International Journal of Environmental Research and Public Health

Research

19 pages, 450 KiB

Open AccessArticle

How Can Quantitative Analysis Be Used to Improve Occupational Health without Reinforcing Social Inequalities? An Examination of Statistical Methods

by Valérie Lederer, Karen Messing and Hélène Sultan-Taïeb

Int. J. Environ. Res. Public Health 2023, 20(1), 19; https://doi.org/10.3390/ijerph20010019 - 20 Dec 2022

Cited by 7 | Viewed by 2580

Abstract

Taking account of sex and gender in occupational health studies poses statistical challenges. Other sociodemographic variables, such as racialization, class, and age, also affect the relations between workplace exposures and health and interact with sex and gender. Our objective was to perform a [...] Read more.

Taking account of sex and gender in occupational health studies poses statistical challenges. Other sociodemographic variables, such as racialization, class, and age, also affect the relations between workplace exposures and health and interact with sex and gender. Our objective was to perform a critical review of conventional and emerging statistical tools, examining whether each analysis takes account of sociodemographic variables (1) in a way that contributes to identification of critical occupational determinants of health (2) while taking account of relevant population characteristics to reflect intersectional approaches to health and (3) using sample sizes and population characteristics available to researchers. A two-step search was conducted: (1) a scientific watch concerning the statistical tools most commonly used in occupational health over the past 20 years; (2) a screening of the 1980–2022 literature with a focus on emerging tools. Our examination shows that regressions with adjustment for confounders and stratification fail to reveal the sociodemographic mechanisms that interact with occupational health problems, endangering the identification of occupational risks. Multilevel (notably MAIHDA) analyses, decision tree, cluster, and latent analyses are useful methods to consider when seeking to orientate prevention. Researchers should consider methods that adequately reveal the mechanisms connecting sociodemographic variables and occupational health outcomes. Full article

(This article belongs to the Special Issue Sex, Gender, and Health)

7 pages, 497 KiB

Open AccessArticle

How Cumulative Statistics Can Mislead: The Temporal Dynamism of Sex Disparities in COVID-19 Mortality in New York State

by Ann Caroline Danielsen, Marion Boulicault, Annika Gompers, Tamara Rushovich, Katharine M. N. Lee and Sarah S. Richardson

Int. J. Environ. Res. Public Health 2022, 19(21), 14066; https://doi.org/10.3390/ijerph192114066 - 28 Oct 2022

Cited by 2 | Viewed by 2029

Abstract

Overall, men have died from COVID-19 at slightly higher rates than women. But cumulative estimates of mortality by sex may be misleading. We analyze New York State COVID-19 mortality by sex between March 2020 and August 2021, demonstrating that 72.7% of the total [...] Read more.

Overall, men have died from COVID-19 at slightly higher rates than women. But cumulative estimates of mortality by sex may be misleading. We analyze New York State COVID-19 mortality by sex between March 2020 and August 2021, demonstrating that 72.7% of the total difference in the number of COVID-19 deaths between women and men was accrued in the first seven weeks of the pandemic. Thus, while the initial surge in COVID-19 mortality was characterized by stark sex disparities, this article shows that disparities were greatly attenuated in subsequent phases of the pandemic. Investigating changes over time could help illuminate how contextual factors contributed to the development of apparent sex disparities in COVID-19 outcomes. Full article

(This article belongs to the Special Issue Sex, Gender, and Health)

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17 pages, 389 KiB

Open AccessArticle

“Broken”—How Identities as Women, Mothers and Partners Are Intertwined with the Experience of Living with and Seeking Treatment for Pelvic Organ Prolapse

by Kaylee Ramage, Ariel Ducey, Natalie V. Scime, Erin Knox and Erin A. Brennand

Int. J. Environ. Res. Public Health 2022, 19(9), 5179; https://doi.org/10.3390/ijerph19095179 - 24 Apr 2022

Cited by 6 | Viewed by 2869

Abstract

Pelvic Organ Prolapse (POP) occurs when one or more pelvic organs descend into or through the vaginal opening, significantly impacting physical and mental health. POP affects the female reproductive tract and, overwhelmingly, people who identify as women. However, little research has examined the [...] Read more.

Pelvic Organ Prolapse (POP) occurs when one or more pelvic organs descend into or through the vaginal opening, significantly impacting physical and mental health. POP affects the female reproductive tract and, overwhelmingly, people who identify as women. However, little research has examined the impact of gendered expectations on women’s treatment-seeking for POP and their decision-making around surgery for POP. To address this gap, we conducted semi-structured interviews with 26 women seeking surgery for POP in Alberta, Canada. Data were analyzed from a gender-based lens, using the Framework Method. Participants reported the need to balance their identities as women, partners, and mothers in their pursuit of treatment and faced many barriers to treatment related to their gendered responsibilities. Findings highlight the gendered experiences of prolapse in the context of healthcare needs and can inform policies and practices which promote more equitable access to prolapse treatment. Full article

(This article belongs to the Special Issue Sex, Gender, and Health)

18 pages, 806 KiB

Open AccessArticle

Integrating Sex/Gender into Environmental Health Research: Development of a Conceptual Framework

by Gabriele Bolte, Katharina Jacke, Katrin Groth, Ute Kraus, Lisa Dandolo, Lotta Fiedel, Malgorzata Debiak, Marike Kolossa-Gehring, Alexandra Schneider and Kerstin Palm

Int. J. Environ. Res. Public Health 2021, 18(22), 12118; https://doi.org/10.3390/ijerph182212118 - 18 Nov 2021

Cited by 27 | Viewed by 5103

Abstract

There is a growing awareness about the need to comprehensively integrate sex and gender into health research in order to enhance the validity and significance of research results. An in-depth consideration of differential exposures and vulnerability is lacking, especially within environmental risk assessment. [...] Read more.

