Gender Disparities In Health
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The World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
(WHO) has defined
health Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." Identified by the ''2012 World Development Report'' as one of two key
human capital Human capital is a concept used by social scientists to designate personal attributes considered useful in the production process. It encompasses employee knowledge, skills, know-how, good health, and education. Human capital has a substantial ...
endowments, health can influence an individual's ability to reach his or her full potential in society. Yet while gender equality has made the most progress in areas such as education and labor force participation, health inequality between men and women continues to harm many societies to this day. While both males and females face
health disparities Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequiti ...
, women have historically experienced a disproportionate amount of health inequity. This stems from the fact that many cultural ideologies and practices have created a structured patriarchal society where women are vulnerable to abuse and mistreatment. Additionally, women are typically restricted from receiving certain opportunities such as
education Education is a purposeful activity directed at achieving certain aims, such as transmitting knowledge or fostering skills and character traits. These aims may include the development of understanding, rationality, kindness, and honesty. Va ...
and paid labor that can help improve their accessibility to better health care resources. Females are also frequently underrepresented or excluded from mixed-sex clinical trials and therefore subjected to physician bias in diagnosis and treatment.


Definition of health disparity

Health disparity Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequitie ...
has been defined by
WHO Who or WHO may refer to: * Who (pronoun), an interrogative or relative pronoun * Who?, one of the Five Ws in journalism * World Health Organization Arts and entertainment Fictional characters * Who, a creature in the Dr. Seuss book '' Horton He ...
as the differences in health care received by different groups of people that are not only unnecessary and avoidable, but also unjust and prejudice. The existence of health disparity implies that
health equity Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequitie ...
does not exist in many parts of the world. Equity in health refers to the situation whereby every individual has a fair opportunity to attain their full health potential. Overall, the term "health disparities", or "health inequalities", is widely understood as the differences in health between people who are situated in different positions in a socioeconomic hierarchy.


Gender as an axis of difference


Bias against females

The social structures of many countries perpetuate the marginalization and oppression of women in the form of
cultural norms Social norms are shared standards of acceptable behavior by groups. Social norms can both be informal understandings that govern the behavior of members of a society, as well as be codified into rules and laws. Social normative influences or soc ...
and
legal codes A code of law, also called a law code or legal code, is a systematic collection of statutes. It is a type of legislation that purports to exhaustively cover a complete system of laws or a particular area of law as it existed at the time the cod ...
. As a result of this unequal social order, women are usually relegated into positions where they have less access and control over healthcare resources, making women more vulnerable to suffering from health problems than men. For example, women living in lower income areas have an acutely restricted protection of their health because they are less likely to have access to tertiary education and employment. As a result, female
life expectancy Life expectancy is a statistical measure of the average time an organism is expected to live, based on the year of its birth, current age, and other demographic factors like sex. The most commonly used measure is life expectancy at birth ...
at birth, nutritional well-being, and immunity against communicable and
non-communicable diseases A non-communicable disease (NCD) is a disease that is not transmissible directly from one person to another. NCDs include Parkinson's disease, autoimmune diseases, strokes, most heart diseases, most cancers, diabetes, chronic kidney disease, oste ...
, are often lower than those of men.


Bias against males

While a majority of the global health gender disparities is weighted against women, there are situations in which men tend to fare poorer. One such instance is
armed conflicts War is an intense armed conflict between states, governments, societies, or paramilitary groups such as mercenaries, insurgents, and militias. It is generally characterized by extreme violence, destruction, and mortality, using regular ...
, where men are often the immediate victims. A study of conflicts in 13 countries from 1955 to 2002 found that 81% of all violent
war War is an intense armed conflict between states, governments, societies, or paramilitary groups such as mercenaries, insurgents, and militias. It is generally characterized by extreme violence, destruction, and mortality, using regular o ...
deaths were male. Apart from armed conflicts, areas with high incidence of violence, such as regions controlled by
drug cartels A drug cartel is any criminal organization with the intention of supplying drug trafficking operations. They range from loosely managed agreements among various drug traffickers to formalized commercial enterprises. The term was applied when the ...
, also see men experiencing higher mortality rates. This stems from social beliefs that associate ideals of
masculinity Masculinity (also called manhood or manliness) is a set of attributes, behaviors, and roles associated with men and boys. Masculinity can be theoretically understood as socially constructed, and there is also evidence that some behaviors con ...
with aggressive, confrontational behavior. Lastly, sudden and drastic changes in economic environments and the loss of
social safety net The social safety net (SSN) consists of non-contributory assistance existing to improve lives of vulnerable families and individuals experiencing poverty and destitution. Examples of SSNs are previously-contributory social pensions, in-kind and fo ...
s, in particular social subsidies and food stamps, have also been linked to higher levels of
alcohol Alcohol most commonly refers to: * Alcohol (chemistry), an organic compound in which a hydroxyl group is bound to a carbon atom * Alcohol (drug), an intoxicant found in alcoholic drinks Alcohol may also refer to: Chemicals * Ethanol, one of sev ...
consumption and
psychological stress In psychology, stress is a feeling of emotional strain and pressure. Stress is a type of psychological pain. Small amounts of stress may be beneficial, as it can improve athletic performance, motivation and reaction to the environment. Exces ...
among men, leading to a spike in male mortality rates. This is because such situations often makes it harder for men to provide for their family, a task that has been long regarded as the "essence of masculinity." A retrospective analyses of people infected with the common cold found that doctors underrate the symptoms of men, and are more willing to attribute symptoms and illness to women than men. Women live longer than men in all countries, and across all age groups, for which reliable records exist. In The United States, men are less healthy than women across all social classes. Non-white men are especially unhealthy. Men are over-represented in dangerous occupations and represent a majority of on the job deaths. Further, medical doctors provide men with less service, less advice, and spend less time with men than they do with women per medical encounter.


Bias against intersex people

Another axis of health disparity is within the intersex community.
Intersex Intersex people are individuals born with any of several sex characteristics including chromosome patterns, gonads, or genitals that, according to the Office of the United Nations High Commissioner for Human Rights, "do not fit typical bina ...
, also known as
disorders of sex development Disorders of sex development (DSDs), also known as differences in sex development, diverse sex development and variations in sex characteristics (VSC), are congenital conditions affecting the reproductive system, in which development of chromoso ...
(DSD), is defined as "physical abnormalities of the sex organs" Intersex is often grouped into categories with the
LGBT ' is an initialism that stands for lesbian, gay, bisexual, and transgender. In use since the 1990s, the initialism, as well as some of its common variants, functions as an umbrella term for sexuality and gender identity. The LGBT term is a ...
community. However, it is commonly mistaken that they are the same when they are not. Transgender persons are born with sex organs that do not match the gender they identify with, whereas intersex persons are born with sex organs or hormones that are neither clearly male nor female, often having to choose one gender to identify with. Healthcare of intersex persons is centered around what may be considered "cultural understandings of gender" or the binary system commonly used as gender.
Surgeries Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
and other interventions are often used for intersex persons to attempt to physically change their body to conform with one sex. It has been debated whether or not this practice is ethical. Much of this pressure to choose one sex to conform to is socially implemented. Data suggest that children who do not have one gender to conform to may face embarrassment from peers. Parents may also pressure their children to having cosmetic surgery to avoid being embarrassed themselves. Particular ethical concerns come into play when decisions are made on behalf of the child before they are old enough to consent. Intersex people can face discrimination when seeking healthcare. Laetitia Zeeman of University of Brighton, UK writes, "LGBTI people are more likely to experience health inequalities due to heteronormativity or heterosexism, minority stress, experiences of victimization and discrimination, compounded by stigma. Inequalities pertaining to LGBTI health(care) vary depending on gender, age, income and disability as well as between LGBTI groupings." James Sherer of Rutgers University Medical School also found, "Many well-meaning and otherwise supportive healthcare providers feel uncomfortable when meeting an LGBT patient for the first time due to a general lack of knowledge about the community and the terminology used to discuss and describe its members. Common mistakes, such as incorrect language usage or neglecting to ask about sexual orientation and gender at all, may inadvertently alienate patients and compromise their care."


