Gender Equality In Health Research Articles

Many crises, one call to action: advancing gender equality in health in response to polycrises

Many crises, one call to action: advancing gender equality in health in response to polycrises

Sex-steroid hormones relate to cerebellar structure and functional connectivity across adulthood.

Aging involves complex biological changes that affect disease susceptibility and aging trajectories. Although females typically live longer than males, they have a higher susceptibility to diseases like Alzheimer's, speculated to be influenced by menopause, and reduced ovarian hormone production. Understanding sex-specific differences is crucial for personalized medical interventions and gender equality in health. Our study aims to elucidate sex differences in regional cerebellar structure and connectivity during normal aging by investigating both structural and functional connectivity variations, with a focus on investigating these differences in the context of sex-steroid hormones. The study included 138 participants (mean age = 57(13.3) years, age range = 35-86 years, 54% women). The cohort was divided into three groups: 38 early middle-aged individuals (EMA) (mean age = 41(4.7) years), 48 late middle-aged individuals (LMA) (mean age = 58(4) years), and 42 older adults (OA) (mean age = 72(6.3) years). All participants underwent MRI scans, and saliva samples were collected for sex-steroid hormone quantification (17β-estradiol (E), progesterone (P), and testosterone (T)). We found less connectivity in females between Lobule I-IV and the cuneus, and greater connectivity in females between Crus I, Crus II, and the precuneus with increased age. Higher 17β-estradiol levels were linked to greater connectivity in Crus I and Crus II cerebellar subregions. Analyzing all participants together, testosterone was associated with both higher and lower connectivity in Lobule I-IV and Crus I, respectively, while higher progesterone levels were linked to lower connectivity in females. Structural differences were observed, with EMA males having larger volumes compared to LMA and OA groups, particularly in the right I-IV, right Crus I, right V, and right VI. EMA females showed higher volumes in the right lobules V and VI. These results highlight the significant role of sex hormones in modulating cerebellar connectivity and structure across adulthood, emphasizing the need to consider sex and hormonal status in neuroimaging studies to better understand age-related cognitive decline and neurological disorders.

Intersectional discrimination and mental health inequalities: a qualitative study of young women’s experiences in Scotland

BackgroundIn 2021, Scotland became the first UK country to launch a Women’s Health Plan. This policy signals increasing commitment to broader ambitions surrounding gender equality in health. Research shows a connection between discrimination and health, representing a contributor to health inequalities. There remains sparse evidence on how certain groups experience discrimination that could be useful for policymaking. This research set out to address this evidence gap through exploring how discrimination shapes young women’s experiences of mental health and inequalities in Scotland.MethodsWe interviewed women aged 16-25 years (n=28), living in Scotland, UK, adopting an intersectional approach to recruitment and data analysis. We used a semi-structured topic guide to facilitate open discussion about discrimination and health. Transcripts were analysed by two researchers using Thematic Analysis and NVivo software.FindingsWe identified three themes that illuminate intersectional discrimination and the impact on mental health. The first outlines how experiences of discrimination in school, work and public spaces (and the anticipation of such) creates stress leading to mental health problems, particularly for participants from ethnic minority groups. The second highlights the lack of support for mental health, both at structural and interpersonal levels, which was viewed by young women as a form of intersectional discrimination, largely because of their gender and age. Finally, we developed a mid-level theory termed the ‘chain of dismissal’ that displays that for both physical or mental health symptoms, young women’s concerns are immediately “written off” as anxiety-related and in turn a natural attribute of young women. These themes show that discrimination has the potential to amplify mental health problems for young women and is a likely contributor to health inequalities.ConclusionsStructural disadvantages such as racism intersect with gender and age to compound the experience of discrimination for marginalised young women. To improve mental health and reduce health inequalities for young women, multi-level approaches are needed, with strong consideration of how the structural and cultural landscape as well as assumptions made by healthcare professionals have critical implications for young women’s health.

Deceptive Gender Equality

Despite achievements in women’s economic and political empowerment, gender inequalities persist in the key socioeconomic areas of health and education in Laos. How can we explain these gaps in equality? We analyze how Lao people perceive gender equality and how differences in the perception of multiple dimensions of gender equality affect women’s rights in healthcare and education. The results of a 2023 survey of 664 Laotians highlight the perception of equal responsibilities as the key dimension of gender equality, which may limit the improvement of gender equality in health. The results imply that female leadership and greater public consideration of gender equality with respect to rights and opportunities may promote gender equality in Laos. This study contributes to the study of perceptions and practices of gender equality in non-Western countries.

Impact of COVID-19 on the private and professional lives of highly educated women working in global health in Europe-A qualitative study.

