SEE ALSO female genital cutting; men’s health; sexual health; social movements; violence; women’s health
Gender mainstreaming is an acknowledgement that gender equality is best achieved by integrating both women’s and men’s health concerns (Smith and Robertson, 2008).
The definitions of gender mainstreaming usually follow the interpretation by the United Nations Economic and Social Council as ‘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’ (United Nations, 1997, p. 27).
The term ‘gender’ includes both masculinity and femininity. Being a man or a woman has a significant impact on health, as a result of biological and gender-related differences and additional factors such as poverty and powerlessness (WHO, 2013b). Gender equality, also known as sex equality or equality of the genders, refers to the view that men and women should be treated equally and not discriminated against based on gender. By operating collectively, men and women have benefited from sharing roles, responsibility and expertise and by having a sense of solidarity for both genders who might otherwise have felt isolated within society (United Nations, 1997, p. 28).
Most health-related gender discussion over the past few decades has focused on women’s health needs because this gender was perceived as being the most vulnerable. However, gender differences can also hurt men’s health, as, for example, when greater risk-taking among young men leads to injuries. Associating gender issues to only one group also fails to recognize the key role that gender relations play in the generation of socially specific health practices for both men and women (Smith and Robertson, 2008).
Mainstreaming was established as the global strategy for promoting gender equality through the United Nations Fourth World Conference on Women in Beijing in 1995. The aim in addressing the inequality between men and women is in the sharing of power and decision-making at all levels. Using a gender perspective in policies and public health programmes requires an analysis of the effects on both women and men. Mainstreaming is not simply about adding a male or female component to an existing policy or programme but situates gender equality issues at the centre of decision-making, budgeting and institutional structures and processes. Gender mainstreaming also requires commitment for changes in organizations, structures, procedures and cultures, to create organizational environments which are conducive to the promotion of gender equality (United Nations, 1997).
Gender mainstreaming activists have been successful when engaging collectively to change the structural and systemic causes of health inequalities. They have achieved these goals through their involvement in pressure groups, social networks and social movements, by mobilizing resources and by improving their individual and collective capacity. The genital integrity activists (intactivists), for example, oppose genital modifications, including genital mutilation and sexual reassignment surgery and are committed to the recognition of the right to an intact body. They also oppose genital modifications that are medically harmful such as circumcision, be it male or female, and challenge the idea that circumcision is a healthy and beneficial procedure. Most opposition to these types of practices by intactivists is on the grounds that they are a violation of human and gender rights (Cakmak, 2007).
Gender mainstreaming continues to be criticized for failing to affect core policy areas or to radically transform policy processes, for not increasing women’s participation in decision-making, for not translating the commitment of gender equality into action and for interventions ignoring the local socio-cultural context (Smith and Robertson, 2008).
•Rai, S. (2007) Mainstreaming Gender, Democratizing the State: Institutional Mechanisms for the Advancement of Women (New Jersey: Transaction Publishers)
•Sargent, C. and Brettell, C. (1996) Gender and Health: An International Perspective (New Jersey: Prentice Hall)
•World Health Organization (2013) ‘Women’s Health’. Available at http://www.who.int/topics/womens_health/en/ Accessed 21 January 2013
SEE ALSO climate change; definition; environmental health; health; health policy; inequalities agenda; population growth
Globalisation describes processes by which people become more connected and interdependent through increased economic integration, communication, cultural diffusion and international travel (Labonte and Laverack, 2008).
Many public health issues are now situated within the context of globalization because health and its determinants in one country cannot be separated from those in another. Worldwide connections and networks of people and organizations that span national, geographic and cultural borders therefore have an influence on health (Naidoo and Wills, 2009).
Public health has in the past been expected to reach for population-wide health improvement across borders and to reduce the causes of health inequalities. This evolved as the field of population health operating at both the international and national levels (Jirojwong and Liamputtong, 2009). The goal of population health is to maintain and improve the health of the entire population and to reduce inequalities in health between population groups. Public health on the other hand aims to reduce disease and maintain and promote the health of a particular population (WHO, 2004).
Until recently, most health development agencies mobilized themselves around international health issues, for example, in reducing HIV prevalence in Africa or to improve maternal and child health programmes in Latin America. These programmes were simply international extensions into other countries of the work they might have done within their own borders. The only global component is that funding for this work was often provided through agencies based in industrialized countries, whether official or through non-government organizations, to aid in health development (Labonte and Laverack, 2008). Global Health describes the entire population of the world including all nations with a cultural and territorial identity, states, multinational organizations and academic institutions involved with the production of knowledge related to global health issues (Parker and Sommer, 2011). International health usually has a public health emphasis and addresses health issues across regional or national boundaries. The distinction between global health issues and those which could be regarded as international health issues is that the global issues defy control by individual countries and require priority setting at both the national and international levels. Planetary health is an attitude towards life and a philosophy for living. Its emphasis is on people, not diseases, and equity, not the creation of unjust societies. It seeks to minimize differences in health according to wealth, education, gender and place and uses knowledge as a source of social transformation, and the right to realize, progressively, the highest attainable levels of health and well-being. Planetary health is therefore based on collective action at every level of society and aims to support sustainable human development (Horton et al., 2014).
The effect of climate change on health is an international, global and planetary issue. The Intergovernmental Panel on Climate Change has stated that if climate change continues as projected until mid-century, major increases of ill health will occur because of an increased risk of conflict, under-nutrition, water-borne diseases and vector-borne diseases (Intergovernmental Panel on Climate Change, 2014).
The transnational impacts of globalization upon health and its determinants are beyond the control of individual nations (Lee, 2004). Issues of globalization and health include the inequities caused by patterns of international trade and investment and the vulnerability of refugee populations, the marketing of harmful products by transnational corporations and the transmission of diseases between countries. The global transfer of health risks as a result of an expansion of the movement of people, environmental threats, lifestyle changes, the effects of global climate change and the trade in harmful products will potentially present the greatest challenges to global public health (Parker and Sommer, 2011).
KEY TEXTS
•Beaglehole, R. and Bonita, R. (eds) (2009) Global Public Health: A New Era (Oxford: Oxford University Press)
•Lee, K. (2004) Globalization and Health: An Introduction (Basingstoke: Palgrave Macmillan)
•Parker, R. and Sommer, M. (2011) Handbook in Global Public Health (Abingdon: Routledge)