Gender and health: an introduction
Gender and health: an introduction
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性别与健康：简介
DOI：
10.4337/9781784710866.00010
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发表时间：
2016
影响因子：
3.3
通讯作者：
Jasmine Gideon
中科院分区：
文献类型：
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作者：
Jasmine Gideon
这本书汇集了来自非洲、美洲、亚洲、欧洲和中东各国的56位性别与健康问题主要作家的文稿。《手册》中的各章就我选定的各种专题提供了丰富的知识、理论思考和经验证据，这些专题是围绕性别和健康问题进行讨论的基本要素。性别不平等作为健康的一个关键决定因素的重要性已得到广泛承认（Marmot等人，2008年），人们普遍认为有必要将性别问题纳入其分析的主流。然而，政策与实践之间仍然存在巨大差距，解决卫生领域的性别平等问题需要的不仅仅是确保妇女更好地获得卫生部门的服务和资源（Gideon，2012年; Hawkes和Buse，2013年; Payne，2014年）。书中的讨论强调，尽管我们现在知道寻求实现性别平等的复杂性，但需要超越实践中仍然经常发现的“增加妇女和搅拌”方法（Chant和Sweetman，2012年; Razavi，2012年）。目前围绕性别和健康的辩论主要涉及健康成果;相比之下，本编辑文集中提出的讨论旨在抓住健康和福祉的多决定因素以及设计和提供保健的组织和体制结构。在经济和社会变革的背景下，该系列考虑了这些因素是如何改变的，变化过程中性别因素的影响程度，以及性别关系对这些变化动态的影响程度。这本手册的一个显著而独特的特点是，许多章节通过来自全球北方和全球南方各种地理环境的实证案例研究探讨了这些挑战，并说明了“性别”仍然是任何健康分析的核心，无论卫生系统或更广泛的经济发展水平如何。此外，这些章节提供了丰富的学科视角，提出了重要的见解和性别与健康研究的多种方法。书中广泛探讨了四个首要主题，所有这些主题都构成了更广泛的性别健康政治经济学中独特但重叠的要素（Gideon，2014）。第一个主题是两性公平和两性平等观念之间的紧张关系，以及这些观念在应用于卫生部门时如何在实践中转化。在实践中，两性平等的方法往往归结为对“妇女”的高度简化，而没有考虑到其他不平等的轴心，包括种族、种姓、阶级、年龄和族裔，同时也没有将“男子”分类，更批判地看待他们与女性同行之间的社会关系。相比之下，如下文更详细讨论的那样，性别平等方法可能会促成一套更具变革性的措施，从而可能在性别正义方面取得进展。联合国促进性别平等和增强妇女权能署（联合国妇女署）（2010年）认为，性别公正需要结束不平等，
This volume brings together the contributions of 56 leading writers on gender and health from a wide range of countries spanning Africa, the Americas, Asia, Europe and the Middle East. The chapters included in the Handbook offer a wealth of knowledge, theoretical reflection and empirical evidence on a diversity of topics that I selected as essential elements of a discussion around gender and health. The importance of gender inequality as a critical determinant of health has been widely acknowledged (Marmot et al., 2008) and there has been a widespread acceptance of the need to mainstream gender into its analysis. Nevertheless, significant gaps remain between policy and practice, and addressing gender issues in health requires more than merely ensuring women gain better access to services and resources within the health sector (Gideon, 2012; Hawkes and Buse, 2013; Payne, 2014). The discussion within the book emphasizes the need to move beyond the ‘add women and stir’ approach that is still frequently found in practice, despite all we now know about the complexities of seeking to achieve gender equality (Chant and Sweetman, 2012; Razavi, 2012). Much of the existing debate around gender and health has been primarily concerned with health outcomes; in contrast the discussion presented in this edited collection seeks to capture the multideterminants of health and wellbeing as well as the organizational and institutional structure of the design and delivery of health care. In the context of economic and social change, the collection considers how these factors are altered and how far processes of change are gendered, as well as how far gender relations impact on these shifting dynamics. A significant and distinctive feature of this Handbook is that many of the chapters explore these challenges through empirical case studies from a variety of geographical settings in both the Global North and the Global South and illustrate that ‘gender’ remains central to any analysis of health, regardless of the level of development within the health system or wider economy. Moreover, the chapters offer a wealth of disciplinary perspectives, presenting critical insights and a diversity of approaches to the study of gender and health. Four overarching themes are broadly explored in the book and all constitute what might be considered as distinct but overlapping elements of a broader gendered political economy of health (Gideon, 2014). The first theme is the tension between ideas of gender equity and gender equality and how these translate in practice when applied to the health sector. In practice gender equity approaches often boil down to a very reductionist focus on ‘women’ and fail to take into account other axes of inequality including race, caste, class, age and ethnicity, while at the same time failing to unpack the category of ‘men’ and looking more critically at the social relations between them and their female counterparts. In contrast, as discussed in more detail below, a gender equality approach can potentially enable a more transformative suite of measures likely to bring about gains in gender justice. The United Nations Entity for Gender Equality and the Empowerment of Women (UN Women) (2010) argues that gender justice entails ending the inequalities