Equity, Diversity & Inclusion: Gender Diversity

Sex and gender can influence health in important ways. While sex and gender are distinct concepts, their influence is often inextricably linked. The scientific studies that generate the most complete data consider sex and/or gender influences in study design, data collection and analysis, and reporting of findings.

Gender bias has a significant negative effect on medical diagnosis and the quality of healthcare people receive. It can lead to substantial delays in diagnosis, as well as misdiagnosis and even death. Gender bias most severely affects women and other marginalized genders. However, it has a negative impact on everyone, and contributes to health inequity worldwide. In this article, we explore gender bias in medical diagnosis, looking at what it is, how it manifests, and its impact on health and healthcare.

Gender refers to the roles, attributes, behaviours and opportunities associated with being male, female, or gender non-binary. It is a complex social structure that patterns power relationships that shape access to and control over resources. Gender has been conceptualised as a process that creates distinguishable social identities, which are then ranked and valued unequally, and consequently produce unequal opportunities and life chances. As such, it is a powerful determinant of health, as it produces unequal living conditions which drive inequalities in health.

Patient attitudes about health and healthcare have emerged as important outcomes to assess in clinical studies. Gender is increasingly recognized as an intersectional social construct that may influence health. Our objective was to determine potential sex differences in self-reported overall health and access to healthcare and whether those differences are influenced by individual social factors in two relatively similar countries.

Despite good intentions, gender bias persists in health care. A survey conducted in early 2019 by TODAY found that more than one-half of women, compared with one-third of men, believe gender discrimination in patient care is a serious problem. One in five women say they have felt that a health care provider has ignored or dismissed their symptoms, and 17% say they feel they have been treated differently because of their gender—compared with 14% and 6% of men, respectively.

Restrictive gender norms and gender inequalities are replicated and reinforced in health systems, contributing to gender inequalities in health. In this Series paper, we explore how to address all three through recognition and then with disruptive solutions.

Some health issues that are common to both men and women affect women differently. Although the symptoms may be similar, the effects of the condition and the care necessary can differ significantly for women.

International Women’s Day celebrates women’s achievements and raises awareness of the continuing mission towards gender equality. So it’s a good time to be reminded we still need to correct decades — centuries even — of gender bias in medicine and medical research.

For more than a decade, women have predominated among Canadian medical school graduates, according to data from the Canadian Post-M.D. Education Registry (CAPER). Although, as a profession, medicine still sees pervasive discrimination that disadvantages certain groups over others, one might argue that gender equity is an area in which progress has been made.

As the world clamored to respond to the rapidly evolving coronavirus 2019 (COVID-19) pandemic, health care systems reacted swiftly to provide uninterrupted care for patients. Within obstetrics and gynecology, nearly every facet of care was influenced. Rescheduling of office visits, safety of labor and delivery and in the operating room, and implementation of telemedicine are examples. Social distancing has impacted academic centers in the education of trainees. COVID-19 vaccine trials have increased awareness of including pregnant and lactating women. Last, the pandemic has reminded us of issues related to ethics, diversity and inclusiveness, marginalized communities, and the women's health workforce.

When it comes to the importance of mental health care for women, it is important to take a look at how their mental health issues differ from those of men. Newer research suggests women are more prone to psychological problems, such as depression, largely due in part to differences in the brains of men and women.

Summary, research and resources on men's health.

Chronic disease incidence among Canadians aged 65 years and older.

There is a paucity of research focusing on the complex interaction between social, behavioral, biological, and psychosocial factors, and health outcomes among men. This symposium contains a collection of papers that discuss some key social determinants of health (SDOH) that can provide insights to advance our understanding of men’s health and aging across the life course.

To the surprise of absolutely no one, a new Cleveland Clinic survey finds that most men — and boomer men in particular — don't like talking about their health.

The national telephone survey of about 500 men ages 18 to 70 found that most would rather talk with their guy friends about current events, sports, their job, their kids — in other words, just about anything other than the state of their health.

Although the concept of stigma has been used to examine the place of various minority populations and women in society, it has not been previously applied to men. This qualitative research explores the experience of 16 Canadian men who believe they were stigmatized due to their sex.

Masculine gender scripts have been influential in health decision making in men. In addition, although past research has identified some success in using churches as sites for health education with women, little is known if similar programs would be successful with men. It is also unclear if religious beliefs influence the health attitudes and behaviors of men. Four focus groups with men from four religious denominations were conducted to learn about their health beliefs, attitudes, and behaviors, with the following themes emerging: men’s health fears, health promotion behaviors, spousal influence, aging and men’s health, and church-based health influence. Finally, the interaction of masculine gender scripts within these themes was considered.

Men have different strategies from women when they are patients, attaching less importance to their treatment and the disease than what might happen subsequently. The author suggests ways in which healthcare professionals can take these different strategies into account when communicating with men.

Despite major health gains over the past few decades, progress has been uneven when analysed by subgroups and specifically by gender, which is a powerful determinant of health outcomes. The World Health Statistics 2019 report from WHO made a first attempt to disaggregate all indicators by sex, and revealed that, globally, boys born in 2018 could expect to live 68·6 years and girls 73·1 years, a difference of 4·5 years. Surprisingly, the life-expectancy gap between genders is larger in high-income countries than in low-income settings, which shows that although biology is important, the biggest drivers of life expectancy are linked to social determinants of health. In this context, there is less discussion on important differences between men and women and why men have worse health outcomes.

Men’s health equity is an area of men’s health research and practice that combines the literature on men’s health with that of health equity. More research is needed that describes how to intervene to promote men’s health equity. This introduction to the American Journal of Men’s Health special collection on promoting men’s health equity was created to feature research that describes aspects of promising interventions.

