Gender Issues

NINFA R. AMBAT, M.D. FPAFP

Objectives

Define gender. Identify some demographic trends in relation to gender issues. Discuss the epidemiology of and national statistics of the above condition. Discuss gender issues in the Philippines.

So God created man in His own image, In the image of God He created him; Male and female He created them. Genesis 1: 27

What is gender?

Gender is about women and men, boys and girls. - United Nations It refers to the differences between men and women. - Wikipedia

commonly used interchangeably with sex within the social sciences it often refers to specifically social differences known as gender roles in the biological sciences.

Gender identity is "an individual's selfconception as being male or female, as distinguished from actual biological sex. - Encyclopdia Britannica Online, 2007

Why study gender issues?

Gender is a significant determinant of health It has an influence on patient care and on the physician-patient interaction Insensitivity to the issue of gender is an important source of bias in health sciences research and can mar both education and health care.
Source: Gender Issues in Family Medicine Research. Canadian Family Physician. Vol 31: June 1991.

Gender Differences

Gender Differences
Then God said, Let us make man in our image, in our likeness, and let them rule over the fish of the sea and the birds of the air, over the livestock, over all the earth , and over all the creatures that move along the ground.26 So God created man in His own image, in the image of God He created him; male and female He created them.27 Genesis 1: 26-27

Gender Differences

Different by design They think differently They process emotions differently They make decisions differently They learn differently

Bill & Pam Farrel. Men are like waffles,Women are like spaghetti.Harvest House Publisher. U.S.A. 2001.

Physical structure of the brain Human male brains are, on the average, approximately ten percent larger than female brains Certain brain areas in women contain more nerve cells

L.A. Gender and the Brain. Washington DC: Society of Neuroscience, 1998.

Physical Attributes

Gender and Social Demography

Gender and Social Demography

In the twentieth century, life expectancy increased for both men and women BUT women live longer on average than men in preindustrialized countries, including Europe. Probably due to economic progress - British sociologist Nicky Hart (1991)

W.C. Cokerman. Medical Sociology.9th ed. Pearson Education, Inc. U.S.A. 2004.

Gender and Social Demography

EXCEPT in few countries in South Asia like Bangladesh and Nepal where men outlive women Reasons: 1. Nutritional deprivation 2. Lessened access to medical care

W.C. Cokerman. Medical Sociology.9th ed. Pearson Education, Inc. U.S.A. 2004.

Gender and Social Demography

Outside of South Asia males exceed female death rates at all ages and for the leading causes of death like heart disease, cancer, cerebrovascular diseases, accidents, and pneumonia.

W.C. Cokerman. Medical Sociology.9th ed. Pearson Education, Inc. U.S.A. 2004.

Gender and Social Demography

Women tend to suffer from more frequent illnesses and disability, but their usual health disorders are not as serious or as life threatening as those encountered by men. Yet women, especially in later life, also die from the same illnesses as men.

W.C. Cokerman. Medical Sociology.9th ed. Pearson Education, Inc. U.S.A. 2004.

Gender and Social Demography

men and women essentially suffer the same types of problems; what distinguishes the sexes is the frequency of those problems and the pace of death.- Lois Verbrugge, 1985

W.C. Cokerman. Medical Sociology.9th ed. Pearson Education, Inc. U.S.A. 2004.

Demographic trends in relation to gender issues

Ageing Population decline Migration Refugees

Source: Gender Issues. United Nations Economic Commission for Europe (UNECE)

Demographic trends in relation to gender issues

Ageing Majority of older people (60+) are women Increased constraints on social protection systems, womens work load escalates affects their health status, access to paid employment, political participation, etc.

Demographic trends in relation to gender issues

Population decline Low fertility and migration slow or negative population growth Low fertility may be the result of unfavourable conditions for women Smaller families enhance womens opportunities In some countries like CEE, mortality among men are either rising or steady

CEE- Central and Eastern Europe

Demographic trends in relation to gender issues

Migration Important factor in the redistributing population Since 1990, dramatic migration changes have occurred in the ECE region There are gender differences in the reasons for migration, types of migration, as well as conditions in which women and men migrants live.

ECE Economic Commission for Europe

Demographic trends in relation to gender issues

Refugees Women and adolescent girls in refugee setting are especially vulnerable to sexual harassment, abuse and violence. Women have specific health needs due to their reproductive role Women often carry the heaviest burden of survival for themselves and their families in refugee situations.

GENDER ROLES and RESPONSIBILITY SHARING In Families and Households

Traditionally in all societies, there is a sex-specific division of labour, which peaks during the family formation years. Changing needs of the families Increasing number of women have entered the labour force Womens lives continue to be influenced by parenthood to a much larger extent than mens lives are

Source: Gender Issues. United Nations Economic Commission for Europe (UNECE)

A key contention is that we live in a social environment where gender plays a significant role in social status and in access to material resources, health and well-being, and where roles, responsibilities and power are not shared equally between males and females.

