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Sara Smith and Marcia C. Inhorn

As men’s health practices change in light of new medicines, technologies and health awareness campaigns, so do the manifold ways in which men conceive of themselves as men. Men’s increasing engagements with health campaigns that promote awareness of male reproductive cancers and mental health issues signal the emergence of novel forms of manhood. To grasp how men newly embody and enact their gendered identities as masculine subjects, the authors explicate the hegemonic, emergent and composite approaches that are central tropes in masculinity studies. They pursue these masculinity theories through an ethnographic case study of men’s involvement in Movember, a relatively new men’s health movement focused on changing men’s attitudes and behaviors toward prostate and testicular cancer. Based on ethnographic research conducted on men’s participation in Movember via the Internet, the authors demonstrate that men are embracing new strategies for well-being through a diverse repertoire of forms of self-care, including testicular self-exams and clinical prostate cancer screening. Understood as a social domain where multiple discourses about well-being and masculinity intersect, they argue that men’s health movements are increasingly transforming social relations among men, as well as conceptions of manhood in relation to men’s health.

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Denise L. Spitzer

The intensity, density and breadth of contemporary global migration is unprecedented in human history, involving over 220 million people around the world, half of whom are women. In this chapter, the author situates findings from her own research undertaken in Canada, Southeast Asia and Ethiopia within the published literature to illuminate the dynamic and complex interactions of migration and gender _ intersecting with other social markers _ and their impact on health and well-being. In so doing, she strives to articulate the pathways as to how macro- and meso-level phenomena such as neoliberal globalization, constructions of gender and racialized categories, and immigration policies, are implicated in the health and well-being of individuals and communities. This holistic and interactive perspective allows the nuancing of the health outcomes of the engendered movements of individuals, households and communities within and across borders under the conditions of neoliberal globalization that can further contribute to theory, health services, immigration and health policies, and community activism.

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Meri Koivusalo and Sarah Sexton

This chapter analyses commercialization of health care services. The authors first define how and what they understand as commercialization, and what is the focus of the chapter. Their chapter explores the different ways in which gender is reflected in commercialization of health care as well as how commercialization affects women as professionals, patients, employees, carers and citizens, and then focuses on particular aspects of commercialization, such as obstetrics, reproductive services and cosmetic surgery, which have predominantly affected women. Their conclusions draw from the importance of recognizing the multiple roles that women play with respect to health care and commercialization so as to understand implications of commercialization fully and in particular, how implications for gender will be shaped by the socio-economic and cultural context in which commercialization takes place.

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Christina Ewig

Health care reform presents an opportunity to ameliorate long-standing inequities in existing health systems – or inequitable ‘policy legacies’. Conversely, reforms may introduce new inequities. This chapter argues that policy legacies are gendered in crucial ways, and that reform is most likely to take place in moments of perceived ‘crisis’ in which epistemic communities play an influential role. In this context, the keys to gender equitable health reform are the ability to overcome previous, gender-inequitable policy legacies and epistemic communities that hold principles compatible with gender equity, and which are integrated with members who are conscious of how health systems can shape gender equity. The salience of these twin elements is illustrated through a case study of Peru’s health reforms of the 1990s and early 2000s.

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Sarah Payne

With growing evidence not only that climate change is happening but also that it brings with it a number of significant threats to health, it is critical that we explore the gendered dimensions of such change. This chapter outlines the evidence on how climate change impacts on the health of women and men, and the significance of these impacts for policy-makers. Patterns of mortality and morbidity in the most affected parts of the world have already started to reveal the burden of climate change for women and men, particularly among the most impoverished populations. The growing frequency of extreme weather events including flooding and heat waves, together with changing seasonal patterns, temperatures and rainfall, all have consequences for the determinants of health, such as food production, pricing and scarcity; water availability and quality; changing vectors of disease and the risk of accidental injury and death. The implications for many of lost livelihoods, lost land and decreasing agricultural yield add further risks, from displacement and enforced migration for example. These effects are not ‘gender neutral’, but impact differently on women and men across the life course reflecting both gender-linked factors such as access to economic resources, access to health care, employment and caring responsibilities, and biological influences on health, including reproductive health in particular. It is vital that policies which seek to mitigate climate change as well as those which aim to help populations adapt to the consequences of these changes are gender mainstreamed, in order to address the various ways in which health risks and burdens are experienced by both men and by women.