Types of gender disparities


Male-female sex ratio

At
birth Birth is the act or process of bearing or bringing forth offspring, also referred to in technical contexts as parturition. In mammals, the process is initiated by hormones which cause the muscular walls of the uterus to contract, expelling the f ...
, boys outnumber girls with the ratio of 105 or 106
male Male (symbol: ♂) is the sex of an organism that produces the gamete (sex cell) known as sperm, which fuses with the larger female gamete, or ovum, in the process of fertilization. A male organism cannot reproduce sexually without access to ...
to 100
female Female (Venus symbol, symbol: ♀) is the sex of an organism that produces the large non-motile ovum, ova (egg cells), the type of gamete (sex cell) that fuses with the Sperm, male gamete during sexual reproduction. A female has larger gamet ...
children. However, after conception, biology favors women. Research has shown that if men and women received similar nutrition, medical attention, and general health care, women would live longer than men. This is because women, on a whole, are much more resistant to diseases and much less prone to debilitating genetic conditions. However, despite medical and scientific research that shows that when given the same care as males, females tend to have better survival rates than males, the ratio of women to men in developing regions such as
South Asia South Asia is the southern subregion of Asia, which is defined in both geographical and ethno-cultural terms. The region consists of the countries of Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka.;;;;;;;; ...
,
West Asia Western Asia, West Asia, or Southwest Asia, is the westernmost subregion of the larger geographical region of Asia, as defined by some academics, UN bodies and other institutions. It is almost entirely a part of the Middle East, and includes Ana ...
, and
China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's most populous country, with a population exceeding 1.4 billion, slightly ahead of India. China spans the equivalent of five time zones and ...
can be as low as 0.94, or even lower. This deviation from the natural male to female sex ratio has been described by Indian philosopher and economist
Amartya Sen Amartya Kumar Sen (; born 3 November 1933) is an Indian economist and philosopher, who since 1972 has taught and worked in the United Kingdom and the United States. Sen has made contributions to welfare economics, social choice theory, econom ...
as the "missing women" phenomenon. According to the 2012 World Development Report, the number of missing women is estimated to be about 1.5 million women per year, with a majority of the women missing in
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
and
China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's most populous country, with a population exceeding 1.4 billion, slightly ahead of India. China spans the equivalent of five time zones and ...
.


Female mortality

In many developing regions, women experience high levels of
mortality Mortality is the state of being mortal, or susceptible to death; the opposite of immortality. Mortality may also refer to: * Fish mortality, a parameter used in fisheries population dynamics to account for the loss of fish in a fish stock throug ...
. Many of these deaths result from
maternal mortality Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pre ...
and
HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
/
AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual m ...
infection. Although only 1,900 maternal deaths were recorded in high-income nations in 2008,
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
and
Sub-Saharan Africa Sub-Saharan Africa is, geographically, the area and regions of the continent of Africa that lies south of the Sahara. These include West Africa, East Africa, Central Africa, and Southern Africa. Geopolitically, in addition to the List of sov ...
experienced a combined total of 266,000 deaths from
pregnancy Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ca ...
-related causes. In
Somalia Somalia, , Osmanya script: 𐒈𐒝𐒑𐒛𐒐𐒘𐒕𐒖; ar, الصومال, aṣ-Ṣūmāl officially the Federal Republic of SomaliaThe ''Federal Republic of Somalia'' is the country's name per Article 1 of thProvisional Constituti ...
and
Chad Chad (; ar, تشاد , ; french: Tchad, ), officially the Republic of Chad, '; ) is a landlocked country at the crossroads of North and Central Africa. It is bordered by Libya to the north, Sudan to the east, the Central African Republic ...
, one in every 14 women die from causes related to child birth. However, some countries, such as Kenya, have made great strides by eliminating maternal and neonatal tetanus. In addition, the
HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
/
AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual m ...
epidemic also contributes significantly to female mortality. The case is especially true for
Sub-Saharan Africa Sub-Saharan Africa is, geographically, the area and regions of the continent of Africa that lies south of the Sahara. These include West Africa, East Africa, Central Africa, and Southern Africa. Geopolitically, in addition to the List of sov ...
, where women account for 60% of all adult HIV infections.


Health outcome

Women tend to have poorer health outcomes than men for several reasons ranging from sustaining greater risk to diseases to experiencing higher
mortality rates Mortality rate, or death rate, is a measure of the number of deaths (in general, or due to a specific cause) in a particular population, scaled to the size of that population, per unit of time. Mortality rate is typically expressed in units of de ...
. In the Population Studies Center Research Report by Rachel Snow that compares the
disability-adjusted life years The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. It was developed in the 1990s as a way of comparing the overall health and life ex ...
(DALY) of both male and females, the global DALYs lost to females for sexually transmitted diseases such as
gonorrhea Gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium '' Neisseria gonorrhoeae''. Infection may involve the genitals, mouth, or rectum. Infected men may experience pain or burning with ...
and
chlamydia Chlamydia, or more specifically a chlamydia infection, is a sexually transmitted infection caused by the bacterium ''Chlamydia trachomatis''. Most people who are infected have no symptoms. When symptoms do appear they may occur only several wee ...
are more than ten times greater than those of the males. Moreover, the female DALYs to male DALYs ratio for malnutrition-related diseases such as
Iron-Deficiency Anemia Iron-deficiency anemia is anemia caused by a iron deficiency, lack of iron. Anemia is defined as a decrease in the number of red blood cells or the amount of hemoglobin in the blood. When onset is slow, symptoms are often vague such as Fatigue (me ...
are often close to 1.5, suggesting that poor
nutrition Nutrition is the biochemical and physiological process by which an organism uses food to support its life. It provides organisms with nutrients, which can be metabolized to create energy and chemical structures. Failure to obtain sufficient n ...
impacts women at a much higher level than men. Additionally, in terms of mental illnesses, women are also two to three times more likely than men to be diagnosed with depression. With regards to suicidal rates, up to 80% of those who
committed suicide Suicide is the act of intentionally causing one's own death. Mental disorders (including major depressive disorder, depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic f ...
or attempted suicide in
Iran Iran, officially the Islamic Republic of Iran, and also called Persia, is a country located in Western Asia. It is bordered by Iraq and Turkey to the west, by Azerbaijan and Armenia to the northwest, by the Caspian Sea and Turkmeni ...
are women. In developed countries with more social and legal gender equality, overall health outcomes can disfavor men. For example, in the United States, as of 2001, men's life expectancy is 5 years lower than women's (down from 1 year in 1920), and men die at higher rates from all top 10 causes of death, especially
heart disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, hea ...
and
stroke A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...
. Men die from suicide more frequently, though women more frequently have suicidal thoughts and the suicide attempt rate is the same for men and women (see
Gender differences in suicide Gender differences in suicide rates have been shown to be significant. There are different rates of suicides and suicidal behavior between males and females (among both adults and adolescents). While females more often have suicidal thoughts, ma ...
). Men may suffer from undiagnosed depression more frequently, due to gender differences in the expression of emotion. American men are more likely to consume alcohol, smoke, engage in risky behaviors, and defer medical care. Incidence of
melanoma Melanoma, also redundantly known as malignant melanoma, is a type of skin cancer that develops from the pigment-producing cells known as melanocytes. Melanomas typically occur in the skin, but may rarely occur in the mouth, intestines, or eye ( ...
has strong gender-related differences which vary by age. Women outlive men in 176 countries. Data from 38 countries shows women having higher life expediencies than men for all years both at birth and at age 50. Men are more likely to die from 13 of the 15 major causes of death in the U.S. However, women are more likely to suffer from disease than men and miss work due to illness throughout life. This is called the mortality-morbidity paradox, or Health Survival paradox This is explained by an excess of psychological, rather than physical, distress among women, as well as higher smoking rates among men. Androgens also contribute to the male deficit in longevity.


Access to healthcare

Women tend to have poorer access to health care resources than men. In certain regions of
Africa Africa is the world's second-largest and second-most populous continent, after Asia in both cases. At about 30.3 million km2 (11.7 million square miles) including adjacent islands, it covers 6% of Earth's total surface area ...
, many women often lack access to malaria treatment as well as access to resources that could protect them against
Anopheles ''Anopheles'' () is a genus of mosquito first described and named by J. W. Meigen in 1818. About 460 species are recognised; while over 100 can transmit human malaria, only 30–40 commonly transmit parasites of the genus ''Plasmodium'', which c ...
mosquitoes Mosquitoes (or mosquitos) are members of a group of almost 3,600 species of small flies within the family Culicidae (from the Latin ''culex'' meaning "gnat"). The word "mosquito" (formed by ''mosca'' and diminutive ''-ito'') is Spanish for "litt ...
during
pregnancy Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ca ...
. As a result of this, pregnant women who are residing in areas with low levels of malaria transmission are still placed at two to three times higher risk than men in terms of contracting a severe malaria infection. These disparities in access to healthcare are often compounded by cultural norms and expectations imposed on women. For example, certain societies forbid women from leaving their homes unaccompanied by a male relative, making it harder for women to receive healthcare services and resources when they need it most. Gender factors, such as women's status and empowerment (i.e., in
education Education is a purposeful activity directed at achieving certain aims, such as transmitting knowledge or fostering skills and character traits. These aims may include the development of understanding, rationality, kindness, and honesty. Va ...
,
employment Employment is a relationship between two parties regulating the provision of paid labour services. Usually based on a contract, one party, the employer, which might be a corporation, a not-for-profit organization, a co-operative, or any othe ...
, intimate partner relationships, and
reproductive health Sexual and reproductive health (SRH) is a field of research, healthcare, and social activism that explores the health of an individual's reproductive system and sexual wellbeing during all stages of their life. The term can also be further de ...
), are linked with women's capacity to access and use maternal health services, a critical component of
maternal health Maternal health is the health of women during pregnancy, childbirth, and the postpartum period. In most cases, maternal health encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to ens ...
. Still,
family planning Family planning is the consideration of the number of children a person wishes to have, including the choice to have no children, and the age at which they wish to have them. Things that may play a role on family planning decisions include marita ...
is typically viewed as the responsibility of women, with programs targeting women and overlooking the role of men—even though men's dominance in decision making, including contraceptive use, has significant implications for family planning and access to reproductive health services.Rottach, E., K. Hardee, R. Jolivet, and R. Kiesel. 2012
"Integrating Gender into the Scale-Up of Family Planning and Maternal, Neonatal, and Child Health Programs."
Washington, DC: Futures Group, Health Policy Project.
In order to promote equity in access to reproductive health care, health programs and services should conduct analyses to identify
gender inequalities Gender inequality is the social phenomenon in which men and women are not treated equally. The treatment may arise from distinctions regarding biology, psychology, or cultural norms prevalent in the society. Some of these distinctions are empir ...
and barriers to health, and determine the programmatic implications. The analyses will help inform decisions about how to design, implement, and scale up health programs that meet the differential needs of women and men. Access to sexual and reproductive healthcare for men is important. Engaging men in sexual and reproductive health help to decrease their higher risk taking behaviors and increase gender equity. However, a scoping review in the Nordic countries have shown that men are facing difficulties in healthcare related to sexual and reproductive health.


