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Eliminating cervical cancer is about more than just spending money. It requires reckoning with the many intangibles that get in the way of this cause. Widespread adherence to patriarchal value systems, for instance, not only threatens women’s health and well-being, but discourages them from freely pursuing the means to a cure. Persons with cervixes must confrontnot only archaic notions about their worth, but also many other hidden barriers to prevention. These include the fear and superstition that arise from lack of knowledge and medical misinformation, a lack of appreciation for self-care, the burden of unpaid work, and the vulnerability resulting from racial and gender inequality. Challenging these societal factors will increase the volume of women’s voices and ultimately save thousands of lives. But until society is ready to acknowledge and address these barriers – the patriarchal structures thwarting women’s autonomy and decision-making power, the stigma associated with this disease, the religious intolerances and traditional values contrary to its prevention – a cancer that strikes only those with a cervix will continue to kill.
I am pleased to introduce this Symposium Edition of The Journal of Law, Medicine & Ethics, which covers a wide variety of issues central to transgender health equity, including Dr. Jamison Green’s recent history of the impact of health policy on transgender communities, Dr. M. Killian Kinney, Ms. Taylor Pearson, and Prof. Julie Ralston Aoki’s transgender equity tool for legal policy analysis, and Prof. Elizabeth Kukura’s analysis of issues facing transgender, non-binary, and gender expansive people during pregnancy and childbirth.
Transgender and gender diverse (TGD), Black, and Latinx communities have long borne a disproportionate share of the U.S. HIV epidemic, yet these same key demographics are continually underrepresented in national PrEP prescriptions. Black, Latinx, and TGD individuals are also more likely to be uninsured, meaning that a proposed federal program to cover PrEP for people without insurance could provide significant benefit to potential PrEP users from these populations. However, coverage of PrEP costs alone will not end disparities in uptake. This commentary provides additional context and recommendations to maximize effectiveness of a national PrEP program for TGD, Black, and Latinx populations in the US.
Research in cardiac care has identified significant gender-based differences across many outcomes. Women with heart disease are less likely both to be diagnosed and to receive standard care. Gender-based disparities in the prehospital setting are under-researched, but they were found to exist within rates of 12-lead electrocardiogram (ECG) acquisition within one urban Emergency Medical Services (EMS) agency.
Study Objective:
This study evaluates the quality improvement (QI) initiative that was implemented in that agency to raise overall rates of 12-lead ECG acquisition and reduce the gap in acquisition rates between men and women.
Methods:
This QI project included two interventions: revised indications for 12-lead acquisition, and training that highlighted sex- and gender-based differences relevant to patient care. To evaluate this project, a retrospective database review identified all patient contacts that potentially involved cardiac assessment over 18 months. The primary outcome was the rate of 12-lead acquisition among patients with qualifying complaints. This was assessed by mean rates of acquisition in before and after periods, as well as segmented regression in an interrupted time series. Secondary outcomes included differences in rates of 12-lead acquisition, both overall and in individual complaint categories, each compared between men/women and before/after the interventions.
Results:
Among patients with qualifying complaints, the mean rate of 12-lead acquisition in the lead-in period was 22.5% (95% CI, 21.8% - 23.2%) with no discernible trend. The protocol change and training were each associated with a significant absolute level increase in the acquisition rate: 2.09% (95% CI, 0.21% - 4.0%; P = .03) and 3.2% (95% CI, 1.18% - 5.22%; P = .003), respectively. When compared by gender and time period, women received fewer 12-leads than men overall, and more 12-leads were acquired after the interventions than before. There were also significant interactions between gender and period, both overall (2.8%; 95% CI, 1.9% - 3.6%; P < .0001) and in all complaint categories except falls and heart problems.
Conclusion:
This QI project resulted in an increase in 12-leads acquired. Pre-existing gaps in rates of acquisition between men and women were reduced but did not disappear. On-going research is examining the reasons behind these differences from the perspective of prehospital providers.
