Does gender make you sick?

Written by Thea Cassel (UCL Geography 2012), Communications Assistant at UCL

Of the multiple meanings that the lecture title alludes to, Dr Sarah Hawkes (Institute for Global Health) addressed the problems of targeting just one half of the population in relation to global health.

Why, when using the term ‘gender’, do businesses and health organisations actually mean women? And why, when looking at policy responses to global health, do they focus on the group that is in reality the least at risk?

The first thing that struck me as I looked around the lecture theatre was the good turnout of both men and women, as well as a large gaggle of teenagers attending on a school trip.

From previous experience, the mention of the word ‘gender’ quickly equates to just ‘women’ and more often than not it is predominantly women who take an interest in the subject – an issue that was subsequently tackled in the lecture. I was pleasantly surprised, therefore, to see a large number of men in the audience.

The lecture began with Dr Hawkes looking back at her initial interest in gender analysis from her work in Bangladesh, where she worked for the largest research organisation in a developing country.

Having recently graduated with a degree in both Sociology and Medicine, she arrived in Bangladesh young and hopeful to tackle some of the world’s biggest health problems. What she found, however, was that the project she ran looked at the rates of sexual health exclusively in women.  The reasoning and indeed feasibility of this focus is questioned when she reminded us that women are the least mobile in society – being unable to leave the house – whereas men can move freely and unaccompanied.

It certainly does appear strange that a project only looks at sexual health in a group with the least risk of being infected, unless of course their husbands are transmitting the diseases. The entire focus for the project stemmed around the belief that women are responsible for health problems, and it is this belief that set the precedent for her work.

20 Years After Bangladesh

Returning to the present day, the lecture then moved on to the discussion of a 10 year study, ‘The Burden of Disease’, which has been recently published in The Lancet. The study revolves around what it is that makes society sick and which subsequently sets a priority for funding.

In a massive collaboration, 400 universities combined their data to produce a DALY (Disability Adjusted Life Years) measure – in more simplified terms, one DALY equates to one year of life loss.

Sarah looked at this data through a gender lens, and for the top ten global DALYS in 2010, in every variable they are more burdensome for men than women.

This is particularly prominent in risk behaviours such as the intake of tobacco and alcohol and the amount of fatal car injuries, which are all three times higher in men globally. A common question that reappeared was whether or not there are inherent biological reasons behind this. The answer, in simple terms, is no – the DALY factors are all very similar in young children of bother genders and it is only when they get older, and influenced by social factors, that the disparities appear.

False Advertising

So what are these social factors? A large influence in risk behaviour is advertising. Men are seen to be manly if they drink, smoke and drive fast cars. Professor Hawkes juxtaposed this idea with humorous and not-so-subtle phallic images of cars, which got the audience laughing (particularly the school girls), whilst also making us appreciate what serious, and indeed deadly, consequences this advertising can have.

Advertisement for sports is particularly pertinent with 99% of alcohol advertising being directed at typically ‘manly’ sports, such as rugby and football, while on the flip side, advertising aimed at female drinkers is based largely around warning them of the dangers associated with alcohol.

All of the evidence so far pointed in the direction of the theory of gender identities and norms set at an early age, illustrated by Professor Hawkes showing the audience a picture of a baby girl, identified by the pink hat that had been placed on her head at only ten minutes old.

However, these gender identities are not fixed, but are flexible and are in fact changing. For example, females are now binge drinking to the same extent as males throughout Europe. Similarly, in Asia, women are now smoking as much as men and the tobacco advertising strategy is now being aimed at women.

So what are the policy responses to the changes in gender-differentiated health concerns? Professor Hawkes looked at the responses from US Global Health and the Global Fund and they are still only responding to women’s health problems, mirroring her previous findings 20 years earlier from Bangladesh.

It seems policy responses are still confusing gender with women, despite the fact that research has proved that health problems target both men and women, albeit differently. All this may change however, as what is killing men today will kill women in the future.