TY - JOUR
T1 - Gender inequality and restrictive gender norms
T2 - framing the challenges to health
AU - Gender Equality, Norms, and Health Steering Committee
AU - Heise, Lori
AU - Greene, Margaret E.
AU - Opper, Neisha
AU - Stavropoulou, Maria
AU - Harper, Caroline
AU - Nascimento, Marcos
AU - Zewdie, Debrework
AU - Darmstadt, Gary L.
AU - Greene, Margaret Eleanor
AU - Hawkes, Sarah
AU - Henry, Sarah
AU - Heymann, Jody
AU - Klugman, Jeni
AU - Levine, Ruth
AU - Raj, Anita
AU - Rao Gupta, Geeta
N1 - Funding Information:
The work of the Series was funded by the Gender Equality, Integrated Delivery, HIV, Nutrition, Family Planning, and Water Sanitation and Hygiene program strategy teams at the Bill & Melinda Gates Foundation and by the United Arab Emirates Ministry of Foreign Affairs and International Cooperation through grants to Stanford University, received by LH, MEG, NO, MS, and CH. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data and had final responsibility to submit the paper for publication. The views expressed are those of the authors and are not necessarily those of the Bill & Melinda Gates Foundation and the United Arab Emirates.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/6/15
Y1 - 2019/6/15
N2 - Gender is not accurately captured by the traditional male and female dichotomy of sex. Instead, it is a complex social system that structures the life experience of all human beings. This paper, the first in a Series of five papers, investigates the relationships between gender inequality, restrictive gender norms, and health and wellbeing. Building upon past work, we offer a consolidated conceptual framework that shows how individuals born biologically male or female develop into gendered beings, and how sexism and patriarchy intersect with other forms of discrimination, such as racism, classism, and homophobia, to structure pathways to poor health. We discuss the ample evidence showing the far-reaching consequences of these pathways, including how gender inequality and restrictive gender norms impact health through differential exposures, health-related behaviours and access to care, as well as how gender-biased health research and health-care systems reinforce and reproduce gender inequalities, with serious implications for health. The cumulative consequences of structured disadvantage, mediated through discriminatory laws, policies, and institutions, as well as diet, stress, substance use, and environmental toxins, have triggered important discussions about the role of social injustice in the creation and maintenance of health inequities, especially along racial and socioeconomic lines. This Series paper raises the parallel question of whether discrimination based on gender likewise becomes embodied, with negative consequences for health. For decades, advocates have worked to eliminate gender discrimination in global health, with only modest success. A new plan and new political commitment are needed if these global health aspirations and the wider Sustainable Development Goals of the UN are to be achieved.
AB - Gender is not accurately captured by the traditional male and female dichotomy of sex. Instead, it is a complex social system that structures the life experience of all human beings. This paper, the first in a Series of five papers, investigates the relationships between gender inequality, restrictive gender norms, and health and wellbeing. Building upon past work, we offer a consolidated conceptual framework that shows how individuals born biologically male or female develop into gendered beings, and how sexism and patriarchy intersect with other forms of discrimination, such as racism, classism, and homophobia, to structure pathways to poor health. We discuss the ample evidence showing the far-reaching consequences of these pathways, including how gender inequality and restrictive gender norms impact health through differential exposures, health-related behaviours and access to care, as well as how gender-biased health research and health-care systems reinforce and reproduce gender inequalities, with serious implications for health. The cumulative consequences of structured disadvantage, mediated through discriminatory laws, policies, and institutions, as well as diet, stress, substance use, and environmental toxins, have triggered important discussions about the role of social injustice in the creation and maintenance of health inequities, especially along racial and socioeconomic lines. This Series paper raises the parallel question of whether discrimination based on gender likewise becomes embodied, with negative consequences for health. For decades, advocates have worked to eliminate gender discrimination in global health, with only modest success. A new plan and new political commitment are needed if these global health aspirations and the wider Sustainable Development Goals of the UN are to be achieved.
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U2 - 10.1016/S0140-6736(19)30652-X
DO - 10.1016/S0140-6736(19)30652-X
M3 - Review article
C2 - 31155275
AN - SCOPUS:85067188086
SN - 0140-6736
VL - 393
SP - 2440
EP - 2454
JO - The Lancet
JF - The Lancet
IS - 10189
ER -