The COVID-19 pandemic has led to a deepening of existing inequalities and a rollback of achievements made in gender equality. Women in Global Health (WGH) is a global movement that aims to achieve gender equality in health and increase female leadership in global health. Here, the aim was to understand how the pandemic affects the private and professional lives of women working in global health in different European countries. Suggestions for future pandemic preparedness including how gender perspectives should be integrated into pandemic preparedness and how a women's network such as WGH helped them to overcome the impact of the pandemic were explored. Qualitative semi-structured interviews were conducted in September 2020 with a sample size of nine highly educated women with a mean age of 42.1 years from the different WGH European chapters. The participants were informed of the study and were formally asked for their consent. The interviews were held in English via an online videoconference platform and lasted 20-25 min each. The interviews were audio recorded and transcribed verbatim. Thematic analysis was conducted according to Mayring Qualitative Content Analysis using MAXQDA. The pandemic has both positive and negative effects on the professional and private lives of women. It led to an increased workload and stress as well as pressure to publish on COVID-19-related themes. Increased childcare and household responsibilities represented a double burden. The available space was limited if other family members were also working from home. Positive aspects included more time for family or partners and reduced travel. The participants report on perceived gender differences in the experience of the pandemic. International cooperation is considered to be a key factor for future pandemic preparedness. Being part of a women's network such as WGH was perceived as being very supportive in difficult situations during the pandemic. This study provides unique insights into the experiences of women working in global health in different European countries. The COVID-19 pandemic influences their professional and private lives. Perceived gender differences are reported and suggest the need for integrating gender perspectives in pandemic preparedness. Networks for women, such as WGH, can facilitate the exchange of information in crises and provide women with professional and personal support.

Uncertainty and gender inequality: A global investigation

There is increasing interest in the consequences of uncertainty, yet research on its effects on gender equality is scarce. This study investigates the impact of uncertainty on gender inequality using a sample of 100 countries over the period 1991–2017. The analysis is carried out for 22 indicators of gender inequality in four dimensions (employment, health, education, rights) and five uncertainties (domestic uncertainty, world uncertainty, world trade uncertainty, global economic policy uncertainty, geopolitical risk). First, uncertainty appears to increase gender inequality in employment by affecting vulnerable employment, unemployment, and self-employment; and by reducing waged and salaried employment, numbers of contributing family workers, labour force participation, and employment in industry and services. Second, uncertainty is found to be very harmful in its effect on gender equality in health, as it decreases life expectancy and survival to age 65, and increases the mortality of women. Third, uncertainty improves gender equality in education, as it increases school enrolment at primary and tertiary levels. Fourth, uncertainty improves the Women, Business and the Law Index, but has mixed effects on women’s economic, political, and social rights.

The association of biological sex and long-term outcomes in patients with acute dyspnea at the emergency department.

Marked differences have been described between women and men in disease prevalence, clinical presentation, response to treatment and outcomes. However, such data are scarce in the acutely ill. An awareness of differences related to biological sex is essential for the success of clinical care and outcomes in patients presenting with acute dyspnea, the most frequent cause of emergency department (ED) admission. The aim of the present study was to assess the effect of biological sex on 1-year all-cause mortality in patients presenting with acute dyspnea to the ED. Consecutive adult patients presenting with acute dyspnea in two Lithuanian EDs were included. Clinical characteristics, laboratory data and medication use at discharge were collected. Follow-up at 1 year was performed via national data registries. The primary outcome of the study was 1-year all-cause mortality. Hazard ratios (HRs) for 1-year mortality according to biological sex were calculated using a Cox proportional hazards regression model, with and without adjustment for the following confounders: age, systolic blood pressure, creatinine, sodium and hemoglobin. A total of 1455 patients were included. Women represented 43% of the study population. Compared to men, women were older [median (interquartile range [IQR]) age 74 (65-80) vs. 68 (59-77) years, P < 0.0001]. The duration of clinical signs before admission was shorter for women [median (IQR) duration 4 (1-14) vs. 7(2-14) days, P = 0.006]. Unadjusted 1-year all-cause mortality was significantly lower in women (21 vs. 28%, P = 0.001). Adjusted HR of 1-year all-cause mortality was lower in women when compared to men [HR 0.68 (0.53-0.88), P = 0.0028]. Additional sensitivity analyses confirmed the survival benefit for women in subgroups including age greater and lower than 75 years, the presence of comorbidities and causes of dyspnea (cardiac or noncardiac). Women have better 1-year survival than men after the initial ED presentation for acute dyspnea. Understanding the biological sex-related differences should lead toward precision medicine, and improve clinical decision-making to promote gender equality in health.