Based on extensive fieldwork, this book demonstrates how gender is an organizing principle of entrepreneurial ecosystems and makes a difference in how ecosystem resources are assembled and how they can be accessed. By bringing visibility to how ecosystem actors are heterogeneous across identities, interactions and experiences, the book highlights the role and complexity of individual, organizational, and institutional factors working in concert to create and maintain gendered inequities. Entrepreneurial Ecosystems provides research-driven insights around effective organizational practices and policies aimed at remedying gendered and intersectional inequalities associated with entrepreneurship activities and economic growth. Proposing a typology of four ecosystem identities, it highlights how some might be more amenable and organized towards gender inclusion and change, while others may be much more difficult to change, reorganize and restructure. It offers scholars, students, practitioners and policymakers insights about gender in relation to analyzing entrepreneurial ecosystems and for fostering inclusive economic development policies.
Suicide is a public health problem which has biopsychosocial aspects. These three compartments function differently for women and men in terms of biology and gender inequality.
Objectives
This study aims to investigate completed suicide rates in Turkey for women and men seperately considering age ranges for each, and their relationship with gender equality.
Methods
Sex and age specific data between 2015-2019 was derived from Turkish Statistical Institute. Utilizing Bağdatlı Kalkan’s study (2018) and Turkey’s Gender Equality Ratings (2019), 81 cities were seperated into two clusters (Table 1). Mann Whitney U and Independent Samples T Test were applied.
Results
Young women’s (<30 years old) crude completed suicide rates were higher, when crude completed suicide rates for men over the age of 30 were fewer in the cities which equality index is low (Table 2). Regardless of age ranges, in better gender equality cluster, female suicide rates were fewer, male suicide rates were higher. The number of deaths by suicide in 1000 deaths didn’t differ for men, while the rate decreases for women in better gender equality cluster (Table 3).
Conclusions
Gender inequality may negatively effect young women’s mental health in more patriarchal cities in Turkey from the point of completed suicide.
Gender disparities between Emergency Medicine physicians with regards to salary, promotion, and scholarly recognition as national conference speakers have been well-documented. However, little is known if similar gender disparities impact their out-of-hospital Emergency Medical Services (EMS) colleagues. Although there have been improvements in the ratio of women entering the EMS workforce, gender representation has improved at a slower rate for paramedics compared to emergency medical technicians (EMTs). Since recruitment, retention, and advancement of females within a specialty have been associated with the visibility of prominent, respected female leaders, gender disparity of these leaders as national conference speakers may contribute to the “leaky pipeline effect” seen within the EMS profession. Gender representation of these speakers has yet to be described objectively.
Study Objective:
The primary objective of this study was to determine if disparity exists in gender representation of speakers at well-known national EMS conferences and trade shows in the United States (US) from 2016-2020. The secondary objective was to determine if males were more likely than females to return to a conference as a speaker in subsequent years.
Methods:
A cross-sectional analysis of programs from well-known national conferences, specifically for EMS providers, which were held in the US from 2016-2020 was performed. Programs were abstracted for type of conference session (pre-conference, keynote, main conference) and speakers’ names. Speaker gender (male, female) was confirmed via internet search.
Results:
Seventeen conference programs were obtained with 1,709 conference sessions that had a total of 2,731 listed speaker names, of whom 537 (20%) were female. A total of 30 keynote addresses had 39 listed speaker names of whom six (15%) were female. No significant difference was observed in the number of years males returned to present at the same conference as compared to females.
Conclusion:
Gender representation of speakers at national EMS conferences in the US is not reflective of the current best estimate of the US EMS workforce. This disparity exists not only in the overall percent of female names listed as speakers, but also in the percent of individual female speakers, and is most pronounced within keynote speakers. Online lecture platforms, as an unintentional consequent of the COVID-19 pandemic, coupled with intentional speaker development and mentorship initiatives, may reduce barriers to facilitating a new pipeline for more females to become speakers at national EMS conferences.
This paper explores gender mainstreaming in the context of health policy and health variations between women and men. Despite the adoption of gender mainstreaming at international, regional and national scales since the Beijing Platform for Action in 1995, gender inequalities in health persist. The paper argues that the translation of gender mainstreaming as a global policy paradigm across and between policy scales has significance for health policies aiming to address gender. The paper suggests that while gender mainstreaming originated to address women's needs, the paradigm is founded on goals that do not translate in health policy; that the representation of the problem of gender in this global paradigm is problematic in a health context; and that the role of global networks in policy translation as part of this paradigm has led to the replacement of transformative ideals with technocratic solutions which shift the focus away from gender relations of power.
