9.5.4. Control
tools and policies
Table 9.5.10.
European Parliament Reports which Impact on Gender Issues
International
Influence on Policy
The WHO Global
Campaign for Violence Prevention was launched in 2002. Its goals are to raise
international awareness about the problem of violence (including youth
violence), highlight the role of public health in its prevention, and increase
violence prevention activities globally, regionally and nationally.
Complementary to this, the Violence Prevention Alliance provides a forum for
the exchange of best practice information between governments and other
agencies working to reduce violence.
International
policy on intimate partner violence includes the Declaration on the Elimination
of Violence towards Women, adopted by the United Nations General Assembly in
December 1993.
UNIFEM, the United
Nations Development Fund for Women, provides financial and technical assistance
to programmes that promote women’s empowerment and gender equality, including
those working to eliminate violence against women (WHO, 2007).
Also relevant, for
the association between alcohol use and violence, is the World Health Assembly
resolution on Public health problems caused by harmful use of alcohol
(WHA58.26[53]) of 2005, which recognizes the health and social consequences
associated to harmful alcohol use, and requests Member States to develop,
implement and evaluate effective strategies for reducing such harms, while
calling on the WHO to provide support to Member States in monitoring
alcohol-related harm, implementing and evaluating effective strategies and
programmes, and to reinforce the scientific evidence on the effectiveness of
policies.
Tackling inequalities
The most effective policy for improving the rights of
vulnerable people is to tackle the inequalities that put them at risk. Gender
inequalities in health need to be addressed both as a public health issue and
as a symptom of underlying gender inequality. The implementation
of policies and programmes that increase access of the most vulnerable
to education and information is essential (Brown, 2003). Most effective
however, are policies that equalise status: most commonly that of women
compared to that of men.
The diversity of
women and young girls’ health-influencing experiences and behaviour need to be
reflected in data. Special attention should be given to vulnerable and
marginalised groups of women to ensure that discrimination is recorded, and
measures are taken to counter the effects of inequity. The life quality of
carers, lone parents, migrants, refugees and those who are coping with chronic
disease or long term disabilities are all subjects for further research. The
identification and measurement of health-damaging cultural attitudes and
practices such as domestic violence have not yet been adequately documented
(EIWH, 2006; Doyal, 1998). Abusive behaviours such as sexual violence,
rape and female genital mutilation have a dramatic influence on physical and
psychological health and need to be placed on the political agenda (Klinge and
Bosch, 2005). Much information is available at present at local and regional
levels. Methods must be found in which to effectively collate this information
for use in planning and policy development at EU level.
Some suggestions
to this end are:
·
The development of
appropriate conceptual frameworks for data collection;
·
The expansion and
standardisation of existing indicators for health;
·
Recognition of the
importance of the social construction in gender indicators;
·
To seek simple yet
comprehensive methods of collection that provide comparable information between
Member States, which follow developments over time and offers explanations for
the existing differences;
·
To ensure these methods
are ethically and culturally appropriate for the collection of data from women
in their own environments;
·
The promotion of
effective monitoring and planning through the use of analytical tools which
examine documents for gender balance;
·
The review and amendment
of pre-2006 policy documents to include gender proofing methodology and
classifications;
·
The modification and
standardisation of Member States’ national data collection practices in the
interests of sharing information, future planning and learning from others (EIWH
2006).
While women’s health has gained specific attention
among gender-related initiatives, some activities have also been dedicated to
the issue of men’s health. Among national governments, Austria produced the
first report on men’s health for the city of Vienna in 2001. A few governments have developed men’s health strategies (England and Wales, Ireland) while
others like Denmark, Finland, Norway and Portugal are now clearly showing an
interest at governmental level in this new field. Examples include the EU
presidency conference on men’s health (Lisbon Nov 2007), National Screening
England Chlamydia (2007) and Aortic Aneurism (2008), Gender Equality Duty
(England and Norway). In Denmark, a number of initiatives were run by The
National Health Board (a governmental institution) for improving the health of
young men including physical activity for those who spend a
lot of time in front of the television or gaming device, health information for
army recruits and for young men in after-school centres, as well as for
prevention of suicide among older men. The Finnish government has been focusing
on reducing the mortality in young men by specifically including programmes to
tackle male suicide and accidental death.