Source: G. Scambler. Sociology as Applied to Medicine. Elsevier Science Limited. U.K. 2003

Changes in the 20th Century

Although there have been significant shifts in gender norms in society, such changes have occurred within a complex web of power and advantage that still leaves women with a long way to go to achieve even material parity with men.

Source: G. Scambler. Sociology as Applied to Medicine. Elsevier Science Limited. U.K. 2003

Mens and Womens Position in Society

Changes in family size and structure Employment The public and private spheres Roles and role conflicts

Changes in family size and structure

Between 1961 and end of 20th century* >1/3 <1/4 traditional families 7% 30% lone-parent families with dependent children 80% live with their mother increase in number of divorces Cohabiting now normally precedes marriage and many couples cohabit but do not marry.

*UK statistics
Source: G. Scambler. Sociology as Applied to Medicine. Elsevier Science Limited. U.K. 2003

Women are getting married later, having their children in later life and having fewer children At present, 40% of all live births occur to women outside marriage, but for women below 20 years the figure rises to 90%

Employment

Equality for the genders is still not obvious in the general area of paid work Pay gaps- accdg to Equal Opportunities Commission report 25% gap in marketing and sales 28% in the legal profession 35% in banking 42% in management

Women are twice likely to work in the public sector, i.e. 32% women workers vs. 15% male workers Pay in the public sector does not match the private sector Women are less likely to reach a higher level of management and less likely to get access to benefits

Feminization of poverty Unpaid work in the domestic sphere Only 69% of all working women are in work as compared to 80% of all working age men Part-time working is most common for mothers 2/3 of mothers with children under 5

Cabinet Office Womens Unit, 2000 Gender earnings gap The difference between equivalently skilled and childless males and females Mother gap The difference between equivalently educated females with and without children

Source: G. Scambler. Sociology as Applied to Medicine. Elsevier Science Limited. U.K. 2003

Parent gap The difference in lifetime earnings between a mother and father in a family

Gender issues in work Occupational health and work hazards research and practice have operated against the interest of women Sexual harassment

The Two Distinct and Gendered Spheres:

The public The private

The public sphere

Paid work has higher status than private sphere The real world Contains institutions and personnel necessary to create a functioning society Natural sphere for men

The private sphere

The domestic sphere Gendered female The domain of unpaid work that is performed for love Where the reproduction and rearing of children and the nurturing of families takes place A place of leisure and a refuge for a paid work, especially for men.

The private sphere

Womens work in the home continues to be valued lower than paid work, and the status of home-worker remains a negative one. Monetary value: 739 billion per annum (Office of Statistics in U.K., 1997) Will double the gross domestic produce (GDP)

The private spheres

Work at home is often rendered invisible Work at home is only recognized when there is a problem and children appear to be badly cared for or the housekeeping is deemed inadequate Women might be seen as lacking in social skills (not a proper woman) and subject to public surveillance, or they could even be classified as suffering from mental illness

The private sphere

Domestic violence at home Has mental and physical health effects Global issue - WHO, 2000 Western countries 20%-30% Asia, Middle East, Central and Latin America, and Africa 16% - 52% (Nicaragua) Kenya and Uganda 40%

Domestic violence: Physical, emotional, psychological and sexual violence Slaps, murder, harassment to mental abuse Mainly directly to females by males (80%) Britain, every 6 seconds

Effects on health of domestic violence Bruising, broken bones, damage genitalia and facial injuries Emotional distress depression, loss of self-esteem, sleep problems and increased risk of suicide

Roles and role conflicts

Gender expectations remains rooted around reproduction Theres a trend for women who have to give up their jobs altogether or to go part-time after having their first babies A study in Quebec, 1999 Stress of mothers with degrees Have greater risk of stress-related illness than their husbands

In Britain, existing culture have disadvantages to women with home responsibilities and who are unable to stay late in the evening or get into work early, or take work home Childbirth remains a barrier to progress of women throughout society and, ironically, paid work culture also now increasingly acts as a

Is there gender inequality?

What is gender equality?

It is an integral part of human rights that aims to promote the full participation of women and men in society. It does not mean that women and men should be treated the same. Moreover, equal treatment of women and men will not necessarily lead to de facto equality, as living conditions of women and men differ.

Source: http://www.unece.org/stats/gender/genpol/keyind/families/repshare.htm

There are differences between the genders BUT Should not have negative impact on the living conditions of both women and men Should not discriminate against them Should contribute to an equal sharing of power in economy, society and policy-making processes

Gender Issues and Women Concerns

Millenium Development Goal (MDG), 2000

1.

2.

Eradicate extreme poverty and hunger Achieve universal primary education

3.

Promote gender equality and empower women

Reduce child mortality Improve maternal health Combat HIV/AIDS, malaria, and other diseases Ensure environmental sustainability Develop a global partnership for development

4.
5. 6.

7.
8.

Source: Gender and the MDGs. iREVIEW. February 2004.

Poverty is a cause and effect of gender inequality. Poverty reduction efforts need to focus on women as they are the poorest of the poor. Women are less endowed with productive assets than men. Therefore, women should be given priority in human development investment. Women manage natural resources. They are thus the natural partners in the management of natural resources and environment.