We explore the difficulty of achieving equity for women in two forest and livelihood restoration (FLR) pilot projects, one each in Papua New Guinea (PNG) and the Philippines. We use institutional bricolage as a framework to explain the context and background of stakeholders’ decision-making and the consequent impact on equity and benefit distribution. In the Philippines, material and institutional support was initially successful in assisting participants to establish small-scale tree plantations. A structured approach to institutional development has successfully evolved to meet the needs of women, even though corruption has re-emerged as a destabilizing influence. In PNG, despite success in establishing trees and crops, the participation of women was subjugated to traditional customs and norms that precluded them from engaging in land management decisions. The capacity-building and gender-equity principles of FLR consequently became compromised. We conclude that in some patriarchal societies achieving equity for women will be difficult and progress will be contingent on a detailed understanding of the effects of traditional customs and norms on participation and decision-making.
There has been an explosion of within-profession studies examining standings on gender representation in advancement, publication patterns, and conference presentations. However, industrial and organizational (I-O) psychology has yet to take such an introspective look and fully join these conversations. This manuscript aims to initiate and encourage such discussion. Through a brief review of relevant background information and the collection and analysis of recent archival data, we seek to examine where we have been with regard to gender representation, where we currently stand, and what steps are needed moving forward. We aim to stimulate continued examinations on this topic while recommending appropriate action items relevant to achieving equity in representation in our field.
Increasing the representation of women in science, technology, engineering, and mathematics (STEM) is one of our nation's most pressing imperatives. As such, there has been increased lay and scholarly attention given to understanding the causes of women's underrepresentation in such fields. These explanations tend to fall into two main groupings: individual-level (i.e., her) explanations and social-structural (i.e., our) explanations. These two perspectives offer different lenses for illuminating the causes of gender inequity in STEM and point to different mechanisms by which to gain gender parity in STEM fields. In this article, we describe these two lenses and provide three examples of how each lens may differentially explain gender inequity in STEM. We argue that the social-structural lens provides a clearer picture of the causes of gender inequity in STEM, including how gaining gender equity in STEM may best be achieved. We then make a call to industrial/organizational psychologists to take a lead in addressing the societal-level causes of gender inequality in STEM.
This paper addresses the theme of the special issue by drawing attention to ways in which gender scholarship can influence management and organizational studies in an analysis of the pathways to senior management. Based on an Australia-wide study of the experiences of women and men in senior management, it adds new empirical data to the body of knowledge on women's career advancement at senior levels of organizations. Many women interviewed expressed reticence and ambivalence about the advancement of their careers and their prospects for promotion, which was called ‘girl disease’ by one woman. Forms of ambivalence varied according to different age and sector cohorts; in particular difficulties were identified in reconciling family responsibilities with the demands of senior level appointments. We analyse expressions of ambivalence and reticence by exploring the tensions between women's gender identity and the organizational factors that shape their ‘managerial’ identity. We conclude by suggesting strategies to improve organizational practices in relation to women's career development and promotion.
Increasingly, social policies combine to intensify old risks and create new social risks with unequal consequences for men and women. These risks include those created by changing normative expectations and the resulting tensions between social policy, paid employment and family life. Policy reliance on highly aggregated standardised outcome data and generalised models of autonomous rational action result in policies that lack an understanding of the rationales that structure everyday life. Drawing on two Australian studies, we illustrate the importance of attending to the intersections and collisions of social change and normative policy frameworks from the perspective of individual ‘lived lives’.
Beyond competitive elections, democratisation should include a transformation of the institutions of state and civil society into spaces that recognise the rights of citizens and allow for their participation. This study explores the question of how Mexican labour unions are transformed into institutions with a commitment to the rights and participation of women workers. Drawing on evidence from five unions, the paper shows that compared to their corporatist counterparts, unions with a ‘democratic ethos’ provide a context within which gender equity rights are more readily recognised. However, recognition of gender equity is primarily dependent on feminist activism and union leadership. The paper argues that women's efforts to transform their unions into spaces that reflect and advocate for gender equity rights are critical to strengthening democratic citizenship in Mexico.
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