The UCL Centre for Gender and Global Health
Welcome to the Gender and Health resources page. Here you can find information and some suggested resources on the role of gender in health outcomes and the importance of gendered approaches to global health. This hub can be used by both beginners and researchers in the field. This hub is an iterative project; please help us build a more comprehensive resources page by identifying gaps, letting us know which themes are missing and sharing literature and resources you find useful via our suggestions form here.
The hub has three sections:
The first gives an introductory background on the topic of gender in global health, setting the context for this resources page.
If you would like to see a resource added to this page, please fill out our suggestions form here. You can also check out our brand new weekly #CGGH book club on Instagram and join the discussions.
As gendered human beings, our health behaviours, specific health risks, and the way that we engage with and are treated by healthcare systems is affected by our gender. This intersects with other factors such as race, class, and sexuality, to determine our susceptibility to different health problems and access to treatment. These interactions are summarised in Figure 1 below.
Because of this, we have put together a reading list and resources hub exploring the different ways that gender interacts with, and influences, health outcomes. It is through recognising the contribution that gender makes to health, and developing tailored public health interventions, that we have the best chance of improving health outcomes and achieving health equity for all.
Figure 1: Conceptual framework illustrating the relationship between gender and health and well-being. Hawkes, S., & Buse, K. The Politics of Gender and Global Health. In The Oxford Handbook of Global Health Politics. : Oxford University Press.
Gender refers to something distinct from biological sex. It is not equivalent to women and girls, or men and boys, but encompasses people of all genders. It is socially constructed and influenced by laws, politics, policies, communities, families and individuals. It shapes how we behave, act and feel, the attitudes and expectations we have of ourselves and of others. Gender norms determine our positions and roles in society.
Despite decades of research demonstrating the link between gender and health outcomes, global health players continue to do too little to address the very real impact of gender and its accompanying issues, such as power and politics, norms, access, vulnerability and violence, on people’s health.
Past discussions of gender and health have often been equated to discussions of reproductive rights and biological differences. While evidently incredibly important, the implications of gender are wider than that: for reasons beyond sex, a baby girl born in 2017 can expect to live 4 years more than a baby boy born on the same day, while in some countries that life expectancy gap is 11.7 years or more. Men’s shorter life expectancies are driven, in part, by their higher rates of consumption of tobacco and alcohol, their likelihood of death from violence (including in peacetime), road injuries, and suicide, all of which occur at much higher rates than among women.
Conversely, girls and women might live longer, but they suffer longer with chronic diseases. Pregnancy complications and unsafe abortions remain a significant cause of death in many settings, with one third of girls married before they are 18. Further, married women in 27 countries still require their husband’s consent before they can access contraceptives.
Gender never acts alone - therefore, to fully understand this link, an analysis of gender and health must encompass the multitude of factors which interact with gender to produce health outcomes. An intersectional approach to health acknowledges that while both are women, the life and health outcomes of a lesbian South African woman in Soweto is very different from that of a white American NGO CEO. While gender is an important determinant of health in its own right, it also interacts with other social, economic and commercial determinants such as race, poverty, education, and nutrition (see Figure 1).
Gender also impacts access to health services and the pathways of care within them. For example, women suffer more frequently and for longer with chronic pain than men, partly because their pain is disbelieved by healthcare providers. Finally, gendered behaviours and expectations shape exposure to unhealthy products, health protection behaviours and care seeking patterns. For example, the belief in the stoic man means that men worldwide are less likely to access health services for ailments. These complicated interactions require attention paid to the specific context of each case in order to fully understand what gender means and how, worldwide, it influences health.
With stark gender inequalities within global health organisations themselves, perhaps it is unsurprising that policy has often been insensitive to this truth. The health workforce is, in some countries, up to 75% female - but men are 50% more likely to reach senior management, and gender parity in senior management is only achieved by 25% of 198 of the most active organisations in global health. Change appears to be coming, but it's difficult to tell how many organisations are going beyond words on paper to do the hard work needed to achieve gender equal leadership and develop programmes that both understand and address the crucial role gender plays in determining health outcomes. I
In the Gender Centre, our diverse team think about this complicated intersection through many lenses. Our studies encompass papers ranging from the definition of women’s empowerment, the impact of sexual torture on Afghan refugee women and masculinities and homicide in Mexico to understanding how evidence on gender and health is used in policy making . To take a look at our publications, please check out the research and dissemination page http://www.ighgc.org/research. To find out more about gender and health, why not take a look at our introductory reading list below.
Gender refers to the socially constructed norms that impose and determine roles, relationships and positional power for all people across their lifetime. Gender interacts with sex, the biological and physical characteristics that define women, men and those with intersex identities.
