=0·0028) and YLD (2·59%; CI 95 0·67%–4·77%; p-value=0·0063) for each 0·1 increments on the GII. The sensitivity analysis indicated that the results were robust to the various specifications of the causal models. Interpretation: Our results suggest that gender inequity pose a sizable impact on population health outcomes. Promoting gender equality as part of public policies is vital for optimizing health on a population scale. Funding Statement: Agencia Nacional de Investigacion y Desarrollo (ANID)/Programa Becas/Magister Becas Chile/2017- 22170332 Declaration of Interests: The authors have declared that no competing interests exist.

National efforts to reduce low birth weight (LBW) and child malnutrition and mortality prioritise economic growth. However, this may be ineffective, while rising gross domestic product (GDP) also imposes health costs, such as obesity and non-communicable disease. There is a need to identify other potential routes for improving child health. We investigated associations of the Gender Inequality Index (GII), a national marker of women's disadvantages in reproductive health, empowerment and labour market participation, with the prevalence of LBW, child malnutrition (stunting and wasting) and mortality under 5 years in 96 countries, adjusting for national GDP. The GII displaced GDP as a predictor of LBW, explaining 36% of the variance. Independent of GDP, the GII explained 10% of the variance in wasting and stunting and 41% of the variance in child mortality. Simulations indicated that reducing GII could lead to major reductions in LBW, child malnutrition and mortality in low- and middle-income countries. Independent of national wealth, reducing women's disempowerment relative to men may reduce LBW and promote child nutritional status and survival. Longitudinal studies are now needed to evaluate the impact of efforts to reduce societal gender inequality.

IntroductionThe HIV pandemic disproportionately impacts young women. Worldwide, young women aged 15–24 are infected with HIV at rates twice that of young men, and young women alone account for nearly a quarter of all new HIV infections. The incommensurate HIV incidence in young – often poor – women underscores how social and economic inequalities shape the HIV epidemic. Confluent social forces, including political and gender violence, poverty, racism, and sexism impede equal access to therapies and effective care, but most of all constrain the agency of women.MethodsHIV prevalence data was compiled from the 2010 UNAIDS Global Report. Gender inequality was assessed using the 2011 United Nations Human Development Report Gender Inequality Index (GII). Logistic regression models were created with predominant mode of transmission (heterosexual vs. MSM/IDU) as the dependent variable and GII, Muslim vs. non-Muslim, Democracy Index, male circumcision rate, log gross national income (GNI) per capita at purchasing power parity (PPP), and region as independent variables.Results and discussionThere is a significant correlation between having a predominantly heterosexual epidemic and high gender inequality across all models. There is not a significant association between whether a country is predominantly Muslim, has a high/low GNI at PPP, has a high/low circumcision rate, and its primary mode of transmission. In addition, there are only three countries that have had a generalized epidemic in the past but no longer have one: Cambodia, Honduras, and Eritrea. GII data are available only for Cambodia and Honduras, and these countries showed a 37 and 34% improvement, respectively, in their Gender Inequality Indices between 1995 and 2011. During the same period, both countries reduced their HIV prevalence below the 1% threshold of a generalized epidemic. This represents limited but compelling evidence that improvements in gender inequality can lead to the abatement of generalized epidemics.ConclusionsGender inequality is an important factor in the maintenance – and possibly in the establishment of – generalized HIV epidemics. We should view improvements in gender inequality as part of a broader public health strategy.

BackgroundAdequate nutrition during adolescence is important for optimal physical and cognitive development and for pregnancy either during adolescence or later life. Thinness amongst adolescent girls in low and middle income...

Introduction Climate change has a disproportionate impact on women in comparison to men and women have a key role to play in climate adaptation. However, evidence is lacking on how gender inequalities may be associated with climate vulnerability and ability to respond at country level. Methods This ecological study investigated the association between climate adaptation, measured by the Notre Dame Global Adaptation Initiative Country Index (ND-GAIN), and gender inequality, measured by the Global Gender Gap Index (GGGI) developed by the World Economic Forum and the Gender Inequality Index (GII) developed by the United Nations. Simple linear regression was used to estimate the associations between the indices and their subdomains for 146 countries. Results There was an approximately linear association between the GGGI and climate adaptation. Each 1% increase in gender equality was associated with a 0.6% increase in the ND-GAIN score (slope 0.59, 95% confidence interval [0.33 to 0.84]). This was driven by a negative association between gender equality and vulnerability (-0.41 [-0.62 to -0.20]), and a positive association between gender equality and readiness (0.77 [0.44 to 1.10]). Gender equality in the education domain of the GGGI had the strongest association with climate adaptation. There was a strong negative linear association between the GII and climate adaptation, which explained most (87%) of the between-country variation in climate adaptation. Each 1% increase in gender inequality was associated with a 0.5% decrease in the ND-GAIN score (-0.53 [-0.57 to -0.50]). The association between gender inequality and readiness was stronger than the association with vulnerability (0.40 [0.37 to 0.44] for vulnerability versus -0.67 [-0.72 to -0.61] for readiness). Conclusions Gender inequality measured broadly across different domains of life is associated with climate adaptation at country level, both in terms of vulnerability to impact and readiness to respond. Key messages • Gender inequality, considered broadly across multiple domains of life, is associated with increased vulnerability to climate change and poor readiness to respond. • Addressing gender inequality needs to be a priority for governments and inter-governmental organisations if populations worldwide are to adapt to climate change.