Causes


Cultural norms and practices

Cultural norms and practices are two of the main reasons why gender disparities in health exist and continue to persist. These cultural norms and practices often influence the roles and behaviors that men and women adopt in society. It is these gender differences between men and women, which are regarded and valued differently, that give rise to gender inequalities as they work to systematically empower one group and oppress the other. Both gender differences and gender inequalities can lead to disparities in health outcomes and access to health care. Some of the examples provided by the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
of how cultural norms can result in gender disparities in health include a woman's inability to
travel Travel is the movement of people between distant geographical locations. Travel can be done by foot, bicycle, automobile, train, boat, bus, airplane, ship or other means, with or without luggage, and can be one way or round trip. Travel c ...
alone, which can prevent them from receiving the necessary health care that they need. Another societal standard is a woman's inability to insist on
condom A condom is a sheath-shaped barrier device used during sexual intercourse to reduce the probability of pregnancy or a sexually transmitted infection (STI). There are both male and female condoms. With proper use—and use at every act of in ...
use by her
spouse A spouse is a significant other in a marriage. In certain contexts, it can also apply to a civil union or common-law marriage. Although a spouse is a form of significant other, the latter term also includes non-marital partners who play a social ...
or sex partners, leading to a higher risk of contracting
HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
.


Son preference

One of the better documented cultural norms that augment gender disparities in health is the preference for sons. In
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
, for instance, the 2001 census recorded only 93 girls per 100 boys. This is a sharp decline from 1961, when the number of girls per 100 boys was nearly 98. In certain parts of India, such as Kangra and
Rohtak Rohtak () is a city and the administrative headquarters of the Rohtak district in the Indian state of Haryana. It lies north-west of New Delhi and south of the state capital Chandigarh on NH 9(old NH 10). Rohtak forms a part of the National ...
the number of girls for every 100 boys can be as low as in the 70s. Additionally, low female to male numbers have also been recorded in other Asian countries – most notably in
China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's most populous country, with a population exceeding 1.4 billion, slightly ahead of India. China spans the equivalent of five time zones and ...
where, according to a survey in 2005, only 84 girls were born for every 100 boys. Although this was a slight increase from 81 during 2001–2004, it is still much lower than the 93 girls per 100 boys in the late 1980s. The increasing number of unborn girls in the late 20th century has been attributed to technological advances that made pre-birth sex determination, also known as
prenatal sex discernment Prenatal sex discernment is the prenatal testing for discerning the sex of a fetus before birth. Methods Prenatal sex discernment can be performed by preimplantation genetic diagnosis before conception, but this method may not always be classif ...
, such as the
ultrasound Ultrasound is sound waves with frequency, frequencies higher than the upper audible limit of human hearing range, hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hea ...
test more affordable and accessible to a wider population. This allowed parents who prefer a son to determine the sex of their unborn child during the early stages of pregnancy. By having early identification of their unborn child's sex, parents could practice
sex-selective abortion Sex-selective abortion is the practice of terminating a pregnancy based upon the predicted sex of the infant. The selective abortion of female fetuses is most common where male children are valued over female children, especially in parts of Eas ...
, where they would abort the
fetus A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal deve ...
if it was not the preferred sex, which in most cases is that of the female. Additionally, the culture of
son preference Sex selection is the attempt to control the sex of the offspring to achieve a desired sex. It can be accomplished in several ways, both pre- and post-implantation of an embryo, as well as at childbirth. It has been marketed under the title family ...
also extends beyond birth in the form of preferential treatment of boys. Economic benefits of having a son in countries like India also explain the preferential treatment of boys over girls. For example, in Indian culture it is the sons that provide care and economic stability to their parents as they age, so having a boy helps to ensure the futures of many Indian families. This preferential care can be manifested in many ways, such as through differential provision of food resources, attention, and medical care. Data from
household A household consists of two or more persons who live in the same dwelling. It may be of a single family or another type of person group. The household is the basic unit of analysis in many social, microeconomic and government models, and is im ...
surveys over the past 20 years has indicated that the female disadvantage has persisted in India and may have even worsened in some other countries such as
Nepal Nepal (; ne, नेपाल ), formerly the Federal Democratic Republic of Nepal ( ne, सङ्घीय लोकतान्त्रिक गणतन्त्र नेपाल ), is a landlocked country in South Asia. It is mai ...
and
Pakistan Pakistan ( ur, ), officially the Islamic Republic of Pakistan ( ur, , label=none), is a country in South Asia. It is the world's List of countries and dependencies by population, fifth-most populous country, with a population of almost 24 ...
.


Female genital mutilation

Harmful cultural practices such as
female genital mutilation Female genital mutilation (FGM), also known as female genital cutting, female genital mutilation/cutting (FGM/C) and female circumcision, is the ritual cutting or removal of some or all of the external female genitalia. The practice is found ...
(FGM) also cause girls and women to face health risks. Millions of females are estimated to have undergone FGM, which involves partial or total removal of the external female
genitalia A sex organ (or reproductive organ) is any part of an animal or plant that is involved in sexual reproduction. The reproductive organs together constitute the reproductive system. In animals, the testis in the male, and the ovary in the female, a ...
for non-medical reasons. It is estimated that 92.5 million females over 10 years of age in
Africa Africa is the world's second-largest and second-most populous continent, after Asia in both cases. At about 30.3 million km2 (11.7 million square miles) including adjacent islands, it covers 6% of Earth's total surface area ...
are living with the consequences of FGM. Of these, 12.5 million are girls between 10 and 14 years of age. Each year, about three million girls in Africa are subjected to FGM. Often performed by traditional practitioners using unsterile techniques and devices, FGM can have both immediate and late complications. These include excessive bleeding,
urinary tract infections A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidney ...
, wound infection, and in the case of unsterile and reused instruments, hepatitis and HIV. In the long run,
scars A scar (or scar tissue) is an area of fibrous tissue that replaces normal skin after an injury. Scars result from the biological process of wound repair in the skin, as well as in other organs, and tissues of the body. Thus, scarring is a natu ...
and
keloids Keloid, also known as keloid disorder and keloidal scar, is the formation of a type of scar which, depending on its maturity, is composed mainly of either type III (early) or type I (late) collagen. It is a result of an overgrowth of granulation ...
can form, which can obstruct and damage the urinary and genital tracts. According to a 2005
UNICEF UNICEF (), originally called the United Nations International Children's Emergency Fund in full, now officially United Nations Children's Fund, is an agency of the United Nations responsible for providing Humanitarianism, humanitarian and Devel ...
report on FGM, it is unknown how many girls and women die from the procedure because of poor record keeping and a failure to report fatalities. FGM may also complicate pregnancy and place women at a higher risk for obstetrical problems, such as prolonged labor. According to a 2006 study by the WHO involving 28,393 women,
neonatal mortality Perinatal mortality (PNM) refers to the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate. Variations in the precise definition of the perinatal mortality exist, specifically concerning the issue of inclusion o ...
increases when women have experienced FGM; an additional ten to twenty babies were estimated to die per 1,000 deliveries. Psychological complications are related to cultural context. Women who undergo FGM might be emotionally affected when they move outside their traditional circles and are confronted with the view that mutilation is not the norm.


