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Advances in Gender Inequality and Women's Health

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 December 2024) | Viewed by 17057

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Special Issue Editor

Dr. Syeda Zakia Hossain

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Guest Editor

Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
Interests: women’s health; health inequality; health service utilization; breast and cervical cancer; quality of life; ageing population resource-limited countries; empowerment; gender violence

Special Issue Information

Dear Colleagues,

Gender equality is not only a fundamental human right, but also important for achieving full human potential, social and economic progression and sustainable development. Gender inequality has become a global phenomenon that has been impacting every sphere of life, particularly the gender health gap. A better understanding of gender inequality through women’s health and well-being is necessary to close the gap as women make up half of the global population. For this Special Issue, we seek thoughtful and well-written manuscripts that address women’s health and inequalities from social, ecological, economic and environmental perspectives and emphasise their local and global implications. Research areas/topics are women’s health, reproductive and sexual health, gender violence, health screening, health promotion and prevention. We will consider methodologies including systematic reviews, meta-analyses, retrospective and prospective assessments of quality of life, as well as articles on both quantitative and qualitative models from diverse fields including epidemiology, public health, medicine, sociology, anthropology, nursing, environmental studies, statistics and psychology.

Dr. Syeda Zakia Hossain
Guest Editor

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Keywords

gender inequality
women’s health
sexual and reproductive health
chronic disease
disability
screening
consent process
empowerment
gender violence
quantitative and qualitative studies
mixed methods

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Published Papers (9 papers)

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Research

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15 pages, 514 KiB

Open AccessEditor’s ChoiceArticle

Social Inequities in Cardiovascular Disease Risk Factors at Multiple Levels Persist Among Mothers in Texas

by Catherine Cubbin, Quynh Nhu (Natasha) B. La Frinere-Sandoval and Elizabeth M. Widen

Int. J. Environ. Res. Public Health 2025, 22(3), 404; https://doi.org/10.3390/ijerph22030404 - 10 Mar 2025

Viewed by 536

Abstract

The life stage between the ages of 30–45 years for women is critical, given the competing demands of occupational advancement, intimate partner relationships, and childcare responsibilities. Cardiovascular disease (CVD) is the leading cause of death among women in the US, which is experienced inequitably by race/ethnicity/nativity and socioeconomic status and is embedded within geographic contexts. The objective of the current study was to examine social inequities in pre-pregnancy risk factors for cardiovascular disease. We analyzed 16 years of geocoded natality data in Texas (N = 2,089,588 births between 2005 and 2020 to mothers aged 30–45 years) linked with census tract- and county-level data. Dependent variables included pre-pregnancy diabetes, hypertension, obesity, and smoking. Independent variables included individual-level race/ethnicity/nativity and educational attainment, tract-level poverty and racial/ethnic concentrations, and county-level urban/rural status, with controls for other sociodemographic characteristics and time trend. Two-level, random intercept hierarchical generalized logistic models were used to estimate associations and model fit. Significant social inequities at the individual-, tract-, and county-levels in each risk factor were found. For example, tract-level variables had substantial and significant association with the four CVD risk factors, ranging from 13% to 72% higher odds in adjusted models. For all four risk factors, the more rural the county of residence was, the higher the odds of having the risk factor (24% to 256% higher odds). Individual-level social inequalities by race/ethnicity/nativity (ORs ranging from 0.04 to 2.12) and education (ORs ranging from 1.25 to 5.20) were also observed. Enhancing our understanding of this important period of life may enable policy and interventions to better support women through this critical life stage. Full article

(This article belongs to the Special Issue Advances in Gender Inequality and Women's Health)

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14 pages, 982 KiB

Open AccessArticle

A Pilot Study of Menstrual Health Education, Attitudes, and Product Access in Rural Honduras

by Eleanor Stubley and Janice M. Marshall

Int. J. Environ. Res. Public Health 2025, 22(3), 374; https://doi.org/10.3390/ijerph22030374 - 4 Mar 2025

