When we talk about health, we rarely speak about it in terms of gender. But why? When women are 2-3 times more likely to report depression and anxiety than men and men have significant higher rates of lung cancer and injuries than women, surely we should be questioning the impact of gender in the discourse of determinants of health?
First lets get a couple of things straight. I will be talking about ‘gender’ - aka the socially constructed roles that involve traits and behaviour that are both culturally and historically located, categorised into ‘masculine’ and ‘feminine’. Do not get confused between this and ‘sex’ which refers to the biological differences between males and females. Both sex and gender have implications for health and both men and women are impacted by gender inequalities. These inequalities are the actions, attitudes and assumptions about men and women that systematically empower one group to the detriment of another. For example in Russia, at least 1 woman dies every hour due to domestic violence. That is 14000 women every year through domestic violence in Russia alone, who fall victim to these deeply rooted social structures.
It is the lower status of women, lower levels of education and discrimination pronounced all over the world that makes women the main focus when addressing gender inequalities. But what has been done to address the issue of gender in health? The story of gender in health politics began in the 60s and 70s: when development policy began to focus on meeting basic needs, governments recognised that women were among the poorest of the poor. This led to programs that focussed on helping women improve their economic position, marking the start of the women in development (WID) movement. The year of 1975 saw the first International Women’s year celebrated and the first world conference on women, that took place in Mexico City. This conference sparked the first world plan of action to improve women’s status. Throughout the following decade, that the UN declared the ‘decade of women’, equity was called for between the sexes. There was a surge of funding and programmes specific to WID activities. The WID movement focussed on the integration of women in development, yet in the 1980s there was a shift to a new movement that focussed not solely on women, but on the unequal power relations between both men and women - the Gender and Development (GAD) movement. The GAD movement stresses the importance of empowering women, whilst emphasising the need to address the problem of unequal power relations that prevent equitable and full participation of women in development.
So progress has been made. Slowly but surely a discourse of gender in health is being created. Indeed, at the 4th UN conference on women that was held in Beijing in 1995, women’s health was recognised as being ‘determined by the social, political and economic context of their lives as well as by biology’. This conference institutionalised the notion of ‘mainstreaming gender’ into health systems. Whilst this has been contested as it removes the political standpoint of the need to address power relations and reduces the emphasis on women, surely the positives of the creation of a more mainstream dialogue of gender with a focus on equity cannot be dismissed!