Gender equality in health means that all people have the right to realise their full potential to lead healthy lives, contribute to health development, and benefit from the results of this development.
Gender equity in health means fairness in addressing the different health needs of people according to their gender. Inequitable health outcomes based on gender are both avoidable and unacceptable. A concept of fairness recognises that there are differences between the sexes and that resources must be allocated differentially to address unfair disparities.
For more definitions we suggest this glossary.
This resource list, while diverse, is far from comprehensive. It instead aims to provide an introduction to many core concepts that inform our research. If there are any readings that you think we missed, or if you would like to request more readings on any topic, please fill in the form included on this page.
These texts are recommended for beginners to gender and global health, as well as anyone looking for an introduction to the origins and current work on the topic.
Core Readings:
Further Readings:
Understanding gender as performed, culturally specific, and as a mechanism of power is key for the current state of development work. Gender has been addressed differently throughout the history of development and it is only within the last 15 years that the idea of “mainstreaming” gender analysis into all development has become standard practise.
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Further Readings:
How should gender be conceptualised, addressed and mainstreamed in development policy? What role does the language of development ‘jargon’ play in driving how gender is addressed in policy? How can we ensure development programmes are gender-sensitive, if not gender-transformative? And should gendered approaches in development focus on women, men or both?
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For additional resources on this topic, we recommend: http://signsjournal.org/currents-identity-politics/poststructuralist-queer/
Kimberlé Crenshaw’s influential work on understanding how identities do not just co-exist, but overlap and reinforce each other in surprising ways, is foundational to all social justice work today. Intersectionality is key when looking at health because globally, women are not a homogenous group; gender interacts with other well-studied factors such as race, dis/ability, and poverty around the world to produce health outcomes which continually depend on context.
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Domestic and sexual violence against women is almost universal, and a prime example of a culturally produced and gender specific health risk. Gender based violence is a global health problem of epidemic proportions and a gross violation of human rights. Gender norms also drive the high rates of death due to violence in men, albeit in a different context, which these readings aim to explore.
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Issues surrounding sexuality and gender identity are tightly linked to gender norms. Sexual orientation and gender variance can be intersecting factors that influence the treatment of a person by society and can influence their specific health risks. The cisgendered, heterosexual body is considered the norm across much of the world; to be seen to exist outside of these categories can carry unique risks and can drive health inequalities.
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Reproductive health is one of the few areas of medicine and research that has historically had more of a gendered approach. Future approaches should expand the classic focus on women’s reproductive health to encompass the reproductive health of all people, as well as implementing gender-transformative strategies to challenge unhelpful societal gender norms which may be shaping these health problems.
Core Readings:
The research and treatment of non-communicable diseases (NCDs) is lagging behind many other fields of health with regards to its gender-sensitivity. This is despite the fact that men and women often have different exposures to risk factors for NCDs, many as a result of social gender norms, from the harmful use of alcohol, tobacco use and unhealthy diets to advertising that exploits gender norms to promote unhealthy products. NCD interventions need to become more gender-sensitive, taking into account the differing relationships that men and women may have to different risk factors and risk-promoting behaviours, and the differences in the way that they may respond to a given intervention as a result of these social gender norms.
Core Readings:
Gender, as it is currently understood within societies across the globe, is a product of historical processes. The process of colonialism under European powers has created and re-created structures of gender throughout much of the world and continues to define how gender is thought about and experienced in development today. Decolonial theory both helps us make sense of this, and is an active political decolonisation process, especially relevant in an aid/development context.
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Often, if organisations do take a gendered approach in their policy, programmes, or research, ‘gendered’ is interpreted as meaning focussed on women and girls. There are also many issues associated specifically with masculinities and men’s health that need addressing, for example the fact that globally men have a shorter life expectancy than women. Biology cannot account solely for this: we know that gendered behaviours, such as increased occurrence of violence, risky behaviours and increased alcohol and tobacco consumption, play a large role. Promoting gender equity in health means promoting the gender-specific health needs of all people; approaches to men’s health should both understand and aim to offset the negative impact that socially dictated - and commercially reinforced - gender norms have on men’s health.
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Gender and sexuality are increasingly being explored as themes in popular culture. Here, we find references to the cultural and social aspects of gender in popular culture and share some of our favourite readings, films and podcasts exploring these topics, as well as many suggestions from the twitter community. Of course these examples are not without their flaws, or perfectly representative, but they help to open up the discussion surrounding gender and sexuality. We welcome your suggestions from your favourite books, podcasts, films and more - so get in touch at [email protected] or via the form at www.ighgc.org/resources.