Violence and abuse

Violence against women is a widespread global occurrence with serious public health implications. This is a result of social and gender bias. Many societies in
developing nations A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...
function on a
patriarchal Patriarchy is a social system in which positions of Dominance hierarchy, dominance and Social privilege, privilege are primarily held by men. It is used, both as a technical Anthropology, anthropological term for families or clans controll ...
framework, where women are often viewed as a form of property and as socially inferior to men. This unequal standing in the social hierarchy has led women to be physically, emotionally, and sexually abused by men, both as children and adults. These abuses usually constitute some form of violence. Although children of both sexes do suffer from physical
maltreatment Abuse is the improper usage or treatment of a thing, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as: physical or verbal maltreatment, injury, assault, violation, rape, unjust practices, crimes, or other t ...
,
sexual abuse Sexual abuse or sex abuse, also referred to as molestation, is abusive sexual behavior by one person upon another. It is often perpetrated using force or by taking advantage of another. Molestation often refers to an instance of sexual assa ...
, and other forms of exploitation and violence, studies have indicated that young girls are far more likely than boys to experience
sexual abuse Sexual abuse or sex abuse, also referred to as molestation, is abusive sexual behavior by one person upon another. It is often perpetrated using force or by taking advantage of another. Molestation often refers to an instance of sexual assa ...
. In a 2004 study on child abuse, 25.3% of all girls surveyed experienced some form of sexual abuse, a percentage that is three times higher than that of boys (8.7%). Such violence against women, especially sexual abuse, is increasingly being documented in areas experiencing armed conflicts. Presently, women and girls bear the brunt of social turmoil worldwide, making up an estimated 65% of the millions who are displaced and affected. Some of these places which are facing such problems include
Rwanda Rwanda (; rw, u Rwanda ), officially the Republic of Rwanda, is a landlocked country in the Great Rift Valley of Central Africa, where the African Great Lakes region and Southeast Africa converge. Located a few degrees south of the Equator ...
,
Kosovo Kosovo ( sq, Kosova or ; sr-Cyrl, Косово ), officially the Republic of Kosovo ( sq, Republika e Kosovës, links=no; sr, Република Косово, Republika Kosovo, links=no), is a partially recognised state in Southeast Euro ...
, and the
Democratic Republic of the Congo The Democratic Republic of the Congo (french: République démocratique du Congo (RDC), colloquially "La RDC" ), informally Congo-Kinshasa, DR Congo, the DRC, the DROC, or the Congo, and formerly and also colloquially Zaire, is a country in ...
. This comes as a result of both the general instability around the region, as well as a tactic of
warfare War is an intense armed conflict between states, governments, societies, or paramilitary groups such as mercenaries, insurgents, and militias. It is generally characterized by extreme violence, destruction, and mortality, using regular ...
to intimidate enemies. Often being placed in emergency and refugee settings, girls and women alike are highly vulnerable to abuse and exploitation by military combatants,
security forces Security forces are statutory organizations with internal security mandates. In the legal context of several nations, the term has variously denoted police and military units working in concert, or the role of military and paramilitary forces (s ...
, and members of rival communities. The
sexual violence Sexual violence is any sexual act or attempt to obtain a sexual act by violence or coercion, act to traffic a person, or act directed against a person's sexuality, regardless of the relationship to the victim.World Health Organization., World re ...
and abuse of both young and adult women have both short and long-term consequences, contributing significantly to a myriad of health issues into
adulthood An adult is a human or other animal that has reached full growth. In human context, the term ''adult'' has meanings associated with social and legal concepts. In contrast to a " minor", a legal adult is a person who has attained the age of major ...
. These range from debilitating physical injuries,
reproductive health Sexual and reproductive health (SRH) is a field of research, healthcare, and social activism that explores the health of an individual's reproductive system and sexual wellbeing during all stages of their life. The term can also be further de ...
issues, substance abuse, and psychological trauma. Examples of the above categories include depression and
post-traumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on ...
,
alcohol Alcohol most commonly refers to: * Alcohol (chemistry), an organic compound in which a hydroxyl group is bound to a carbon atom * Alcohol (drug), an intoxicant found in alcoholic drinks Alcohol may also refer to: Chemicals * Ethanol, one of sev ...
and drug use and dependence, sexually transmitted diseases, lower frequency of certain types of health screenings (such as cervical cancer), and
suicide Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and s ...
attempts. Abused women often have higher rates of unplanned and problematic
pregnancies Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but can ...
,
abortions Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregnan ...
, neonatal and infant health issues,
sexually transmitted infections Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are spread by sexual activity, especially vaginal intercourse, anal sex, and oral se ...
(including HIV), and mental disorders (such as depression,
anxiety disorders Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal function are significantly impaired. Anxiety may cause physi ...
,
sleep disorders A sleep disorder, or somnipathy, is a medical disorder of an individual's sleep patterns. Some sleep disorders are severe enough to interfere with normal physical, mental, social and emotional functioning. Polysomnography and actigraphy are test ...
and eating disorders) as compared to their non-abused peers. During
peacetime Peace is a concept of societal friendship and harmony in the absence of hostility and violence. In a social sense, peace is commonly used to mean a lack of conflict (such as war) and freedom from fear of violence between individuals or groups. ...
, most violence against women is perpetrated by either male individuals whom them know or intimate male partners. An eleven-country study conducted by WHO between 2000 and 2003 found that, depending on the country, between 15% and 71% of women have experienced physical or sexual violence by a
husband A husband is a male in a marital relationship, who may also be referred to as a spouse. The rights and obligations of a husband regarding his spouse and others, and his status in the community and in law, vary between societies and cultures, ...
or partner in their lifetime, and 4% to 54% within the previous year. Partner violence may also be fatal. Studies from
Australia Australia, officially the Commonwealth of Australia, is a Sovereign state, sovereign country comprising the mainland of the Australia (continent), Australian continent, the island of Tasmania, and numerous List of islands of Australia, sma ...
,
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tot ...
,
Israel Israel (; he, יִשְׂרָאֵל, ; ar, إِسْرَائِيل, ), officially the State of Israel ( he, מְדִינַת יִשְׂרָאֵל, label=none, translit=Medīnat Yīsrāʾēl; ), is a country in Western Asia. It is situated ...
,
South Africa South Africa, officially the Republic of South Africa (RSA), is the southernmost country in Africa. It is bounded to the south by of coastline that stretch along the South Atlantic and Indian Oceans; to the north by the neighbouring countri ...
and the United States show that between 40% and 70% of female murders were carried out by intimate partners. Other forms of violence against women include
sexual harassment Sexual harassment is a type of harassment involving the use of explicit or implicit sexual overtones, including the unwelcome and inappropriate promises of rewards in exchange for sexual favors. Sexual harassment includes a range of actions fro ...
and abuse by authority figures (such as
teachers A teacher, also called a schoolteacher or formally an educator, is a person who helps students to acquire knowledge, competence, or virtue, via the practice of teaching. ''Informally'' the role of teacher may be taken on by anyone (e.g. whe ...
,
police officers A police officer (also called a policeman and, less commonly, a policewoman) is a warranted law employee of a police force. In most countries, "police officer" is a generic term not specifying a particular rank. In some, the use of the ...
or employers), trafficking for forced labour or sex, and traditional practices such as forced
child marriages Child marriage is a marriage or similar union, formal or informal, between a child under a certain age – typically 18 years – and an adult or another child. * * * * The vast majority of child marriages are between a female child and a m ...
and dowry-related violence. At its most extreme, violence against women can result in female infanticide and violent death. Despite the size of the problem, many women do not report their experience of
abuse Abuse is the improper usage or treatment of a thing, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as: physical or verbal maltreatment, injury, assault, violation, rape, unjust practices, crimes, or other t ...
and do not seek help. As a result, violence against
women A woman is an adult female human. Prior to adulthood, a female human is referred to as a girl (a female child or Adolescence, adolescent). The plural ''women'' is sometimes used in certain phrases such as "women's rights" to denote female hum ...
remains a hidden problem with great human and health care costs. Worldwide men account for 79% of all victims of homicide. Homicide statistics by gender


