Relevance of gender in the policy area

Gender plays a specific role both in the incidence and the prevalence of specific pathologies, as well as in their treatment and impact in terms of well-being and recovery. This is due to the interrelations between sex-related biological differences and socio-economic and cultural factors that affect the behaviour of women and men and their access to health services.

Regarding the health policy field, it is of utmost importance to bear in mind the distinction between the concepts of ‘sex’ and ‘gender’. Health research and health policy need to adequately explore and address the combination of social and biological sources of differences in women’s and men’s health. An understanding of the interaction between sex and gender in the development and management of health and disease can benefit both sexes in terms of prevention, intervention and outcome. For example, gender medicine has made strong advances in explaining how the incorporation of gender issues into research can affect the medical understanding. This affects the treatment of heart disease, osteoporosis, arthritis and pain, among other conditions.

In the European population, there are more women than men. Women generally live longer than men in all parts of Europe and there are more male deaths than female deaths in the working-age population (15 – 64 years). However, while living longer, women experience more years of disability than men. Across Europe, women are expected to live a smaller proportion of their years in good health than men, as measured in healthy life years (HLYs). This is an indicator of disability-free life expectancy, or the remaining years a person of a specific age is expected to live without any moderate or severe health problems, or acquired disabilities). With an ageing population, the risk of chronic disease such as diabetes and mental health problems – dementia, Alzheimer’s disease, and depression – is increased, notably among women. Moreover, some diseases such as breast cancer, osteoporosis and eating disorders are more common in women, while others, such as endometriosis and cervical cancer, affect women exclusively. Men are more likely to contract, and die from, lung and colorectal cancers, ischaemic heart diseases and traffic accidents. Some diseases, such as prostate cancer, affect men exclusively.

Besides biological factors, social norms also affect the health status of women and men differently. Women are less likely to engage in risky health behaviour and consequently face fewer of the related illnesses and disabilities than men. However, they are more likely than men to present ‘invisible’ illnesses and disabilities which are often not adequately recognised by the healthcare system. Examples include depression, eating disorders, disabilities related to home accidents and sexual violence, as well as diseases and disabilities related to old age.

Sexual abuse and domestic violence particularly affect women and girls in all countries and in all social classes. Domestic violence against women remains one of the most pervasive human rights violations of our time. In the EU, 9 out of 10 victims of intimate partner violence are women. The number of women victims of physical intimate partner violence in the EU Member States ranges between 12% and 35%. The World Health Organisation (WHO) provides global data on violence against women. Recent global prevalence figures indicate that 35% of women worldwide have experienced either intimate partner violence or non-partner sexual violence in their lifetime. Moreover, on average, 30% of women who have been in a relationship report that they have experienced some form of physical or sexual violence by their partner. Globally, 38% of murders of women are committed by an intimate partner.

An EU-28 survey on violence against women was launched in 2010 by the Fundamental Rights Agency (FRA), and carried out between April and September 2012. According to the FRA survey, an estimated 13 million women in the EU had experienced physical violence over the course of the 12 months preceding the survey interviews. This corresponds to 7% of women aged 18 – 74 years in the EU. Around 22% of women are, or have been, involved in a relationship with a partner where they experienced physical and/or sexual intimate partner violence. Equally, around 1 in 5 women (22%) has experienced this type of violence by somebody other than an intimate partner. Overall, 1 in 3 women in the EU has been a victim of physical and sexual violence by a partner, a non-partner, or both.

Overall, it can be noted that women are more aware of their health status and are greater users of healthcare services than men. There are several reasons for this:

  • their reproductive role
  • their role as care-givers for dependants (children and the elderly or disabled)
  • their position in representing a larger proportion of the older population
  • gender stereotypes

There is a strong gender dimension to lifestyle choices and risky behaviours that place men at higher risk of ill health. Men face greater levels of occupational exposure to physical and chemical hazards, behaviours associated with ‘masculine norms’ of risk-taking and adventure. There are health-behaviour paradigms related to masculinity and the fact that men are less likely to visit a doctor when they are ill. When they do see a doctor, men are less likely to report on the symptoms of disease or illness. At the same time, men usually tend to pay less attention than women to health-related issues.