Viewed by 659

Abstract

Research data on menstrual health in Honduras are limited, particularly in rural and ethnic minority areas. This pilot study aimed to assess women’s perceptions of menstrual healthcare in rural Honduran communities, focusing on menstrual health education, access to menstrual products and healthcare, and community attitudes towards menstruation. This study was conducted at a 3-day medical clinic set up by Global Brigades in the rural Potrerillos community. Seventy-three female participants (aged 18–55 years) completed a paper-based survey on menstrual health using a Likert scale. Results are reported as descriptive statistics, including median with interquartile range, and 95% confidence intervals. Main findings were that 73.9% of the participants received menstrual health education predominantly at home, with 25% receiving insufficient education before menarche. Additionally, 52.8% of participants reported a lack of and an inadequate range of menstrual products, while 52.9% experienced menstruation anxiety. These findings suggest that community educational initiatives and increased access to menstrual products could significantly improve the menstrual health of rural Honduran women and help reduce negative menstruation experiences. Full article

(This article belongs to the Special Issue Advances in Gender Inequality and Women's Health)

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10 pages, 226 KiB

Open AccessArticle

Women Living with HIV in Zimbabwe: Their Stigma-Related Emotional Life and Sense of Self

by Limkile Mpofu, Elias Mpofu and Azwihangwisi H. Mavhandu-Mudzusi

Int. J. Environ. Res. Public Health 2025, 22(3), 364; https://doi.org/10.3390/ijerph22030364 - 1 Mar 2025

Viewed by 600

Abstract

This study explored women living with HIV (WLHIV)’s stigma-related emotional life and sense of self in a rural Zimbabwean setting. The objective of this study was to understand the sense of stigma in the emotional lives and self-perception of women living with HIV in rural Zimbabwe. The participants were a purposive sample of 20 rural women living with HIV. Their age ranged from 20 to 65 years old. WLHIV completed semi-structured individual interviews on their emotions and sense of life. The interpretive phenomenological analysis (IPA) revealed that these rural women living with HIV endure humiliation and isolation, leading them to feeling hopeless. Their society (significant others) perceived them as burdensome social others from which little could be expected. These women experience this sense of “otherness” that represents them as social outcasts, which results in a deep sense of social isolation and loneliness, worthlessness, withdrawal, and hopelessness. The women self-perceived themselves to be constantly managing their sense of dehumanization and being stereotyped as primarily with an identity defined by disease or illness by society. The findings suggest a need for the development and implementation of support programs for building healthy self-identities for women living with HIV. Such programs would focus on strategies that counteract societal and self-stigmatization living with HIV and AIDS for full community inclusion. Full article

(This article belongs to the Special Issue Advances in Gender Inequality and Women's Health)

15 pages, 1165 KiB

Open AccessArticle

Gender Differences in Whether and How Perceived Inequality Hampers Self-Rated Health and Mental Health: Evidence from the Chinese General Social Survey and a Randomized Experiment in China

by Jacqueline Chen Chen, Chenling Yu and Jianhua Zhu

Int. J. Environ. Res. Public Health 2024, 21(12), 1640; https://doi.org/10.3390/ijerph21121640 - 10 Dec 2024

Viewed by 892

Abstract

A substantial body of research has explored the relationship between inequality and health, yet little is known about the gender-specific effects and pathways through which inequality affects health outcomes. This study focuses on China, a country characterized by high income inequality and uneven health distribution across social groups. In Study 1, repeated nationally representative cross-sectional data from the Chinese General Social Survey is utilized (N = 3798 for 2017, N = 1578 for 2015, and N = 2827 for 2008), revealing that perceived inequality negatively affects self-rated health, particularly among women. The high level of perceived economic inequality substantially contributes to the gender health gap in China. Study 2 employs a randomized experiment (N = 3568) to show that perceived inequality affects the health of women and men differently, that is, social mobility framing accounts for the negative effect on women’s mental well-being, whereas reducing status anxiety mainly benefits men’s mental health. To advance research on economic inequality and health, this study investigates gender differences in whether and how perceived inequality affects health. Full article

(This article belongs to the Special Issue Advances in Gender Inequality and Women's Health)

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21 pages, 1327 KiB

Open AccessArticle

Lessons Learned from the Experiences of Domestic Violence Service Providers in Times of Crisis: Insights from a Central Asian Country

by Akmaral Karabay, Saltanat Akhmetova and Naureen Durrani

Int. J. Environ. Res. Public Health 2024, 21(10), 1326; https://doi.org/10.3390/ijerph21101326 - 7 Oct 2024