Much of European Commission public health strategy
focuses on the prevention of communicable diseases, health determinants
(alcohol, smoking, obesity) and major disease areas such as cardiovascular
disease, cancer, diabetes and mental health. Despite the substantial contribution
tackling late presentation and poor health literacy in men could make to the
improvement of health in these areas, the Community’s public health policy
hasn’t so far taken men’s health issues specifically into consideration aside
from their evaluation of prostate cancer and colorectal screening guidelines
(COM (2003) 0230, Proposal for a Council Recommendation on cancer screening).
Steps to improve men’s health tend to follow similar
patterns of integration into other policy areas seen at EU level. As men tend
to present themselves later or less frequently, workplace health services are
likely to offer strong benefits for men’s health. Both the WHO (European
region) and the EU have planned the development of prevention programmes for
high prevalence diseases among men such as lung cancer (WHA Resolution 60.26
Workers' Health: Global Plan of Action - 2008-2017 ). The European Men’s Health
Forum (EMHF) and its network of not-for-profit associations have developed
guidelines for policy development at national and European levels including
national policy documents in England and Wales, Scotland, Ireland, Denmark or
the Declaration for the health of men and boys in Europe endorsed by Key EU
Commissioners.
Gender proof research
Entrenched biomedical paradigms,
[non-compatible] interdisciplinary terminology and a high degree of theoretical
abstraction have been cited as reasons for the slow response of medical science to evidence
of gender difference. Negative attitudes to gender issues and resistance to the
introduction of gender aware practice are renowned reasons for this
intransigence (Risberg 2006).
In recent years, a variety of tools have
been developed which employ both socio-economic perspectives and methods for
gender-proofing research. These tools can offer a means of identifying major
biases and can point the way to preventive or counterbalancing solutions
(Eichler et al, 2006). Using tools of this type, all regional, national
and European level policy documents could be subjected to gender-proofing and
Gender Equality Impact Assessment before they are issued, thereby facilitating
the provision of disaggregated data.
Top priorities
/ key areas for a European action plan
The implementation
of gender mainstreaming is a core prerequisite for any biomedical research; in
particular, any agenda setting requires a mandatory reflection on how women and
men are potentially affected by the ‘chain of research’, i.e. hypothesis,
diagnostic tools, therapies, prevention rehabilitation programs and health information
messages. Examples of diseases relevant to gender research are cardiovascular
diseases - e.g. acute coronary syndrome - and mental illnesses - e.g.
depression and schizophrenia;
Gender mainstreaming
Doyal (1998) observed that the mainstreaming of gender
would require a shift in organisational culture and ways of thinking, as well
as a change in the goals, structures and resource allocations of our society.
Nearly ten years later, change still needs to occur at several levels: in
agenda setting, policymaking, planning, implementation and evaluation. There is
considerable emphasis in the EU and some Member States towards embedding gender
equity into policy and planning. Much work remains to be done in others. More
gender-sensitive research would support the monitoring and evaluation of gender
awareness, where analysis of the context in which a policy will be operating
would include building a mapping process and action plan into programme
objectives.
The WHO’s Millennium Development Goals (MDG) apply as much
to the health goals for the countries of Europe as to developing countries. A
shared vision, joint principles and a common framework for the development
policies of the European Community and EU Member States recognises the central
role of education as the foundation for all development and economic growth.
Gender Equality Impact Assessment
In 2001, a series of Gender Equality Impact Assessment
(GIA) studies were ordered by the European Commission as part of the Research
Framework Programme (FP5) Gender Watch System, to examine earlier Programmes
for gender awareness. On their release in 2002, the FP6 framework texts
reflected many of the recommendations made by the GIA studies, and consequently
gender mainstreaming became a prime focus in policy development across the EU.
Organisations such as Eurostat and WHO have been working
supra-nationally to bring together common frameworks, and are currently
developing commonly agreed and tested indicators which produce comparable data
(De Smedt, 2004). In 2006 a EU report on gender equity asked special attention
to be paid to statistical methodology and classifications. It called for policy
monitoring to be supported by the collection, compilation and dissemination of
timely, reliable and comparable data disaggregated per sex (European
Commission, 2006).