Poverty

Poverty Poverty is the state of having few material possessions or little income. Poverty can have diverse social, economic, and political causes and effects. When evaluating poverty in ...
is another factor that facilitates the continual existence of gender disparities in health. Poverty is often directly linked with poor health. However, indirectly it affects factors such as lack of education, resources, and transportation that have the potential to contribute to poor health. In addition to economic constraints, there are also cultural constraints that affect people's ability or likelihood to enter a medical setting. While gender disparities continue prevalent in health, the extent to which it occurs within poor communities often depends on factors like the socioeconomic state of their location, cultural differences and even age. Children living in poverty have limited access to basic health needs overall, however gender inequalities become more apparent as children age. Research done on children under the age of five suggests that in low to middle income countries, approximately 50% of children living in poverty had access to basic health care. There was also no significant difference between boys and girls in access to healthcare services, such as immunizations and treatment for prevalent diseases such as malaria for both. Research focused on a wider age range, from infancy to adolescence, showed different results. It was found that in developing countries girls had more limited access to care, and if accessed they were likely to receive inferior care to that of boys. Girls in
developing countries A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...
were also found to be more likely to suffer emotional and physical abuse inflicted by their family and community. Gender inequalities in health for those living in poverty continue into adulthood. In research that excluded
women's health Women's health differs from that of men in many unique ways. Women's health is an example of population health, where health is defined by the World Health Organization as "a state of complete physical, mental and social well-being and not mer ...
disadvantages (childbirth, pregnancy, susceptibility to HIV, etc.) it was found that there was not a significant gender difference in diagnosis and treatment of chronic conditions.  In fact, women were diagnosed more, which was attributed to the fact that women had more access to healthcare due to reproductive needs, or from taking their children in for checkups. By contrast, research that was inclusive of women's health disadvantages revealed that
maternal health Maternal health is the health of women during pregnancy, childbirth, and the postpartum period. In most cases, maternal health encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to ens ...
widened the gap between men and women's health. Poor women in underdeveloped countries were said to be at greater risk of disability and death. The lack of resources and proper nourishment is often a cause of death, and contributes to issues of preterm birth and infant mortality, as well as a contributor to maternal mortality. It is estimated that about 800 women die daily from maternal mortality, and most cases are preventable. However, 99% of the cases occur in poverty ridden regions that lack the resources to access prompt, as well as preventive medical care. The gendered health differences were slightly different for people living in poverty in wealthier countries. Women were reported to be more low-income than men, and more likely to forgo medical treatment due to financial circumstances. In the United States the Patient Protection and Affordable Care Act ( PPACA) made it more possible for more people living in poverty to have access to healthcare, especially for women, however it is argued that the Act also promotes gender inequality because of differences in coverage. Gender- specific cancer screenings, such as for prostate cancer is not covered for men, while similar screenings for women are. At the same time, screenings such as counseling and other services for intimate partner violence is covered for women and not for men. In European countries the results were different than those of people in the United States. While in the United States poor men had less quality healthcare than women, in European countries men had less access to healthcare. The studies revealed that people, of age 50 and over, who struggled to make ends meet (subjective poverty) were 38% more likely to decline in health than those who were considered low income or had low overall wealth. However, men with subjective poverty of the same age group were 65% more likely to die than women, within a 3 to 6-year period.


Healthcare system

The
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
defines health systems as "all the activities whose primary purpose is to promote, restore, or maintain health". However, factors outside of healthcare systems can influence the impact healthcare systems have on the health of different demographics within a population. This is because healthcare systems are known to be influenced by social, cultural and economic frameworks. As a result, health systems are regarded as not only "producers of health and health care", but also as "purveyors of a wider set of societal norms and values," many of which are biased against women In the Women and Gender Equity Knowledge Network's Final Report to the WHO Commission on Social Determinants of Health in 2007, health systems in many countries were noted to have been unable to deliver adequately on
gender equity Gender equality, also known as sexual equality or equality of the sexes, is the state of equal ease of access to resources and opportunities regardless of gender, including economic participation and decision-making; and the state of valuing d ...
in health. One explanation for this issue is that many healthcare systems tend to neglect the fact that men and women's health needs can be very different. In the report, studies have found evidence that the healthcare system can promote gender disparities in health through the lack of
gender equity Gender equality, also known as sexual equality or equality of the sexes, is the state of equal ease of access to resources and opportunities regardless of gender, including economic participation and decision-making; and the state of valuing d ...
in terms of the way women are regarded – as both
consumers A consumer is a person or a group who intends to order, or uses purchased goods, products, or services primarily for personal, social, family, household and similar needs, who is not directly related to entrepreneurial or business activities. T ...
(users) and producers (carers) of health care services. For instance, healthcare systems tend to regard women as objects rather than subjects, where services are often provided to women as a means of something else rather on the well-being of women. In the case of reproductive health services, these services are often provided as a form of fertility control rather than as care for women's well-being. Additionally, although the majority of the workforce in health care systems are female, many of the working conditions remain discriminatory towards women. Many studies have shown that women are often expected to conform to male work models that ignore their special needs, such as childcare or protection from violence. This significantly reduces the ability and efficiency of female
caregivers A caregiver or carer is a paid or unpaid member of a person's social network who helps them with activities of daily living. Since they have no specific professional training, they are often described as informal caregivers. Caregivers most commo ...
providing care to patients, particularly female ones.


Structural gender oppression

Structural gender inequalities in the allocation of resources, such as
income Income is the consumption and saving opportunity gained by an entity within a specified timeframe, which is generally expressed in monetary terms. Income is difficult to define conceptually and the definition may be different across fields. For ...
,
education Education is a purposeful activity directed at achieving certain aims, such as transmitting knowledge or fostering skills and character traits. These aims may include the development of understanding, rationality, kindness, and honesty. Va ...
, health care,
nutrition Nutrition is the biochemical and physiological process by which an organism uses food to support its life. It provides organisms with nutrients, which can be metabolized to create energy and chemical structures. Failure to obtain sufficient n ...
and political voice, are strongly associated with poor health and reduced well-being. Very often, such structural
gender discrimination Sexism is prejudice or discrimination based on one's sex or gender. Sexism can affect anyone, but it primarily affects women and girls.There is a clear and broad consensus among academic scholars in multiple fields that sexism refers primaril ...
of women in many other areas has an indirect impact on women's health. For example, because women in many
developing nations A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...
are less likely to be part of the formal labor market, they often lack access to job security and the benefits of social protection, including access to health care. Additionally, within the formal workforce, women often face challenges related to their lower status, where they suffer
workplace discrimination Employment discrimination is a form of illegal discrimination in the workplace based on legally protected characteristics. In the U.S., federal anti-discrimination law prohibits discrimination by employers against employees based on age, race, ge ...
and
sexual harassment Sexual harassment is a type of harassment involving the use of explicit or implicit sexual overtones, including the unwelcome and inappropriate promises of rewards in exchange for sexual favors. Sexual harassment includes a range of actions fro ...
. Studies have shown that this expectation of having to balance the demands of paid work and work at home often give rise to work-related
fatigue Fatigue describes a state of tiredness that does not resolve with rest or sleep. In general usage, fatigue is synonymous with extreme tiredness or exhaustion that normally follows prolonged physical or mental activity. When it does not resolve ...
, infections, mental ill-health and other problems, which results in women faring poorer in health. Women's health is also put at a higher level of risk as a result of being confined to certain traditional responsibilities, such as
cooking Cooking, cookery, or culinary arts is the art, science and craft of using heat to Outline of food preparation, prepare food for consumption. Cooking techniques and ingredients vary widely, from grilling food over an open fire to using electric ...
and water collection. Being confined to unpaid
domestic labor A domestic worker or domestic servant is a person who works within the scope of a residence. The term "domestic service" applies to the equivalent occupational category. In traditional English contexts, such a person was said to be "in service ...
not only reduces women's opportunities to education and formal job employment (both of which can indirectly contribute to better health in the long run), but also potentially expose women to higher risk of health issues. For instance, in developing regions where
solid fuel Solid fuel refers to various forms of solid material that can be burnt to release energy, providing heat and light through the process of combustion. Solid fuels can be contrasted with liquid fuels and gaseous fuels. Common examples of solid fuels ...
s are used for cooking, women are exposed to a higher level of
indoor air pollution Indoor air quality (IAQ) is the air quality within and around buildings and structures. IAQ is known to affect the health, comfort, and well-being of building occupants. Poor indoor air quality has been linked to sick building syndrome, reduce ...
due to extended periods of cooking and preparing meals for the family. Breathing air tainted by the burning of
solid fuel Solid fuel refers to various forms of solid material that can be burnt to release energy, providing heat and light through the process of combustion. Solid fuels can be contrasted with liquid fuels and gaseous fuels. Common examples of solid fuels ...
s is estimated to be responsible for 641,000 of the 1.3 million deaths of women worldwide each year due to
chronic obstructive pulmonary disorder Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce mu ...
(COPD). In some settings, structural gender inequity is associated with particular forms of violence, marginalization, and oppression against females. This includes violent assault by men,
child sexual abuse Child sexual abuse (CSA), also called child molestation, is a form of child abuse in which an adult or older adolescent uses a child for sexual stimulation. Forms of child sexual abuse include engaging in sexual activities with a child (whet ...
, strict regulation of women's behavior and movement, female genital mutilation, and exploitative, forced labor. Women and girls are also vulnerable to less well-documented forms of abuse or exploitation, such as
human trafficking Human trafficking is the trade of humans for the purpose of forced labour, sexual slavery, or commercial sexual exploitation for the trafficker or others. This may encompass providing a spouse in the context of forced marriage, or the extrac ...
or "
honor killings An honor killing (American English), honour killing (Commonwealth English), or shame killing is the murder of an individual, either an outsider or a member of a family, by someone seeking to protect what they see as the dignity and honor of ...
" for perceived behavioral transgressions and deviation of their social roles. These acts are associated with a wide range of health problems in women such as physical injuries, unwanted
pregnancies Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but can ...
,
abortions Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregnan ...
, mental disorders such as depression, and
anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
, substance abuse, and
sexually transmitted infections Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are spread by sexual activity, especially vaginal intercourse, anal sex, and oral se ...
, all of which can potentially lead to premature death. The ability of women to utilize health care is also heavily influenced by other forms of structural gender inequalities. These include unequal restriction on one's mobility and behavior, as well as unequal control over financial resources. Many of these social gender inequalities can impact the way women's health is regarded, which can in turn determine the level of access women have to healthcare services and the extent by which households and the larger community are willing to invest in women's health issues.