Viewed by 2573

Abstract

Domestic violence is a widespread problem in both stable and crisis contexts. During crisis-driven periods, such as environmental, economic, political, and health emergencies, existing gender inequalities are exacerbated, and the risks of violence against women (VAW) are amplified. This qualitative study explores the experiences of professionals working in VAW organisations in a Central Asian country during the COVID-19 pandemic. By interviewing 45 professionals from social care organisations in Kazakhstan, this study aims to understand the impact of COVID-19 on the ability of VAW organisations to assist victims of domestic violence and comprehend the adjustments they made to support victims. The findings shed light on the challenges faced by VAW organisations, including reduced capacity, increased service demand, the shift to remote services, and funding cuts. The study highlights the critical role of these organisations in crises and urges the consideration of lessons learned to prevent VAW in emergency and non-emergency situations. In the Central Asian region, where domestic violence is persistent, this research offers valuable insights for interventions during and after crises. The study offers effective strategies for achieving Sustainable Development Goal 5.2, which aims to eliminate violence against women, and SDG 3.8, ensuring access to healthcare, psychological support, and safe environments. Full article

(This article belongs to the Special Issue Advances in Gender Inequality and Women's Health)

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19 pages, 352 KiB

Open AccessArticle

Basic Affective Systems and Sex Differences in the Relationship between Anger and Fear

by Paola Manfredi

Int. J. Environ. Res. Public Health 2024, 21(10), 1266; https://doi.org/10.3390/ijerph21101266 - 24 Sep 2024

Viewed by 994

Abstract

Background: The possible interactions between anger and fear have not been widely explored in the psychological literature. Fear and anger are currently beginning to be studied by looking at their interrelationships, rather than seeing them as simply opposing emotions. Furthermore, there is a tendency to think that anger is more typical of men and fear of women. Our contribution proposes a particular perspective of affective neuroscience. The objectives of the study are as follows: (1) to assess possible differences in affective systems, and states and traits of anger in relation to biological sex; (2) to assess correlations between ANGER, FEAR, and SADNESS, as well as state and trait anger in both a female and male sample; (3) to assess possible differences in basic affective systems in relation to different levels of ANGER, FEAR, and SADNESS, state and trait anger, in female and male samples. Methods: A non-clinical sample of 339 females and 99 males completed the ANPS 3.1 to assess basic affective states and the STAXI-2 to assess anger states and traits. Results: No significant differences were found for ANGER and FEAR scores and for state and trait scores between the male and female samples. Clear correlations emerged (p < 0.01) between SADNESS and FEAR in both the female and male samples. Among the differences that emerged in the affective systems, we emphasise that in the female group, the highest scores on the SEEKING and PLAY scales are expressed by the group of women who have the lowest scores in FEAR; PLAY and CARE also vary in relation to different scores in SADNESS. Discussion: Given the importance of the SEEKING and PLAY variables, it is of paramount importance to monitor the environmental and relational situations to guarantee that women, too, are provided with the conditions of safety and protection that are prerequisites for their well-being and the positive expression of their resources. Full article

(This article belongs to the Special Issue Advances in Gender Inequality and Women's Health)

15 pages, 387 KiB

Open AccessArticle

A Sex- and Gender-Based Approach to Chronic Conditions in Central Catalonia (Spain): A Descriptive Cross-Sectional Study

by Georgina Pujolar-Díaz, Queralt Miró Catalina, Aïna Fuster-Casanovas, Laia Sola Reguant and Josep Vidal-Alaball

Int. J. Environ. Res. Public Health 2024, 21(2), 152; https://doi.org/10.3390/ijerph21020152 - 29 Jan 2024

Viewed by 2678

Abstract

The growth of chronic conditions worldwide poses a challenge for both health systems and the quality of life of people with these conditions. However, sex- and gender-based approaches are scarce in this field. Adopting this perspective, this study aims to describe the prevalence of chronic conditions in the Bages–Moianès region (Catalonia, Spain), and analyse the associations of chronic conditions with sex and age. This cross-sectional study used data from the population assigned to the Catalan Health Institute primary care settings in this area between 2018 and 2021 (n = 163,024). A total of 26 chronic conditions (grouped into 7 typologies), sex and age were the analysis variables. A total of 75,936 individuals presented at least one chronic condition, representing 46.6% of the analysed population. The prevalence was higher among women and older individuals. Being male was associated with a greater probability of presenting cardiovascular diseases, neurodevelopmental disorders and metabolic diseases and a lower probability of presenting neurodegenerative diseases, chronic pain and mental health disorders. Adjusting by sex, a positive age gradient was observed in most groups, except for respiratory diseases and mental health disorders. Chronic conditions have a high prevalence in the Bages–Moianès region, showing differences in typology, sex and age. Adopting gender perspectives (both in health systems and future research) is crucial when dealing with chronic conditions in order to take into account their differential impact. Full article