There is a growing awareness about the need to comprehensively integrate sex and gender into health research in order to enhance the validity and significance of research results. An in-depth consideration of differential exposures and vulnerability is lacking, especially within environmental risk assessment. Thus, the interdisciplinary team of the collaborative research project INGER (integrating gender into environmental health research) aimed to develop a multidimensional sex/gender concept as a theoretically grounded starting point for the operationalization of sex and gender in quantitative (environmental) health research. The iterative development process was based on gender theoretical and health science approaches and was inspired by previously published concepts or models of sex- and gender-related dimensions. The INGER sex/gender concept fulfills the four theoretically established prerequisites for comprehensively investigating sex and gender aspects in population health research: multidimensionality, variety, embodiment, and intersectionality. The theoretical foundation of INGER’s multidimensional sex/gender concept will be laid out, as well as recent sex/gender conceptualization developments in health sciences. In conclusion, by building upon the latest state of research of several disciplines, the conceptual framework will significantly contribute to integrating gender theoretical concepts into (environmental) health research, improving the validity of research and, thus, supporting the promotion of health equity in the long term. Full article

(This article belongs to the Special Issue Sex, Gender, and Health)

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17 pages, 378 KiB

Open AccessArticle

Implementing Indigenous Gender-Based Analysis in Research: Principles, Practices and Lessons Learned

by Carlos E. Sanchez-Pimienta, Jeffrey R. Masuda, Mary B. Doucette, Diana Lewis, Sarah Rotz, on behalf of the Native Women’s Association of Canada, Hannah Tait Neufeld and Heather Castleden

Int. J. Environ. Res. Public Health 2021, 18(21), 11572; https://doi.org/10.3390/ijerph182111572 - 4 Nov 2021

Cited by 3 | Viewed by 4515

Abstract

Numerous tools for addressing gender inequality in governmental policies, programs, and research have emerged across the globe. Unfortunately, such tools have largely failed to account for the impacts of colonialism on Indigenous Peoples’ lives and lands. In Canada, Indigenous organizations have advanced gender-based [...] Read more.

Numerous tools for addressing gender inequality in governmental policies, programs, and research have emerged across the globe. Unfortunately, such tools have largely failed to account for the impacts of colonialism on Indigenous Peoples’ lives and lands. In Canada, Indigenous organizations have advanced gender-based analysis frameworks that are culturally-grounded and situate the understanding of gender identities, roles, and responsibilities within and across diverse Indigenous contexts. However, there is limited guidance on how to integrate Indigenous gender-based frameworks in the context of research. The authors of this paper are participants of a multi-site research program investigating intersectoral spaces of Indigenous-led renewable energy development within Canada. Through introspective methods, we reflected on the implementation of gender considerations into our research team’s governance and research activities. We found three critical lessons: (1) embracing Two-Eyed Seeing or Etuaptmumk while making space for Indigenous leadership; (2) trusting the expertise that stems from the lived experiences and relationships of researchers and team members; and (3) shifting the emphasis from ‘gender-based analysis’ to ‘gender-based relationality’ in the implementation of gender-related research considerations. Our research findings provide a novel empirical example of the day-to-day principles and practices that may arise when implementing Indigenous gender-based analysis frameworks in the context of research. Full article

(This article belongs to the Special Issue Sex, Gender, and Health)

Review

Jump to: Research, Other

21 pages, 1285 KiB

Open AccessReview

The Operationalisation of Sex and Gender in Quantitative Health–Related Research: A Scoping Review

by Sophie Horstmann, Corinna Schmechel, Kerstin Palm, Sabine Oertelt-Prigione and Gabriele Bolte

Int. J. Environ. Res. Public Health 2022, 19(12), 7493; https://doi.org/10.3390/ijerph19127493 - 18 Jun 2022

Cited by 19 | Viewed by 5608

Abstract

Current trends in quantitative health research have highlighted the inadequacy of the usual operationalisation of sex and gender, resulting in a growing demand for more nuanced options. This scoping review provides an overview of recent instruments for the operationalisation of sex and gender [...] Read more.