Current literature has overlooked the impact of chronic illness on masculine identity. We therefore aimed to investigate the impact of rheumatoid arthritis (a long term condition, affecting more women than men) on masculine identity.

It’s being called a silent crisis, a sleeper issue. But there are signs that this sleeper is at last awakening. Around the world studies, surveys, web networks, journals and newspaper articles are shedding light on a shadowy subject: men’s mental health. Among the findings is the revelation that new fathers are also vulnerable to postpartum depression. In Canada, young and middle-aged men are being hospitalized for schizophrenia in increasing numbers. The gender gap among people with mental illness is much narrower than might be suspected.

Underpinning a general pattern of higher suicide rates in men is the assumption that men do not ask for help or utilize the health-care system during times of psychological distress. There has been a failure to grapple with the dynamic of when, how and from whom men might ask for help during times of psychological distress, and what key barriers or enabling factors are likely to influence potential help-givers' capacity or willingness to offer help to men in psychological distress. The aim of this study was to investigate how masculine norms impact men's help-seeking as well as care givers' behaviors and willingness to support men in need of psychological help or perceived to be at risk of suicide.

This study uses data from the Health and Retirement Study and an approach informed by the Biopsychosocial Model of Racism as a Stressor to examine the extent to which SES, stressors, discrimination and neighborhood conditions are mechanisms underlying racial/ethnic disparities in functional limitations among men. Results reveal that racial/ethnic differences in SES, stressors, discrimination and neighborhood conditions—individually and collectively—account for a substantial proportion of racial/ethnic disparities in functional limitations. Findings suggest that the social determinants of health for men of color need to be more seriously considered in investigations of and efforts to address health disparities.

To consider how manhood is a key social determinant of minority men’s health. This commentary explicates how manhood intersects with other determinants of health to shape minority men’s stress responses, health behaviors and health outcomes across the life course.

Marked disparities in health indicators exist between White men and racial/ethnic minority men in the United States. These disparities begin early in life and persist through the life course until advanced ages. Not only do minority men have poor outcomes across a broad variety of health conditions when compared with White men, but they are also less likely to interact and engage with the health care system.

Black, Indigenous, and people of color (BIPOC)People of color face inequalities across the board and research shows especially how dangerous this reality is in healthcare.

Women from ethnic minorities face endemic structural racism when seeking and accessing healthcare.

On account of their racial/ethnic minority status, class, and gender, African-American women of low socioeconomic status are among the least privileged, underserved, and most marginalized groups in the United States. Generally, African Americans continue to experience poorer health outcomes, in which disparities have been attributed to socioeconomic inequities and structural racism. This objective of this study was to explore the lived experiences of low-income African-American women in interacting with the healthcare system and healthcare providers.

Studies show that people with disabilities are more likely than people without disabilities to report having poorer health and less access to adequate health care. This is especially true for women and girls of color with disabilities, who face inequalities because of their disability status, race, and gender. The systemic and structural barriers faced by Black disabled women and girls in the health care system stem from a legacy of slavery, ongoing anti-Black racism, and ableism.

The COVID-19 pandemic is wreaking havoc worldwide, but its disproportionate impact on specific communities and groups of people follow along familiar lines, reflecting existing societal inequalities. In the United States, some of these vulnerable groups include the elderly and individuals with pre-existing conditions, homeless people, individuals with disabilities, and racial and ethnic minority communities.

A new report into the barriers facing Indigenous women trying to access health care during the pandemic describes serious issues including racism and lack of access to mental health services.

When research is conducted from a Western paradigm alone, the findings and resultant policies often ignore Indigenous peoples’ health practices and fail to align with their health care priorities. There is a need for decolonized approaches within qualitative health research to collaboratively identify intersecting reasons behind troubling health inequities and to integrate Indigenous knowledge into current health care services. We engaged with First Nations women to explore to what extent digital storytelling could be a feasible, acceptable, and meaningful research method to inform culturally safe health care services.

Relationship to place is integral to Indigenous health. A qualitative, secondary phenomenological analysis of in-depth interviews with four non-Choctaw Indigenous women participating in an outdoor, experiential tribally-specific Choctaw health leadership study uncovered culturally grounded narratives using thematic analysis as an analytic approach. Results revealed that physically being in historical trauma sites of other Indigenous groups involved a multi-faceted process that facilitated embodied stress by connecting participants with their own historical and contemporary traumas. Participants also experienced embodied resilience through connectedness to place and collective resistance. Implications point to the role of place in developing collective resistance and resilience through culturally and methodologically innovative approaches.

According to data from a new national study on trans health published this week, trans and non-binary Canadians still face under-employment, issues having their health-care needs met, and fear of harassment that leads many to avoid certain public spaces.

The increasing visibility of transgender people and others who do not conform to traditional gender norms challenges us to think about gender in new ways, and to use new terminology when communicating with patients. People who describe themselves as nonbinary have a gender identity that is not exclusively girl/woman or boy/man. A small but growing body of research indicates they experience high levels of societal victimization and discrimination, and are misunderstood by health care clinicians. Using language that is inclusive of all gender identities can reduce these burdens and barriers. In this essay, we use a case scenario that illustrates ways to interact respectfully and affirmatively with nonbinary people throughout the patient care experience.

Resources to help health care staff provide an inclusive and respectful practice for 2SLGBTQ+ BIPOC individuals.

Welcome to the new Social Inclusion portal linked to Canada's Anti-Racism Strategy and the Centre for Gender, Diversity and Inclusion. This new portal brings together key statistical information on the inclusion (or exclusion) of ethnocultural groups and immigrants in Canada.

From the National Institute of Environmental Health Sciences.