Other axes of oppression

Apart from gender discrimination, other axes of oppression also exist in society to further marginalize certain groups of women, especially those who are living in poverty or of minority status in which they live.


Race and ethnicity

Race Race, RACE or "The Race" may refer to: * Race (biology), an informal taxonomic classification within a species, generally within a sub-species * Race (human categorization), classification of humans into groups based on physical traits, and/or s ...
is a well known axis of oppression, where people of color tend to suffer more from
structural violence Structural violence is a form of violence wherein some social structure or social institution may harm people by preventing them from meeting their basic needs. The term was coined by Norwegian sociologist Johan Galtung, who introduced it in his ...
. For people of color, race can serve as a factor, in addition to gender, that can further influence one's health negatively. Studies have shown that in both high-income and low-income countries, levels of
maternal mortality Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pre ...
may be up to three times higher among women of disadvantaged
ethnic groups An ethnic group or an ethnicity is a grouping of people who identify with each other on the basis of shared attributes that distinguish them from other groups. Those attributes can include common sets of traditions, ancestry, language, history, ...
than among white women. In a study on race and mother-death within the US, the
maternal mortality Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pre ...
rate for
African Americans African Americans (also referred to as Black Americans and Afro-Americans) are an ethnic group consisting of Americans with partial or total ancestry from sub-Saharan Africa. The term "African American" generally denotes descendants of ens ...
is close to four times higher than that of white women. Similarly in
South Africa South Africa, officially the Republic of South Africa (RSA), is the southernmost country in Africa. It is bounded to the south by of coastline that stretch along the South Atlantic and Indian Oceans; to the north by the neighbouring countri ...
, the maternal mortality rate for black/African women and women of color is approximately 10 and 5 times greater respectively than that of white/European women.


Socioeconomic status

Although women around the world share many similarities in terms of the health-impacting challenges, there are also many distinct differences that arise from their varying states of socioeconomic conditions. The type of living conditions in which women live is largely associated with not only their own socioeconomic status, but also that of their nation. At every single age category, women in
high income countries A high-income economy is defined by the World Bank as a nation with a gross national income per capita of US$12,696 or more in 2020, calculated using the Atlas method. While the term "high-income" is often used interchangeably with "First World" a ...
tend to live longer and are less likely to suffer from ill health than and premature mortality than those in
low income countries A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreeme ...
. Death rates in high-income countries are also very low among children and younger women, where most deaths occur after the age of 60 years. In low-income countries however, the death rates at young ages are much higher, with most death occurring among girls, adolescents, and younger adult women. Data from 66 developing countries show that child mortality rates among the poorest 20% of the population are almost double those in the top 20%. The most striking health outcome difference between rich and poor countries is
maternal mortality Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pre ...
. Presently, an overwhelming proportion of maternal mortality is concentrated within the nations that are suffering from poverty or some other form of
humanitarian crises A humanitarian crisis (or sometimes humanitarian disaster) is defined as a singular event or a series of events that are threatening in terms of health, safety or well-being of a community or large group of people. It may be an internal or extern ...
, where 99% of the more than half a million maternal deaths every year occur. This comes from the fact that institutional structures which could protect women's health and well-being are either lacking or poorly developed in these places. The situation is similar within countries as well, where the health of both girls and women is critically affected by social and economic factors. Those who are living in poverty or of lower
socioeconomic status Socioeconomic status (SES) is an economic and sociological combined total measure of a person's work experience and of an individual's or family's economic access to resources and social position in relation to others. When analyzing a family's ...
tend to perform poorly in terms of health outcomes. In almost all countries, girls and women living in wealthier households experience lower levels of mortality and higher usage of health care services than those living in the poorer households. Such socioeconomic status-related health disparities is present in every nation around the world, including developed regions.


Environmental Injustice

Environmental injustice Environmental racism or ecological apartheid is a form of institutional racism leading to landfills, incinerators, and hazardous waste disposal being disproportionally placed in communities of colour. Internationally, it is also associated with ...
at its core is the presence of distributional injustice including both the distribution of decision-making power as well as the distribution of environmental burden. Environmental burdens, which include water pollution, toxic chemicals, etc., can disproportionately impact the health of women. Women are often left out of policy making and decisions. These injustices occur because women are generally affected by intersectionality of oppression which leads to lower incomes and less social status. Root causes of these injustices is the fundamental presence of gender inequality, particularly in marginalized communities (Indigenous women, women from low-income communities, women from the Global South, etc.) that will become amplified by climate change. These women are often reliant on natural resources for their livelihoods and, therefore, are one of the first groups of people to be severely impacted by global climate change and environmental injustice. In addition, women all around the world are held responsible for providing food, water, and care to their families. This has sparked a movement to make the literature, research, and teaching more gender aware in the sphere of feminism. However, women continue to face oppression in the sphere of media. CNN and Media Matters have reported that only 15% of those interviewed in the media on climate change have been women. Comparatively, women make up 90% of environmental justice groups across the United States. UN climate chief
Christiana Figueres Karen Christiana Figueres Olsen (born 7 August 1956) is a Costa Rican diplomat who has led national, international and multilateral policy negotiations. She was appointed Executive Secretary of the UN Framework Convention on Climate Change (UNFC ...
has publicly recognized gender disparity in environmental injustice and has pledged to put gender at the center of the Paris talks on climate change. "Women are disproportionately affected by climate change. It is increasingly evident that involving women and men in all decision-making on climate action is a significant factor in meeting the climate challenge". Studies have shown that women's involvement and participation in policy leadership and decision-making has led to a greater increase in conservation and climate change mitigation efforts. When we analyze root causes, it is clear that women experience climate change with disproportionate severity precisely because their basic rights continue to be denied in varying forms and intensities across the world. Enforced gender inequality reduces women's physical and economic mobility, voice, and opportunity in many places, making them more vulnerable to mounting environmental stresses. Indigenous pregnant women and their unborn children are more vulnerable to
climate change and health The effects of climate change on human health include direct effects of extreme weather, leading to injury and loss of life, as well as indirect effects, such as undernutrition brought on by crop failures or a lack of access to safe drinking water. ...
impacts by way of environmental injustice. Indigenous women, women from low-income communities, and women from the Global South bear an even heavier burden from the impacts of climate change because of the historic and continuing impacts of colonialism, racism and inequality; and in many cases, because they are more reliant upon natural resources for their survival and/or live in areas that have poor infrastructure. Drought, flooding, and unpredictable and extreme weather patterns  present life or death challenges for many women, who are most often the ones responsible for providing food, water and energy for their families.


Gender bias in clinical trials

Gender bias is prevalent in medical research and diagnosis. Historically, women were excluded from
clinical trial Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, dietar ...
s, which affects research and diagnosis. Throughout clinical trials, Caucasian males were the normal test subjects and findings were then generalized to other populations. Women were considered more expensive and complicated clinical trial subjects because of variable hormone levels that differ significantly from men's. Specifically, pregnant women were considered an at-risk population and thus barred from participation in any clinical trials. In 1993, the
U.S. Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
(FDA) published "Guidelines for the Study and Evaluation of Gender Differences in the Clinical Evaluation of Drugs", overwriting the 1977 decision to bar all pregnant women from clinical trials. Through this, they recommended that women be included in clinical trials to explore differences in the sexes, specifying that the population included in clinical trials should be indicative of the population to whom the drug would be prescribed. This mandated the inclusion of female participants in clinical trials sponsored by the
National Institutes of Health The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
(NIH). The FDA's 1998 "Presentation of Safety and Effectiveness Data for Certain Subgroups of the Population in Investigational New Drug Application Reports and New Drug Applications" regulations mandated that drug trials prove safety and efficacy in both sexes in order to gain FDA approval and led to drugs being taken off the market due to adverse affects on women that had not been appropriately studied during clinical trials. Several more recent studies determined in hindsight that many federally funded studies from 2009 included a higher percentage of female participants but did not include findings specified between males and females. In 1994, the FDA established an Office of Women's Health, which promotes that sex as a biological variable should be explicitly considered in research studies. The FDA and NIH have several ongoing formal efforts to improve the study of sex differences in clinical trials, including the Critical Path Initiative, which uses biomarkers, advanced technologies, and new trial designs to better analyze subgroups. Another initiative, Drug Trial Snapshots, offers transparency to subgroup analysis via a consumer-focused website. However, despite such work, women are less likely to be aware of or to participate in clinical trials. Although inclusion of women in clinical trials is now mandated, there is no such mandate for use of female animal models in non-human research. Typically, male models are used in non-human research and results are generalized to females. This can complicate diagnosis. A 2011 review article examined sex bias in biomedical research and found that while sex bias has decreased in human clinical trials, particularly since the US National Institute of Health Revitalization Act of 1993, sex bias has increased in non-human studies. Additionally, studies often fail to analyze results by sex specifically. Another example of this is the
thalidomide Thalidomide, sold under the brand names Contergan and Thalomid among others, is a medication used to treat a number of cancers (including multiple myeloma), graft-versus-host disease, and a number of skin conditions including complications of ...
epidemic. In the late 1950s thalidomide was prescribed to pregnant women to treat morning sickness. Its use unexpectedly resulted in severe birth defects in over 10,000 children. However, proper studies were not conducted to determine adverse effects in women, specifically those who are pregnant and it was determined that mice, the animal model used to test thalidomide, were less sensitive to it than humans.