Men generally have poorer knowledge and awareness of health. Across the EU, women and men make different use of health systems and services, and this affects their health status. There is evidence that some men use primary health services less frequently and are more likely to need hospitalisation for the principal causes of disease compared to women. This may be due to the services only being available during the working day, and thus less accessible to many working men. In addition, women and men may receive a different diagnosis and treatment when they seek medical assistance for similar health problems. For example, women are more frequently diagnosed with ‘depression’ and men with ‘stress’, based on the same complaints.

Health is also important while considering the sexual and reproductive behaviours of people. Reproductive health is defined as a state of physical, mental and social well-being in all matters relating to the reproductive system, at all stages of life. Good reproductive health implies that people are able to have a satisfying and safe sex life, the ability to reproduce and the freedom to decide if, when and how often to do so. This implies that women and men should be informed about and have access to safe, effective, affordable and acceptable methods of family planning of their choice. They should also have the right to appropriate healthcare services that ensure women a safe pregnancy and childbirth.

The healthcare workforce is predominantly composed of women. However, women healthcare workers tend to occupy lower-status positions (e.g. nurses and midwives) and, at the same time, to be a minority among more highly trained health professionals (e.g. doctors and dentists). Women are also under-represented in managerial and decision-making positions in the sector. Moreover, due to the high presence of women in the healthcare sector, specific attention should be paid to gender-sensitive training and education in the sector.

The major gender differences and inequalities within the health policy sectors are the following:

  • gender differences in health status and behaviours
  • gender inequalities and barriers in terms of access to health services
  • sexual and reproductive health
  • gender segregation in the healthcare workforce
  • gender-sensitive training and education for health professionals.

Issues of Gender Inequality in the policy area

Gender equality policy objectives at EU and international level

Both at the EU and the international level, the eradication of gender-based inequalities in health is a policy priority. Existing gender-based inequalities in health regard health status as well as the provision of healthcare services.

Policy cycle in health

Click on a phase for details

How and when? Health and the integration of the gender dimension into the policy cycle

The gender dimension can be integrated in all phases of the policy cycle. For a detailed description of how gender can be mainstreamed in each phase of the policy cycle visit EIGE's Gender mainstreaming platform.

Below, you can find useful resources and practical examples for mainstreaming gender into health policy. They are organised according to the most relevant phase of the policy cycle they may serve.

Practical examples of gender mainstreaming in health

Key milestones of the EU health policy

Current policy priorities at EU level

EU health policy complements national policies to ensure that everyone living in the EU has access to quality healthcare. EU actions are directed towards improving public health, preventing physical and mental illness and diseases, and avoiding sources of danger to physical and mental health. Such actions cover the fight against the major health scourges by promoting research into their causes, their transmission and their prevention. They also include health information and education, and monitoring, early warning and combating serious cross-border threats to health. The EU complements the Member States’ action in reducing drugs-related health damage, including information and prevention.

The European health policy thus aims to give all people living in the European Union access to high-quality healthcare, specifically by:

  • preventing illnesses and diseases
  • promoting healthier lifestyles
  • protecting people from health threats such as pandemics.

The EU health policy, implemented through the Health Strategy, focuses on:

  • prevention – especially by promoting healthier lifestyles
  • equal chances of good health and quality healthcare for all (regardless of income, gender, ethnicity, etc.)
  • tackling serious health threats involving more than one EU country
  • keeping people healthy into old age
  • supporting dynamic health systems and new technologies.

In this context, the current priorities of EU policy for health are clearly identified in the third EU health programme, which is the main instrument the European Commission uses to implement the EU health strategy. It is implemented by means of annual work plans which set out priority areas and the criteria for funding actions under the programme.

In particular, the current third health programme (2014 – 2020) has 4 overarching objectives. It seeks to:

  • promote health, prevent diseases and foster supportive environments for healthy lifestyles taking into account the ‘health in all policies’ principle
  • protect Union citizens from serious cross-border health threats
  • contribute to innovative, efficient and sustainable health systems
  • facilitate access to better and safer healthcare for Union citizens.

Through the funding of health projects, the health programme aims to:

  • improve the health of EU citizens and reduce health inequalities
  • encourage innovation in health and increase sustainability of health systems
  • focus on themes that address current health issues across Member States
  • support and encourage cooperation between Member States.

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