|
Recently men too have begun to draw attention to the negative implications of "maleness"
for their health. There is an increasing danger that these campaigns could be drawn into conflict
with each other as they compete for public sympathy and scarce resources.
If conflict is to be avoided there needs to be a much clearer understanding of the impact of
both sex and gender on health.
The differences between male and female reproductive systems have always been an important
consideration in healthcare delivery. This reflects the crucial role of high quality family planning
and obstetric services in enabling women to realise their potential for health. Despite recent
progress, around half a million women continue to die each year as a direct consequence of
pregnancy and childbirth, and more than 10 times that number are seriously disabled
There has also been a growing recognition that the biological differences between the sexes
extend beyond the reproductive. A wide range of genetic, hormonal, and metabolic influences
play a part in shaping distinctive male and female patterns of morbidity and mortality.
Sex specific diseases such as cancers of the cervix and prostate are the most obvious
examples. However, there is also growing evidence of sex differences in the incidence,
symptoms, and prognosis of many other health problems including HIV/AIDS, tropical infectious
diseases, tuberculosis, autoimmune problems, and coronary heart disease. One of the most
important of these sex differences is the greater biological propensity of men to develop heart
disease early in life.
Until recently very little attention had been paid to the impact of gender on men's health.
This is now changing as the links between masculinity and wellbeing begin to emerge.
At first glance maleness might seem to be straightforwardly health promoting since it offers
privileged access to a range of valuable resources. However, closer examination reveals a more
complex picture. Though the shape of masculinity may vary between communities,
the development and maintenance of a heterosexual male identity usually requires the taking
of risks that are seriously hazardous to health
This brief analysis has highlighted the complex links between biological sex, social gender,
and health. In one sense it is clearly an oversimplification since there are marked similarities
in the healthcare needs of women and men as well as major differences between different groups
of women and different groups of men. However, this does not mean that issues of maleness
and femaleness are not important. If health services are to be equitable and efficient greater
sensitivity will be needed to sex and gender concerns. This will need to be reflected in research,
in patterns of service delivery, and in wider social and economic policies.
Finally, we need to examine the potential of wider social and economic policies for promoting
gender equity in health, and here the issues are especially complex. On the one hand,
the further development of antidiscriminatory policies could clearly be valuable in tackling the
economic and social inequalities that continue to affect women's health. On the other hand,
changes in patterns of social security provision or employment conditions would make it easier
for men to develop the "female" side of themselves. Greater flexibility of working hours,
for example, as well as more generous provision of parental leave could make it easier for men
to bridge the gap between work and home. Carefully designed educational initiatives could also
be used to reshape the gender relations of the next generation.
|
|