Gender bias in diagnosis

A 2018 literature review of 77 medical articles found gender bias in the patient-provider encounter as it related to pain. Their findings confirmed a pattern of expectations and treatment differences between men and women, "not embedded in biological differences but gendered norms." For example, women with pain were viewed as " hysterical, emotional, complaining, not wanting to get better, malingerers, and fabricating the pain, as if it is all in her head." Women suffering with chronic pain are often erroneously attributed psychological rather than somatic causes for their pain by physicians. And in searching for the effect on pain medication given to men and women, studies determined that women received less effective pain relief, less opioid pain medication, more antidepressants, and more psychiatric referrals.


Management

The Fourth World Conference on Women asserts that men and women share the same right to the enjoyment of the highest attainable standard of
physical Physical may refer to: *Physical examination In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally co ...
and
mental health Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health ...
. However, women are disadvantaged due to social, cultural, political and economic factors that directly influence their
health Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
and impede their access to health-related information and care. In the 2008 World Health Report, the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
stressed that strategies to improve women's health must take full account of the underlying determinants of health, particularly
gender inequality Gender inequality is the social phenomenon in which men and women are not treated equally. The treatment may arise from distinctions regarding biology, psychology, or cultural norms prevalent in the society. Some of these distinctions are empi ...
. Additionally, specific socioeconomic and cultural barriers that hamper women in protecting and improving their
health Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
must also be addressed.


Gender mainstreaming

Gender mainstreaming Gender mainstreaming is the public policy concept of assessing the implications for people of different genders of a planned policy action, including legislation and programmes. Mainstreaming offers a pluralistic approach that values the diversi ...
was established as a major global strategy for the promotion of
gender equality Gender equality, also known as sexual equality or equality of the sexes, is the state of equal ease of access to resources and opportunities regardless of gender, including economic participation and decision-making; and the state of valuing d ...
in the
Beijing } Beijing ( ; ; ), alternatively romanized as Peking ( ), is the capital of the People's Republic of China. It is the center of power and development of the country. Beijing is the world's most populous national capital city, with over 21 ...
Platform for Action from the Fourth United Nations World Conference on Women in Beijing in 1995. Gender mainstreaming is defined by the
United Nations The United Nations (UN) is an intergovernmental organization whose stated purposes are to maintain international peace and international security, security, develop friendly relations among nations, achieve international cooperation, and be ...
Economic and Social Council in 1997 as follows:
"Mainstreaming a gender perspective is the process of assessing the implications for women and men of any planned action, including legislation, policies or programmes, in all areas and at all levels. It is a strategy for making women’s as well as men’s concerns and experiences an integral dimension of the design, implementation, monitoring and evaluation of policies and programmes in all political, economic and societal spheres so that women and men benefit equally and inequality is not perpetuated. The ultimate aim is to achieve gender equality".
Over the past few years, "
gender mainstreaming Gender mainstreaming is the public policy concept of assessing the implications for people of different genders of a planned policy action, including legislation and programmes. Mainstreaming offers a pluralistic approach that values the diversi ...
" has become a preferred approach for achieving greater health parity between men and women. It stems from the recognition that while technical strategies are necessary, they are not sufficient in alleviating gender disparities in health unless the
gender discrimination Sexism is prejudice or discrimination based on one's sex or gender. Sexism can affect anyone, but it primarily affects women and girls.There is a clear and broad consensus among academic scholars in multiple fields that sexism refers primaril ...
, bias and inequality that in organizational structures of
governments A government is the system or group of people governing an organized community, generally a state. In the case of its broad associative definition, government normally consists of legislature, executive, and judiciary. Government is a ...
and organizations – including health systems – are being challenged and addressed. The
gender mainstreaming Gender mainstreaming is the public policy concept of assessing the implications for people of different genders of a planned policy action, including legislation and programmes. Mainstreaming offers a pluralistic approach that values the diversi ...
approach is a response to the realisation that gender concerns must be dealt with in every aspect of
policy development Policy is a deliberate system of guidelines to guide decisions and achieve rational outcomes. A policy is a statement of intent and is implemented as a procedure or protocol. Policies are generally adopted by a governance body within an organ ...
and programming, through systematic gender analyses and the implementation of actions that address the balance of power and the distribution of resources between women and men. In order to address gender health disparities, gender mainstreaming in health employs a dual focus. First, it seeks to identify and address gender-based differences and inequalities in all health initiatives; and second, it works to implement initiatives that address women's specific health needs that are a result either of biological differences between women and men (e.g. maternal health) or of gender-based discrimination in society (e.g. gender-based violence; poor access to health services).
Sweden Sweden, formally the Kingdom of Sweden,The United Nations Group of Experts on Geographical Names states that the country's formal name is the Kingdom of SwedenUNGEGN World Geographical Names, Sweden./ref> is a Nordic country located on ...
's new public health policy, which came into force in 2003, has been identified as a key example of mainstreaming gender in health policies. According to the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
,
Sweden Sweden, formally the Kingdom of Sweden,The United Nations Group of Experts on Geographical Names states that the country's formal name is the Kingdom of SwedenUNGEGN World Geographical Names, Sweden./ref> is a Nordic country located on ...
's public health policy is designed to address not only the broader
social determinants of health The social determinants of health (SDOH) are the economic and social conditions that influence individual and group differences in health status. They are the health promoting factors found in one's living and working conditions (such as the d ...
, but also the way in which gender is woven into the public health strategy. The policy specifically highlights its commitment to address and reduce gender-based inequalities in health.


Female Empowerment

The
United Nations The United Nations (UN) is an intergovernmental organization whose stated purposes are to maintain international peace and international security, security, develop friendly relations among nations, achieve international cooperation, and be ...
has identified the enhancement of women's involvement as way to achieve
gender equality Gender equality, also known as sexual equality or equality of the sexes, is the state of equal ease of access to resources and opportunities regardless of gender, including economic participation and decision-making; and the state of valuing d ...
in the realm of education, work, and health. This is because women play critical roles as caregivers, formally and informally, in both the household and the larger community. Within the United States, an estimated 66% of all caregivers are female, with one-third of all female caregivers taking care of two or more people According to the World Health Organization, it is important that approaches and frameworks that are being implemented to address gender disparities in health acknowledge the fact that majority of the care work is provided by women. A meta-analysis of 40 different women's empowerment projects found that increased female participation have led to a broad range of
quality of life Quality of life (QOL) is defined by the World Health Organization as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards ...
improvements. These improvements include increases in women's advocacy demands and organization strengths, women-centered policy and governmental changes, and improved economic conditions for lower class women. In Nepal, a community-based participatory intervention to identify local
birthing Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globall ...
problems and formulating strategies has been shown to be effective in reducing both
neonatal An infant or baby is the very young offspring of human beings. ''Infant'' (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is a formal or specialised synonym for the common term ''baby''. The terms may also be used to ...
and
maternal mortality Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pre ...
in a rural population. Community-based programs in
Malaysia Malaysia ( ; ) is a country in Southeast Asia. The federation, federal constitutional monarchy consists of States and federal territories of Malaysia, thirteen states and three federal territories, separated by the South China Sea into two r ...
and
Sri Lanka Sri Lanka (, ; si, ශ්‍රී ලංකා, Śrī Laṅkā, translit-std=ISO (); ta, இலங்கை, Ilaṅkai, translit-std=ISO ()), formerly known as Ceylon and officially the Democratic Socialist Republic of Sri Lanka, is an ...
that used well-trained
midwives A midwife is a health professional who cares for mothers and newborns around childbirth, a specialization known as midwifery. The education and training for a midwife concentrates extensively on the care of women throughout their lifespan; con ...
as front-line health workers also produced rapid declines in
maternal mortality Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pre ...
.