(This article belongs to the Special Issue Advances in Gender Inequality and Women's Health)

Review

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19 pages, 1349 KiB

Open AccessReview

Abortion Experiences and Perspectives Amongst Migrants and Refugees: A Systematic Review

by Sharanya Napier-Raman, Syeda Zakia Hossain, Elias Mpofu, Mi-Joung Lee, Pranee Liamputtong and Tinashe Dune

Int. J. Environ. Res. Public Health 2024, 21(3), 312; https://doi.org/10.3390/ijerph21030312 - 8 Mar 2024

Cited by 2 | Viewed by 3872

Abstract

(1) Background: Access to abortion care is a crucial reproductive health right. Refugees and migrants may have restricted access to and utilisation of abortion care, associated with histories of displacement, precarious migrant and citizenship status and difficulty navigating unfamiliar host country healthcare systems. However, there is limited evidence on the abortion experiences and perspectives of refugees and migrants. Moreover, existing research has not been synthesised to identify trends informing sexual and reproductive care access among this marginalised population. This systematic review aimed to address this gap in the cumulative evidence on refugee and migrant experiences and perspectives of abortion in host countries. (2) Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the following databases for studies on refugee and migrant abortion attitudes, decision making and experiences: Embase, Medline, CINAHL, Web of Science, Sociological Abstracts, and Scopus. We also searched the grey literature on the same. Inclusion criteria specified qualitative studies involving migrant and/or refugee populations, examining their abortion experiences, attitudes or perspectives, written in English, published between January 2000 and December 2022. Two reviewers screened titles, abstracts and full-text articles, resulting in 27 articles included in the review, following consensus checks by two co-authors. The included studies were assessed for methodological quality using the Critical Appraisal Skills Programme tool. (3) Results: Abortion was stigmatised and generally considered impermissible and undesirable. However, participants discussed socioculturally determined ‘exceptions’ to this, positing circumstances where abortion was acceptable. There were striking differences in experiences between participants in higher-income settings and those in lower- and middle-income settings. Difficulties accessing care were ubiquitous but were heightened in lower-resource settings and among participants with precarious citizenship, financial and legal statuses. (4) Conclusions: The findings highlight the need for an international convention to guide policy and programming that acknowledges the specific abortion requirements of migrant and refugee communities, with attention to their financial, legal and social precarity. Full article

(This article belongs to the Special Issue Advances in Gender Inequality and Women's Health)

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16 pages, 886 KiB

Open AccessReview

The Importance of Gender-Sensitive Health Care in the Context of Pain, Emergency and Vaccination: A Narrative Review

by Joachim Graf, Elisabeth Simoes, Angela Kranz, Konstanze Weinert and Harald Abele

Int. J. Environ. Res. Public Health 2024, 21(1), 13; https://doi.org/10.3390/ijerph21010013 - 21 Dec 2023

Cited by 5 | Viewed by 2821

Abstract

So far, health care has been insufficiently organized in a gender-sensitive way, which makes the promotion of care that meets the needs of women and men equally emerge as a relevant public health problem. The aim of this narrative review was to outline the need for more gender-sensitive medical care in the context of pain, emergency care and vaccinations. In this narrative review, a selective search was performed in Pubmed, and the databases of the World Health Organization (WHO), the European Institute for Gender Equality and the German Federal Ministry of Health were searched. Study data indicate that there are differences between men and women with regard to the ability to bear pain. On the other hand, socially constructed role expectations in pain and the communication of these are also relevant. Studies indicate that women receive adequate pain medication less often than men with a comparable pain score. Furthermore, study results indicate that the female gender is associated with an increased risk of inadequate emergency care. In terms of vaccine provision, women are less likely than men to utilize or gain access to vaccination services, and there are gender-sensitive differences in vaccine efficacy and safety. Sensitization in teaching, research and care is needed to mitigate gender-specific health inequalities. Full article

(This article belongs to the Special Issue Advances in Gender Inequality and Women's Health)

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