Gender, health, and communication

Communication, health and gender are interconnected with each other, and gender has a profound impact on healthcare policies. Women's opinions on health and illness are deeply affected by their role as primary caretakers, with a strong involvement in disease management, control and prevention. However, gender does also affect women's access to health information and the ways in which they respond to disease. Therefore considering ‘gender’ as a key factor in health communication programming could make communication more effective, and also help eliminate the gender divide that has been broadened by the Internet and other technologies in many regions of the world.¹

When addressing the issue of women's health, it is important to highlight that early health care interventions throughout the life course affect lifelong health quality across generations; that gender inequality increases risk exposure and vulnerability and limits access to health care and information; and that women are healthcare consumers as well as providers, because of their productive and reproductive roles in the society.²

The gender health paradox is well documented: women live longer than men, yet they have higher morbidity rates. In fact, men experience more life-threatening chronic diseases and die younger, whereas women live longer but have more nonfatal acute and chronic conditions and disability. Today, too many girls and women are still unable to reach their full potential because of persistent health, social and gender inequalities and health system inadequacies.

While there are many commonalities in the health challenges facing women around the world, there are also striking differences due to the varied conditions in which they live. The most striking difference between rich and poor countries is in maternal mortality — 99% of more than a half a million maternal deaths happen every year in developing countries. Globally, the leading cause of death among women of reproductive age is HIV/ AIDS. Girls and women are particularly vulnerable to HIV infection due to a combination of biological factors and gender-based inequalities, particularly in cultures that limit women's knowledge about HIV and their ability to protect themselves and negotiate safer sex. The most important risk factors for death and disability in this age group in low- and middle-income countries are lack of contraception and unsafe sex. These risk factors result in unwanted pregnancies,^3,4 unsafe abortions, pregnancy and childbirth complications, and sexually transmitted infections including HIV. For women over 60 years of age in low-, middle- and high-income countries, cardiovascular disease and stroke are major killers and causes of chronic health problems.^5,6

Moreover, women face particular problems in disasters and emergencies. Available data suggest that there is a pattern of gender differentiation at all stages of a disaster: exposure to risk, risk perception, preparedness, response, physical impact, psychological impact, recovery and reconstruction.

Therefore, protecting and promoting women's health is crucial not only for the present generations but also most importantly for those of the future. Research, interventions, health system reforms, health education, health outreach, health policies and programs must consider gender from the beginning. The process of creating this knowledge and awareness of — and responsibility for — gender among all health professionals is called ‘gender mainstreaming’.

Integrating gender perspectives especially into public health communication means that the different needs of women and men are considered at all stages of policy and program development. Gender mainstreaming in public health communication means addressing the role of social, cultural and biological factors that influence health outcomes, and in doing so improving program efficiency, coverage and equity. An example of the application of this approach can be seen in an HIV intervention in South Africa that addressed poverty, violence and the lack of power to negotiate safe sex as factors contributing to high HIV rates among women.⁷

A gender-based approach to public health communication begins from the recognition of the differences between women and men. It helps us identify the ways in which the health risks, experiences, and outcomes are different for women and men, boys and girls, and to act accordingly as part of intervention design and implementation. A gender-based approach has broadened our understanding of women's health problems and has helped identify ways to addressing them for women of all ages. For example, the identification of gender differences in cardiovascular disease has made it possible to develop more effective health promotion and prevention strategies that have improved women's health in many countries.⁸

Furthermore, to encourage gender sensitivity through health communication programmes, it is necessary to analyse communities from a gender perspective, that should consider ways in which gender influences health needs and concerns, as well as how women perceive and act upon health messages, and access to and control over health communication. It essential to ensure ‘communication capacity building’ to promote women's access to media and ‘monitor’ their media habits. For example, a gender-sensitive approach to policy and program development about women and tobacco should include an exploration of the effects of tobacco on women, a gendered approach to advertising, marketing, and other kinds of communication interventions, and factors associated with smoking and cessation commonly experienced by women.⁹

The main purposes here are to increase health professionals' awareness of the role of gender norms, values, and inequality in perpetuating disease, disability, and death, and to promote societal change to eliminate gender as a barrier to good health. Until then, unequal access to information, healthcare services, and basic health behaviors will further increase women's health risks.

Disclaimer statement

No conflict of interest. This article was not supported by any funds.

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Notes on contributors

Michaela Liuccio

Michaela Liuccio, PhD, is Vice President for the Master's degree in Scientific Biomedical Communication at Sapienza University of Rome, Italy, where she teaches ‘Health and Society’. She is also the Director of the publishing series ‘Communication and health’, Aracne Editrice, and the Project leader of ‘Comunicare la salute ai giovani’/Portal ‘Chiediloqui’ [Communicating about Health with Youth/Chiedoloqui Portal] in cooperation with the Italian ‘Istituto Superiore di Sanita’: http://www.coris.uniroma1.it/testo.asp?id=4535. She has been awarded fellowships by the Centre d'Etude sur l'Actuel et le Quotidien, Université René Descartes, La Sorbonne, Paris, and the Institute of Communication and Health, University of Lugano, Switzerland. Her recent publications include: Parlare di salute con i giovani. Il portale Chiediloqui, Roma: Aracne, 2014; Giovani, salute e società, Milano: Egea, 2012; and La società pandemica, Roma: Carocci, 2012.

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Inside commentaries are authored by members of the editorial board of the Journal of Communication in Healthcare: Strategies, Media, and Engagement in Global Health on topics within the Journal's scope and objectives, and only represent the opinion of the authors. This is an occasional section of the Journal, which only includes invited perspectives and short commentaries.