International states of gender disparities in health

South-East Asia region Women in South-East Asia often find themselves in subordinate positions of power and dependency on their male counterparts-regarding cultural, economics, and societal relations. Because there is a limited level of control and access granted to women in this region, the capability for daughters to counteract generational biases regarding gender specific roles are highly limited. In contrast to many other industrialised countries, life expectancy is equal or shorter for women in this region, with the probability of surviving the first five years of life for women equal to or smaller than that of males. A potential explanation as to why there are disparate difference in health status and access between genders is due to an unbalanced sex ratio-for example, the
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
n subcontinent has a ratio of 770 women per 1000 men. Neglect of female children, limited or poor access to health care, sex selective abortions, and reproductive mortality are all additional reasons as to why there is a severe inequity between genders. Education and increased socioeconomical independency are projected to assist in the leveling of health-care access between the genders, but there are sociocultural circumstances and attitudes concerning the prioritization of males over females that stagnates progress.
Sri Lanka Sri Lanka (, ; si, ශ්‍රී ලංකා, Śrī Laṅkā, translit-std=ISO (); ta, இலங்கை, Ilaṅkai, translit-std=ISO ()), formerly known as Ceylon and officially the Democratic Socialist Republic of Sri Lanka, is an ...
has repeatedly been identified as a role model of sorts for other nations within this region, as there are minimal differences in health, educational, and employment levels between genders. European Region According to the
World Health Organization (WHO) The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
gender discrimination in relation to lack of access and provision of health in this region is supported by concrete survey data. In the European Region, 1 in 5 women have been
domestic violence Domestic violence (also known as domestic abuse or family violence) is violence or other abuse that occurs in a domestic setting, such as in a marriage or cohabitation. ''Domestic violence'' is often used as a synonym for ''intimate partner ...
victims, while
honour killings An honor killing (American English), honour killing (English in the Commonwealth of Nations, Commonwealth English), or shame killing is the murder of an individual, either an outsider or a member of a family, by someone seeking to protect wha ...
,
female genital mutilation Female genital mutilation (FGM), also known as female genital cutting, female genital mutilation/cutting (FGM/C) and female circumcision, is the ritual cutting or removal of some or all of the external female genitalia. The practice is found ...
, and
bride kidnapping Bride kidnapping, also known as marriage by abduction or marriage by capture, is a practice in which a man abducts the woman he wishes to marry. Bride kidnapping (hence the portmanteau bridenapping) has been practiced around the world and ...
still occur. Additional studies done by the WHO have found that immigrant women face a 43% higher risk of having an underweight child, 61% greater risk of having a child with congenital malformations, and 50% higher chance of perinatal mortality. In European countries, women make up the majority of those unemployed, earning an average 15% less than men while 58% were observed to be unemployed. Differences in wages are even greater in the Eastern part of the region, as represented in the comparison of wages between women (4954 US dollars) in
Albania Albania ( ; sq, Shqipëri or ), or , also or . officially the Republic of Albania ( sq, Republika e Shqipërisë), is a country in Southeastern Europe. It is located on the Adriatic and Ionian Seas within the Mediterranean Sea and shares ...
versus men (9143 US dollars.) Eastern Mediterranean Region Access to education and employment are key elements in achieving gender equality in health. Female literacy rates in the
Eastern Mediterranean Eastern Mediterranean is a loose definition of the eastern approximate half, or third, of the Mediterranean Sea, often defined as the countries around the Levantine Sea. It typically embraces all of that sea's coastal zones, referring to communi ...
were found by the WHO to fall sharply behind their male counterparts, as evident in the cases of
Yemen Yemen (; ar, ٱلْيَمَن, al-Yaman), officially the Republic of Yemen,, ) is a country in Western Asia. It is situated on the southern end of the Arabian Peninsula, and borders Saudi Arabia to the Saudi Arabia–Yemen border, north and ...
(66:100) and
Djibouti Djibouti, ar, جيبوتي ', french: link=no, Djibouti, so, Jabuuti officially the Republic of Djibouti, is a country in the Horn of Africa, bordered by Somalia to the south, Ethiopia to the southwest, Eritrea in the north, and the Red ...
(62:100.) Further barriers other than the prioritization of providing opportunities for males, include the inability for females in this region to pursue anything more than a tertiary education because of economic constraints. Contraceptive usage and knowledge of reproductive options were found to be more present amongst women who had received higher levels of education in
Egypt Egypt ( ar, مصر , ), officially the Arab Republic of Egypt, is a transcontinental country spanning the northeast corner of Africa and southwest corner of Asia via a land bridge formed by the Sinai Peninsula. It is bordered by the Mediter ...
, the rate of contraceptive usage being 93% among those who were university-educated versus illiterate. In regards to the influence of employment upon a woman's capability to know of and fight for equity in health care, in this region, women were found by the WHO to participate lower in the labor market than other regions (at an average of 28%.) The lowest number of women in paid employment within this region was found in
Saudi Arabia Saudi Arabia, officially the Kingdom of Saudi Arabia (KSA), is a country in Western Asia. It covers the bulk of the Arabian Peninsula, and has a land area of about , making it the fifth-largest country in Asia, the second-largest in the A ...
and other countries of the
Gulf Cooperation Council (GCC) The Cooperation Council for the Arab States of the Gulf ( ar, مجلس التعاون لدول العربية الخليج ), also known as the Gulf Cooperation Council (GCC; ar, مجلس التعاون الخليجي), is a regional, interg ...
, while the highest number of women with paid employment were in
Morocco Morocco (),, ) officially the Kingdom of Morocco, is the westernmost country in the Maghreb region of North Africa. It overlooks the Mediterranean Sea to the north and the Atlantic Ocean to the west, and has land borders with Algeria to ...
,
Lebanon Lebanon ( , ar, لُبْنَان, translit=lubnān, ), officially the Republic of Lebanon () or the Lebanese Republic, is a country in Western Asia. It is located between Syria to the north and east and Israel to the south, while Cyprus li ...
, and
Yemen Yemen (; ar, ٱلْيَمَن, al-Yaman), officially the Republic of Yemen,, ) is a country in Western Asia. It is situated on the southern end of the Arabian Peninsula, and borders Saudi Arabia to the Saudi Arabia–Yemen border, north and ...
. The lack of availability of health care services in this region particularly complicates matters as certain countries are already strained by ongoing conflict and war. According to WHO, the ratio of physicians per population is drastically lower in the countries
Sudan Sudan ( or ; ar, السودان, as-Sūdān, officially the Republic of the Sudan ( ar, جمهورية السودان, link=no, Jumhūriyyat as-Sūdān), is a country in Northeast Africa. It shares borders with the Central African Republic t ...
,
Somalia Somalia, , Osmanya script: 𐒈𐒝𐒑𐒛𐒐𐒘𐒕𐒖; ar, الصومال, aṣ-Ṣūmāl officially the Federal Republic of SomaliaThe ''Federal Republic of Somalia'' is the country's name per Article 1 of thProvisional Constituti ...
, Yemen, and Djibouti, while health infrastructures are nearly nonexistent in
Afghanistan Afghanistan, officially the Islamic Emirate of Afghanistan,; prs, امارت اسلامی افغانستان is a landlocked country located at the crossroads of Central Asia and South Asia. Referred to as the Heart of Asia, it is bordere ...
. With additional complications of distance to and from medical services, the access of health care services is even more complex for women in this region as the majority are unable to afford the transportation costs or time. Western Pacific Region Gender based division of labor in this region has been observed by the WHO as reason for the differences in health risks that the two genders are exposed to in contrast to one another. Most commonly, women of this region are engaged in insecure and informal forms of labor, therefore being unable to gain related benefits such as insurance or pension. In regards to education, the gap between male and females is relatively small in primary and secondary schools, however, there is undeniably an uneven distribution of literacy rates between the various countries within this region. According to the WHO substantial differences in literacy rates between men and women exist particularly in
Papua New Guinea Papua New Guinea (abbreviated PNG; , ; tpi, Papua Niugini; ho, Papua Niu Gini), officially the Independent State of Papua New Guinea ( tpi, Independen Stet bilong Papua Niugini; ho, Independen Stet bilong Papua Niu Gini), is a country i ...
(55.6% for women and 63.6% for men) and
Lao People's Democratic Republic Laos (, ''Lāo'' )), officially the Lao People's Democratic Republic ( Lao: ສາທາລະນະລັດ ປະຊາທິປະໄຕ ປະຊາຊົນລາວ, French: République démocratique populaire lao), is a socialist ...
(63.2% for women and 82.5% for men.)


See also

*
Women's health Women's health differs from that of men in many unique ways. Women's health is an example of population health, where health is defined by the World Health Organization as "a state of complete physical, mental and social well-being and not mer ...
*
Men's health ''Men's Health'' (''MH''), published by Hearst, is the world's largest men's magazine brand, with 35 editions in 59 countries. It is also the best-selling men's magazine on U.S. newsstands. Started as a men's health magazine by Rodale, Inc. ...


References

{{reflist Determinants of health Feminism and health Men's health Women's health Health equity
Health Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...