Why is it important to address gender inequalities?

Gender inequalities remain deeply rooted in every society. Women often lack access to decent work and face pay gaps, and they lack access to basic education and healthcare. Women are underrepresented in political and economic decision-making processes, leadership positions, are underestimated, and experience discrimination in scientific and healthcare fields worldwide. In all parts of the world, they are exposed to gender-based violence and discrimination. In addition to gender equality being a basic human right, achieving it has especially socio-economic consequences. Strengthening women’s status is beneficial for economies, productivity, and growth (UN WOMEN).

Gendered power relations, norms, and stereotypes affect the exposure of women and men to certain health risks, affect their behavior in trying to maintain good health, and also influence their access to healthcare services and the way healthcare systems respond to their needs (discrimination in the provision of healthcare services). Fairer gender norms and relations have the potential to substantially improve the health of both women and men (WHO, 2019).

A feminist approach can point to the need to examine the relationships between gender, disadvantage, and health, and also power relations in public health processes, including policy-making through program implementation. The complexity of public health requires analysis from multiple perspectives and attention to detail that can identify health issues that are important for women and study ways to address these issues (Rogers, 2006).

Consequences

There are many areas where gender inequalities directly or indirectly affect the health of women as well as men. Sex and gender affect each person’s health throughout their life. They influence how crises and emergencies are experienced, exposure to diseases, and access to healthcare, water, hygiene, and sanitation. Gender inequality disproportionately affects girls and women in most societies. They have a lower social status and less control over decisions about their own bodies, in intimate relationships, families, and communities, which exposes them to various forms of violence, pressure, and harmful practices. In addition, girls and women face high risks of unintended pregnancy, sexually transmitted infections, cervical cancer, undernutrition, and depression (WHO, 2021).

The member states of the WHO European Region have one of the highest levels of gender equality in the world, but there are certain differences within the region. It is necessary to understand that gender inequality is not only a human rights issue, but has a significant negative impact on health and well-being—whether through discrimination, violence, inadequate sexual and reproductive rights and health, unpaid care work, child marriage, or female genital mutilation (WHO, 2019).

Gender-biased structures and attitudes of researchers, teachers, or managers in science, technology, engineering, medicine, and global health can be a barrier for girls and women when entering their professions and advancing in them. The result is the persistent underrepresentation of women in research and leadership positions in these areas (Ratele et al., 2019). In contrast, women are overrepresented in informal care roles, where they are more exposed to physical and psychological risk factors (Davies et al., 2019).

Sexual and sexualized violence against women is one form of discrimination and is also considered a gender-specific violation of human rights. Sexual violence in most cultures enables patriarchal social order. To defend against sexual violence against women, gender equality must be ensured. Sexual violence against women and girls is not limited to any political or economic system; it is widespread in every society around the world. It crosses boundaries of wealth, race, and culture and is an expression of historical, cultural, and religious specific values and norms that are still in force today through many social and political institutions that promote discrimination against women and girls (Banarjee, 2020). Regional, national, and institutional differences and dynamics are of course present, but gender inequality affects most, if not all, societies (Ratele et al., 2019).

Feminist public health

The World Health Organization emphasized that community interventions addressing gender norms and attitudes can change both individuals and entire communities. These may include, for example, methods for economically empowering women and no less important, engaging men as partners against gender-based violence. In addition, media interventions and public awareness campaigns can use mass media to question gender norms and attitudes and try to increase awareness across society about violent behavior toward women and how to prevent it (Banarjee, 2020). In a society in which all people are equal, there is no space for violence or other forms of discrimination.

Yet as long as we live in a society that grants individuals varying degrees of respect depending on gender, age, ethnicity, wealth, disability, or other identity markers, this social gradient will persist (Aphramor, 2017). Often, only services that treat the symptoms of inequality are used, but this can largely be avoided by addressing the root social causes. Addressing social determinants is even less economically costly than addressing the medical consequences of inequality. Nevertheless, debate still continues over whether laws should address inequality and whether government resources should support the most at-risk groups (McCuskey, 2018).