Current trends in quantitative health research have highlighted the inadequacy of the usual operationalisation of sex and gender, resulting in a growing demand for more nuanced options. This scoping review provides an overview of recent instruments for the operationalisation of sex and gender in health-related research beyond a concept of mutually exclusive binary categories as male or masculine vs. female or feminine. Our search in three databases (Medline, Scopus and Web of Science) returned 9935 matches, of which 170 were included. From these, we identified 77 different instruments. The number and variety of instruments measuring sex and/or gender in quantitative health-related research increased over time. Most of these instruments were developed with a US-American student population. The majority of instruments focused on the assessment of gender based on a binary understanding, while sex or combinations of sex and gender were less frequently measured. Different populations may require the application of different instruments, and various research questions may ask for different dimensions of sex and gender to be studied. Despite the clear interest in the development of novel sex and/or gender instruments, future research needs to focus on new ways of operationalisation that account for their variability and multiple dimensions. Full article

(This article belongs to the Special Issue Sex, Gender, and Health)

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16 pages, 514 KiB

Open AccessReview

Sex, Gender, and Alcohol Use: Implications for Women and Low-Risk Drinking Guidelines

by Lorraine Greaves, Nancy Poole and Andreea C. Brabete

Int. J. Environ. Res. Public Health 2022, 19(8), 4523; https://doi.org/10.3390/ijerph19084523 - 8 Apr 2022

Cited by 20 | Viewed by 5941

Abstract

Alcohol use is coming under increasing scrutiny with respect to its health impacts on the body. In this vein, several high-income countries have issued low-risk drinking guidelines in the past decade, aiming to educate the public on safer levels of alcohol use. Research [...] Read more.

Alcohol use is coming under increasing scrutiny with respect to its health impacts on the body. In this vein, several high-income countries have issued low-risk drinking guidelines in the past decade, aiming to educate the public on safer levels of alcohol use. Research on the sex-specific health effects of alcohol has indicated higher damage with lower amounts of alcohol for females as well as overall sex differences in the pharmacokinetics of alcohol in male and female bodies. Research on gender-related factors, while culturally dependent, indicates increased susceptibility to sexual assault and intimate partner violence as well as more negative gender norms and stereotypes about alcohol use for women. Sex- and gender-specific guidelines have been issued in some countries, suggesting lower amounts of alcohol consumption for women than men; however, in other countries, sex- and gender-blind advice has been issued. This article reports on a synthesis of the evidence on both sex- and gender-related factors affecting safer levels of drinking alcohol with an emphasis on women’s use. We conclude that supporting and expanding the development of sex- and gender-specific low-risk drinking guidelines offers more nuanced and educative information to clinicians and consumers and will particularly benefit women and girls. Full article

(This article belongs to the Special Issue Sex, Gender, and Health)

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Other

Jump to: Research, Review

6 pages, 268 KiB

Open AccessCommentary

Medical Devices, Invisible Women, Harmful Consequences

by Susan P. Phillips, Katrina Gee and Laura Wells

Int. J. Environ. Res. Public Health 2022, 19(21), 14524; https://doi.org/10.3390/ijerph192114524 - 5 Nov 2022

Cited by 3 | Viewed by 2667

Abstract

In this commentary, we explore the disproportionate risk women experience with the insertion of various medical devices. Although pre-market device testing and complication tracking could be improved for all, a failure to consider sex differences in hormones, anatomy, inflammatory responses, and physical function [...] Read more.

In this commentary, we explore the disproportionate risk women experience with the insertion of various medical devices. Although pre-market device testing and complication tracking could be improved for all, a failure to consider sex differences in hormones, anatomy, inflammatory responses, and physical function puts women at particular risk. This invisibility of women is an example of gender bias in medical science and practice, a bias that could be corrected in the ways we suggest. Full article

(This article belongs to the Special Issue Sex, Gender, and Health)

13 pages, 344 KiB

Open AccessEditor’s ChoiceConcept Paper

Sex, Gender and Health: Mapping the Landscape of Research and Policy

by Lorraine Greaves and Stacey A. Ritz

Int. J. Environ. Res. Public Health 2022, 19(5), 2563; https://doi.org/10.3390/ijerph19052563 - 23 Feb 2022

Cited by 33 | Viewed by 7808

Abstract

Including sex and gender considerations in health research is considered essential by many funders and is very useful for policy makers, program developers, clinicians, consumers and other end users. While longstanding confusions and conflations of terminology in the sex and gender field are [...] Read more.

Including sex and gender considerations in health research is considered essential by many funders and is very useful for policy makers, program developers, clinicians, consumers and other end users. While longstanding confusions and conflations of terminology in the sex and gender field are well documented, newer conceptual confusions and conflations continue to emerge. Contemporary social demands for improved health and equity, as well as increased interest in precision healthcare and medicine, have made obvious the need for sex and gender science, sex and gender-based analyses (SGBA+), considerations of intersectionality, and equity, diversity and inclusion initiatives (EDI) to broaden representation among participants and diversify research agendas. But without a shared and precise understanding of these conceptual areas, fields of study, and approaches and their inter-relationships, more conflation and confusion can occur. This article sets out these areas and argues for more precise operationalization of sex- and gender-related factors in health research and policy initiatives in order to advance these varied agendas in mutually supportive ways. Full article

(This article belongs to the Special Issue Sex, Gender, and Health)

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