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Luc'a Artazcoz, Imma Cortès-Franch and Vicenta Escribà-Agüir

Working life, in all its forms and domains, is probably one of the most important arenas for action if the objective is to improve the health status of populations in general and to reduce gender inequalities in health. However, the relationship between work and health goes beyond its consideration from a traditional occupational health perspective that only addresses exposure to job hazards, primarily from traditional male jobs, and when addressing specific job hazards for women is often limited to reproductive health. Work, both employment and unpaid domestic and family work, is a social determinant of health that to a great extent shapes the identities and opportunities of people. Moreover, the gender division of work determines work-related gender inequalities in health. Two parallel approaches have dominated the research on work and health. On the one hand, classical occupational health has focused on job safety and hygiene hazards prioritizing the study of male worker populations where their prevalence is typically higher. On the other hand, social epidemiology has considered work as a social determinant of health or as a proxy of socio-economic status. Traditional occupational health has focused on job hazards typical of male occupations and the interest in women’s occupational health has often been limited to reproductive hazards. On the other hand, the examination of work as a determinant of health has used different conceptual frameworks depending on gender. Moreover, it has emphasized sex differences, a biological construct; rather than gender differences, a social, cultural and personal construct, based on the categories of male and female. Three types of problems in the way occupational health research has dealt with sex and gender are: (1) hazards in women’s work have been underestimated; (2) although male workers have been relatively well studied, their experience has not often been examined in relation to their gender; and (3) gender has not always been treated appropriately in studies of mixed populations. In order to examine work as a social determinant of health, we propose a framework of analysis that: (1) starts with the interaction between paid work and the domestic sphere; (2) takes into account the intersection with other axes of inequality, primarily social class, through a unified model that brings gender and socio-economic inequality together in a common framework; (3) separates the carer and the breadwinner roles in the private sphere; and (4) includes a comparative approach between different welfare state regimes.

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Elisa Ansoleaga Moreno, Ximena D'az Berr and Amalia Mauro Cardarelli

Mental health issues among Chilean wage earners have been escalating over the past decade. Workplace violence and psychological harassment, widely acknowledged as major working life stressors, are a growing public health issue, viewed with increasing concern everywhere. In Chile, although the evidence shows a high prevalence of mental health and workplace violence issues among women workers, research into the links between mental health, work and gender have rarely been studied. The chapter discusses how the deep gender inequalities in the labour market – as reflected in women filling lower-quality jobs, lower-ranking positions and being more exposed to psychosocial hazards than male counterparts _ helps to explain increased exposure to workplace violence and the higher prevalence of mental health issues among women. The chapter further discusses how tradition-bound portrayals and depictions of the role of women in society can pervade organizational practices, behaviours and social interactions, shaping conditions of asymmetry and inequality that provide an environment for gender violence in the workplace. This chapter is based on a quantitative, gender-sensitive study of psychosocial hazards and mental health issues among Chilean salaried workers.

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Edited by Jasmine Gideon

This Handbook brings together a groundbreaking collection of chapters that uses a gender lens to explore health, healthcare and health policy in both the Global South and North. Empirical evidence is drawn from a variety of different settings and points to the many ways in which the gendered dimensions of health have become reworked across the globe.
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Rima R. Habib, Kareem Elzein and Nadia Younes

The emergent intersectionality framework may offer a powerful vehicle to improve understandings of the role of gender in occupational health outcomes, especially as gender is connected and intersected by class, race, ethnicity, physiology, task, occupational exposure, and other work and life variables that impact health. This chapter explores the applicability of intersectionality to occupational health research, including its value-added to sex/gender research. The chapter first develops a practical definition of the intersectionality framework for the reader. Discussing several ethical dilemmas facing the occupational health discipline, it then makes the case that the central tenets of intersectionality are valuable to the field if it is to maintain a connection to social justice issues. Next, the chapter documents a brief history of the framework in the health sciences field, before discussing several methodological considerations that occupational health researchers should account for when applying an intersectional perspective to their work. The discussion focuses on whether and how an intersectionality framework benefits the study of gender in occupational health research.