A narrative review on policies and practices for gender equity in cardiovascular disease prevention and management

Women’s health global agenda has recently reformulated to address more accurate cardiovascular diseases (CVDs) prevention, diagnosis and treatment. The aim of the present work was to review the hitherto global and national policies and practices which address gender equality in health with the focus oriented towards CVDs in women. Scientific databases and health organizations’ websites that present/discuss policies and initiatives targeting to enhance a sex-centered approach regarding general health and/or specifically cardiac health care were reviewed in a systematic way. In total, n=53 relevant documents were selected. The selected policies and initiatives included position statements, national action plans, evidence-based guidelines, guidance/recommendations, awareness campaigns, regulations/legislations and state-of-the art reports by national/international projects and conferences. The target audiences of large stakeholders (e.g., American Heart Association, European Society of Cardiology, Centre of Disease Control and Prevention) were female citizens, health professionals and researchers. Much as policy makers have recognized the sex/gender gap in CVD field, there is still much to be done. Thereby, tailor-made strategies,shouldbe designed, evaluated and delivered on a global, yet most importantly a national basis, to achieve gender equity against CVDs.

Have Policies Tackled Gender Inequalities in Health? A Scoping Review.

Gender is recognized as one of the most relevant determinants of health inequalities. This scoping review sought to identify and analyse policies, either implemented or formulated as proposals, which aimed to reduce gender inequalities in health. We searched Medline, Web of Science, and Scielo. Of 2895 records, 91 full text articles were analysed, and 33 papers were included. Of these papers, 22 described the process of formulation, implementation, or evaluation of policies whose aim was to reduce gender inequalities in health; six focused on recommendations, and the remaining five dealt with both issues. Our review showed that the policies aimed at reducing gender inequalities in health, either implemented or formulated as proposals, are scarce. Moreover, despite some success, overall progress has been slow. The studies show failures in design and particularly in the implementation process. We found a lack of awareness and capacity in the policy-making progress, under-financing, bureaucratization, shortage of relevant data, and absence of women’s participation in decision-making. Therefore, an emphasis on the design and implementation of gender-sensitive policies seems essential to advance gender equality in health. This scoping review gathers evidence to support the design of such policies and recommendations that can facilitate their implementation.

Adolescence and Gender Equality in Health

Adolescence and Gender Equality in Health

A human rights-based framework to assess gender equality in health systems: the example of Zika virus in the Americas

ABSTRACTBackground: The right to health was enshrined in the constitution of the World Health Organization (WHO) in 1946 and in the Universal Declaration of Human Rights in 1948. The latter Declaration, which also guaranteed women’s rights, was signed by almost all countries in the world. Subsequent international conventions reinforced these rights, requiring that women be able to realize their fundamental freedoms and dignity. Although the value of incorporating gender into health systems has been increasingly acknowledged over the years, gender inequalities in health persist.Objective: To introduce a tool to help countries assess their performance in addressing gender inequalities in their health systems, using the example of the Zika virus (ZIKV) in countries of the Americas.Methods: This paper is based on comprehensive reviews of the literature on the links between gender equality, health systems and human rights, and available scientific evidence about an adequate response to ZIKV.Results: The authors present a simple two-part framework from the human rights perspectives of the health system as duty bearer, incorporating WHO’s six health system building blocks, and of its clients as rights holders. The authors apply the framework to ZIKV in the Americas, and identify strengths and weaknesses at every level of the health system. They find that when considering gender, health systems have focused mainly on dichotomous sex differences, failing to consider broader gender relations and processes affecting access to services, quality of care, and health outcomes.Conclusions: The authors’ framework will permit countries to assess progress toward gender equality in health, within the context of their human rights commitments, by examining each health system building block, and the degree to which clients are realizing their rights. By applying the framework to specific health conditions, gender-related achievements and shortcomings can be identified in each health system component, fostering a more comprehensive and gender-sensitive response.

Working together to accomplish gender equality in health: World Health Organization

Working together to accomplish gender equality in health: World Health Organization

Towards gender equality in health in Afghanistan

The Afghanistan gender inequality index shows that 70% loss in development is due to the limited participation of women in the workforce, low education and poor women's health outcomes. However, since the fall of the Taliban regime in 2002, gender inequalities in health have improved. This paper will review factors that led to these improvements. The review draws upon information from various sources, including formative and applied research, surveys and existing information systems. The review showed gender differentials in morbidity, mortality and accessing and utilising health services. Health professionals have expressed inadequate medical knowledge and interpersonal skills to address sensitive issues, such as domestic, physical and sexual violence. Discussing sexuality and its impact on health remains taboo both within and outside of the medical profession. Strict cultural norms restrict a woman's autonomy to seek health care, choose a marriage partner and have control over her body, indicating a need to increase awareness about how harmful social practices adversely affect health. The policy review showed that the Ministry of Public Health has made a commitment to reducing gender inequity in health and developed a two-pronged action plan to improve health providers' skills in handling gender-sensitive issues and mass media campaigns to change social norms.