It is recognized that gender equality is important not only as a goal in itself but is also critical to achieving all the other goals. the contributions that women make to economic development and the costs to societies of the multiple disadvantages that women face in nearly every country.

Source: Gender and the MDGs. iREVIEW. February 2004.

In 2002-2003, the United Nations Development Fund for Women (UNIFEM) examined womens progress in: Literacy and education Paid employment and political decision making Addressing the impact of armed conflict on women and their important role in peace building End of violence against women

While progress has indeed taken place in all regions, it is everywhere uneven and slow, subject to setbacks and reversals.

UNIFEM reported in Progress of the Worlds Women 2002 that Gender equality can mean different things to different societies. Progress in one area does not guarantee progress in all areas: women may enjoy certain rights yet still suffer extreme discrimination.

Four Priorities
1. Achieving gender equality - in education, health, labor markets, political life, and social opportunities is fundamental to achieving all MDGs Accdg. to a World Bank paper attempting to meet the MDGs without promoting gender equality will both increase the costs and reduce the likelihood of attaining the goals.

2. Investing in the education, health, safety, and economic well-being of adolescents, especially girls, is a priority. 3. Reducing womens and girls timepoverty through well-designed gendersensitive infrastructure investments and public policies that support womens care responsibilities is critical.

4. Sex-disaggregated data are key to catalyzing and monitoring progress toward the MDGs.

How then gender equality achieved?

Mainstreaming gender issues in all policies

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.

Mainstreaming a gender perspective

It is a strategy for making womens as well as mens 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.

Mainstreaming a gender perspective

The ultimate goal is to achieve gender equality.

Do we need to focus on mens health now?

Current evidence does little to suggest that there are fundamental changes taking place in the power base of society or the gender order that underpins gender health profiles.

Source: G. Scambler. Sociology as Applied to Medicine. Elsevier Science Limited. U.K. 2003

Gender Issues in the Philippines

Gender Assessment, Philippines

1987 the Government spearheaded the formulation of the Philippine Development Plan for Women (19891992) 1995-2025 Philippine Plan for Gender-Responsive Development whose preparation and adoption were coordinated by the government agency for women, the National Commission on the Role of Filipino Women (NCRFW).

More recently, a Framework Plan for Women was drafted by the NCRFW. Objectives of the Framework Plan: economic empowerment of women protection and fulfillment of womens human rights gender-responsive governance

Philippine Scenario

Population (2002): 79.9 million 13th most populous country in the world The large average household size reduces available financial resources and lessens womens opportunities to participate fully in the job market. The overall poverty level in the Philippines is severe.

Human development indicators for health and education is better than in other Southeast Asian countries BUT there is still significant gender imbalances and issues related to the quality of social services. e.g. ARMM =lowest functional literacy rate for women (50%) and men (63%)

Functional literacy = the ability to use literacy skills for specific purposes in the community or at the workplace.

The Philippines continues to have one of the highest maternal mortality rates (MMRs), population growth rates and total births per year (1995-2000) is Southeast Asia. Effects: Health risks Reduces womens opportunities to participate at the labor market.

High population growth decrease in employment opportunities High unemployment rate = 17.1% (19972003) High underemployment rate = 17.1% (2003) Womens labor force participation rate (51.7%) lags behind men (80.8%), 2002

Gender-based differences in employment status within the informal (and formal) sector Women are more-likely to be ownaccount workers and subcontract workers and are less-likely than men to be owner-operators or paid employees of informal enterprises

Effects of the gender-based differences in employment status Average female income in 2001 was almost 50% lower than that of males Women with low skills and in poorly paid jobs create a condition of dependency on male incomes hampers personal autonomy and wellbeing

Low employment opportunities leave the country In 2001, 49% of the one million overseas Filipino workers were women In 1994, the Philippine Overseas Employment Agency (POEA) estimated that 68% of women overseas had been subjected to physical or sexual violence and exploitation.

Violence of women is widespread Effects: Health problems Affects their earning, job performances, and ability to keep a job Low productivity of women vulnerability to income and human poverty

Need to increase participation of women in politics and governance Males continue to dominate decisionmaking processes

Finally

Gender inequality is not a problem that has no solution. Ultimately, political commitment and determination at the highest levels of international agencies and national governments are required to end gender inequality and empower women.

Gender disparities slow down economic development and deepen poverty. For effective poverty reduction, the role of women in development has to be enhanced.

Source: Country Gender Assessment Philippines Lecture. Asian Development Bank, Southeast Asia Department.

Investing in women and increasing their personal autonomy are likely to advance women as active agents who will benefit themselves, their household, and the whole economy.

Objectives

Defined gender. Discussed some demographic trends in relation to gender issues. Discussed the epidemiology of and national statistics of the above condition. Discussed gender issues in the Philippines.

Accept one another, then, just as Christ accepted you, in order to bring praise to God. Romans 15:7