Please desregard previous e-mail on the same subject and
see correction below. My apologies for reposting. I just pressed "send" on the wrong
draft.
--Celeste
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Research Paper
CIHR 2000: Sex, Gender and Women's Health
Research Team: Lorraine Greaves, PhD
Olena Hankivsky, PhD
Carol Amaratunga, PhD
Penny Ballem, MD
Donna Chow, PhD
Maria De Koninck, PhD
Karen Grant, PhD
Abby Lippman, PhD
Heather Maclean, EdD
Janet Maher, PhD
Karen Messing, PhD
Bilkis Vissandjee, PhD
INTRODUCTION
With the opportunity for transforming
and integrating health research in
Canada offered by the Canadian Institutes
for Health Research (CIHR), an analysis
of sex, gender and women's health and
their relationship to health research is both
timely and instructive. The inclusion of
sex and gender as variables in health
research is now recognised as good science,
and the omission of these variables leads
to problems of validity and generalizability,
weaker clinical practice and less
appropriate health care delivery. Further,
such an omission will perpetuate the
knowledge gaps with respect to women's health
in particular. We reviewed a vast
international literature on gender, sex, health,
women's health, development and medicine.
In addition, our team interviewed thirty-two
key informants across four countries who are
specialists in aspects of health research.
Why sex and gender?
Sex refers to the biological differences
between men and women, while gender refers
to the social and cultural differences experienced
by women and men. In the determination of health
status, both sex and gender have profound impacts
on Canadians. Sex can determine differential
propensities for certain health conditions or
diseases, different risk factors, or treatment
requirements. Gender can determine different
exposures to certain risks, different treatment-seeking
patterns, or differential impacts of social and economic
determinants of health. All societies are divided along
the "fault lines" of sex and gender (Papanek, 1984). In
health, biological differences associated with femaleness
and maleness create an immediate classification in
treatment along sex lines. It is just as important to
classify health research in its initial stages by
sex-linked characteristics, in order to produce the
highest quality of knowledge.
However, most critical for determining health in
Canadian women and men is the interaction between the
sex-linked factors and the gender-based factors
that combine to affect health. For example, we are
learning that sex-based factors affect the presentation
of symptoms of myocardial infarctions. Gender-related factors
affect the timing of treatment-seeking in women as well
as the responses of health practitioners to women and men
presenting with cardiac symptoms. Taken together, the
combined effects of sex and gender affect health status,
health systems responses, and eventual health outcomes.
Underlying this profound and important link is a serious
need for more research on sex, gender and the interaction
between the two. Clinical trials, basic laboratory research,
epidemiological studies, surveys and ethnographic investigations
have not always taken sex and gender into account. As a
result, inappropriate generalizations have been made, assuming
that research results apply equally to both males
and females and/or are not affected by sex and gender.
The lack of inclusion or misapplication of sex and gender as
important and basic scientific concepts(across disciplines)
renders research partial at best, and dangerously incomplete
at worst. Indeed, it can result in continued suffering, illness
or even death. The quality of science suffers from lack of
inclusivity, comprehensiveness and limited generalizablity.
Why women's health?
In research environments where sex and gender are poorly
operationalized or ignored altogether, women's health is
particularly at risk. As a result of decades of androcentric
research we are collectively working with an uneven evidence
base pertaining to women's health in particular. Additionally,
we have little research information regarding differences
between groups of women (race, ethnicity, age, ability,
social class, etc). Fortunately, the speciality of women's health
is positioned to be an integrated and transformative area of
research,clinical practice, health promotion and health care
delivery in that it includes data and information from all
disciplines in determining paths to improving women's
health. Critically, women's health research also utilizes
a wide range of mixed methodologies(i.e. a combination of
qualitative and quantitative methodologies) and sources of
data in order to assess the complex interactions between sex,
gender and health. Women's health has long recognised that
it is impossible for any single discipline or type of specialist
to have the requisite expertise to identify women's health risks
and needs.
However, the clear development of a focus for women's health
research within the evolving CIHR is needed to correct the
unevenness of the evidence base, attract more researchers to
the speciality and encourage a comprehensive set of
variables to be included across the entire field of health research.
Most importantly, it will provide better health outcomes for
Canadian women and girls and their families.
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To download a copy of this research paper go to the
BC Centre of Excellence for Women's Health website at:
http://www.bccewh.bc.ca/cihr.htm or email [log in to unmask] to order a
paper copy of the report.
To learn more about women's health and the CIHR,
visit the Canadian Women's Health Network website at:
http://www.cwhn.ca/hot/next.html
Celeste Wincapaw
Communications & Networking Strategist
BC Centre of Excellence for Women's Health
Vancouver, British Columbia
http://www.bccewh.bc.ca
mailto:[log in to unmask]
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