Debate: Gender equity or gender equality in health?

Debate: Gender equity or gender equality in health?

Sexually Harassing Behavior Against Adolescent Girls in Rural Bangladesh

This study examines the extent and type of sexually harassing behavior or intimidations unmarried adolescent girls experienced on their way to school, college or social visits and type of perpetrators in victims' view in rural Bangladesh using data of the 2004 National Nutrition Programme baseline survey. The survey collected self-reported data on sexual harassments of 5,106 girls aged 13-19 years selected randomly. Results reveal that gendered harassments were experienced by 35% of the girls, unwanted sexual attentions by 34%, and sexual intimidations by 14%, yielding prevalence of sexual harassments of any type 43%. Higher girls' education and household economic status heightened their risks of being harassed. Perpetrators were male young spoilt bullies (64%), neighborhood youths (30%), students (22%) and hoodlums (6%). High prevalence of sexual harassments mirrors vulnerability of adolescent girls in the community and deserves to be tackled to achieve millennium development goals (MDGs) in gender equality in health and social development.

Gender health and policies: the state of the art from exposure to solutions.

To synthesize the determinants of gender inequalities through a narrative review that: (i) describes gender related variables that can create different levels of health; (ii) describes key points that may assist in policy development and its reorientation towards gender differences; (iii) debates potential approaches in understanding gender issues. Review of the international literature through online databases (Pubmed), search engines, publications and documents from "grey literature". publications from 1997, English language; keywords used: gender based analysis; gender and public policy; women's health; gender differences; health policy; gender impact assessment. Among the 300 papers retrieved, 55 were selected for relevance. We performed a narrative synthesis of the included literature, regarding: (i) gender differences and their determinants; (ii) elements for the changing; (iii) possible approaches; (iv) gender influences the pursuit of health and health care access through specific variables; (v) health policies can modify these variables only by a minimal percentage. These interventions should guarantee equity and allow efficient resources allocation. The gap between political announcements and real policy implementation remains unchanged. (vi) Standard approaches to the topic are not feasible due to the scarcity of a specific literature and the numerous cultural differences. . Gender analysis of policies suggests they can differently affect women in comparison to men. However, reforms, strategies and interventions introduced in the last two decades, have achieved a limited success towards better gender equality in health. The main aim is to attack the structural sources of gender inequity in the society.

Integrating a gender perspective into health statistics: an ongoing process in Central America

The harmonization of a set of basic national indicators for gender equity analysis in health is a priority for advancing toward the objective of gender equality in the Americas. The availability of gender-sensitive health indicators facilitates informed decision-making and the monitoring of progress toward the achievement of gender equality in health. With the object of helping to strengthen national capacity to integrate a gender perspective into the production, analysis, and use of health indicators, the Gender, Ethnicity, and Health Unit of the Pan American Health Organization has prepared a proposal to guide that process. This proposal includes resources to support interaction between the users and producers of health statistics and an intersectoral approach in health statistics. Implementation of this proposal has yielded significant results at the national level. Intersectoral working groups have been created that are searching for mechanisms to institutionalize the process, publishing statistical profiles on health and gender, as well as brochures of basic indicators on gender, health, and development.

Promoting Gender Equality in the Medical Profession: A Physician's Reflection on Her Experiences as a Medical Student

The medical profession is committed to the protection and promotion of health and well-being of all persons, irrespective of their sex, cultural or social background. How ever, in this very profession the reinforcement of gender stereotypes, inequity and gender-based discrimination persist from the time of enrolment in medical school until the end of one's professional carrier. The following groups of factors have been identified as the impediment for women's advancement in medicine: reinforcement of traditional gender roles, sexism and lack of effective mentoring. Suggested strategies for overcoming these obstacles include: creating supportive female networks among students and practitioners, peer mentoring, using gender-sensitive language and de signing favourable working conditions. The importance of training medical students and professionals in gender analysis and gender-sensitive programming is suggested as a strategy towards achieving gender equality in health. Gender analysis contributes to the understanding of differentials in: risk factors and exposures; manifestation, severity and frequency of diseases; and social and cultural responses to diseases.