Feminist research and activism have significantly contributed to the realization of social health studies and have also succeeded in influencing public health policy. Today it is generally recognized that sex is considered a key driving force in the social determination of health (Keane, 2014). Feminist public health is a multidisciplinary approach aimed at improving the health of gender-subordinate groups, that is, reducing health inequalities between these groups. Feminist research is based on action, often in close cooperation with the women’s movement (or non-governmental women’s organizations), as well as on social change. Therefore, feminist research is useful in public health, especially in health promotion. Feminist public health is an interdisciplinary field in which fundamental questions are emphasized about the role of gender constructions in health matters, as well as the role of gender power relations for the unequal distribution of health in a population (Hammarström, 1999).

Contemporary feminism demands equal rights and opportunities for everyone without distinction (Molyneux M. et al. 2021). These rights and opportunities make it possible to:

• access education for those who have so far been excluded from an adequate educational process,
• gain employment and with it financial income and economic security, enabling them to maintain their living standards and social mobility, as well as independence and non-reliance on a partner for housing and family support (which is particularly important in cases of gender-based violence and intimate partner violence),
• improve health literacy, and with it the ability to maintain better health,
• and, if needed, have equal access to healthcare without discrimination.

Conclusion

This paper does not aim to be an exhaustive list of the ways in which women are discriminated against, but to outline the links between feminist studies/movements and public health while also pointing to the often unnecessary and irrational negative connotation of the word feminism. Women are undervalued and discriminated against in access to education and work, while studies show that these are important determinants of health. The higher the education, the better the job, the higher the income, and the better the health literacy, which implies better health and living conditions (social gradient)—thereby ensuring protection, support, and development of public health.

Authors: Mgr. Lívia Kaňuková doc. MUDr. Kvetoslava Rimárová, CSc., mim. prof. The work was supported by 3 KEGA grant projects of the Ministry of Education, Science, Research and Sport of the Slovak Republic: KEGA 008 UPJŠ-4/2020; KEGA 010UPJŠ-4/2021.

List of bibliographic references

APHRAMOR, Lucy. 2017. Feminism, Dietetics, and Realistic Fitness: Can They Be Team Players ? The Palgrave Handbook of Feminism and Sport, Leisure and Psysical Education. Pp 769-792. Available: https://link.springer.com/chapter/10.1057/978-1-137-53318-0_49

BANARJEE, Subrata. 2020. Identifying factors of sexual violence against women and protection of their rights in Bangladesh. Aggression and Violent Behavior: vol. 52, 101384. Available: https://www.sciencedirect.com/science/article/pii/S1359178919301843

DAVIES. Sara. E. et al. 2019. Why it must be a feminist global health agenda? The Lancet: 393, 10171, P601-603. Available: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32472-3/fulltext

HAMMARSTRÖM, Anne. 1999. Why feminism in public health? Scandinavian Journal of Public Health: 27, 4. Available: https://journals.sagepub.com/doi/abs/10.1177/14034948990270040601

KEANE, Helen. 2014. Feminism and the Complexities of Gender and health. Australian Feminist Studies: 29, 80, 180-188. Available: https://www.tandfonline.com/doi/abs/10.1080/08164649.2014.928192

McCUSKEY, Elizabeth Y. 2018. The Body politic: Federalism as feminism in Health reform. 11 St. Louis U. J. Health L. & Pol'y 303 (2017-2018). Available: https://heinonline.org/HOL/LandingPage?handle=hein.journals/sljhlp11÷=18&id=&page=

MOLYNEUX, Maxine. et al. 2021. UN WOMEN. New Feminist Activism, Waves and Generations. BACKGROUND PAPER PREPARED FOR THE 25th ANNIVERSARY OF THE BEIJING PLATFORM FOR ACTION, 64th SESSION OF THE COMMISSION ON THE STATUS OF WOMEN.

RATELE, Kopano. et al. 2019. Engaging men to support women in science, medicine, and global health. The Lancet: 393, 10171, P609-610. Available: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30031-5/fulltext

ROGERS, W. A. 2006. Feminism and public health ethics. Journal of Medical Ethics: 32, 6. Available: https://jme.bmj.com/content/32/6/351

UN WOMEN. Available: https://www.unwomen.org/en/about-us/about-un-women

WHO. Last updated 24 May 2021. Available: https://www.who.int/news-room/questions-and-answers/item/gender-and-health

WHO. 2019. Health and Gender Equality Policy Brief. Available: https://www.euro.who.int/__data/assets/pdf_file/0008/404495/SDG-5-policy-brief_2.pdf