Chapter 5: The Chief Public Health Officer's Report on the State of Public Health in Canada 2012 – Sex, gender and public health – a path forward

Chapter 5: Sex, Gender and Public Health – A Path Forward

• A time to act

This report illustrates the important influence of sex and gender on the health of Canadians. The good news is that the majority of Canadians enjoy good to excellent physical and mental health, and are living longer, healthier lives. The bad news is that not all Canadians are experiencing the same good health. Because good health is not equally shared, it is essential that we understand the many factors that contribute to this difference.

Taking action to improve health and well-being will require time, effort and resources. Everyone (governments, not-for-profit organizations, communities, individuals, etc.) has a role to play to make Canada healthier. This report features many examples of effective, promising and/or supportive approaches and interventions that illustrate how sex and gender are important considerations in developing and implementing the right solutions.

A time to act

Working across sectors and jurisdictions, there is a reason to believe that health outcomes can be improved for all Canadians. In particular, Canada needs to:

• recognize and understand the importance of sex and gender in health;
• foster a shared vision and collective action to ensure sex and gender are key considerations in public health research, programs, policy and practices; and
• build on (and share) sex and gender evidence from research and practice.

Recognizing and understanding the role of sex and gender

Canadians must acknowledge and address the role of sex and gender in all facets of health. In addition, it is also important to consider the pathways that an individual takes and how these influence health outcomes. This report clearly illustrates how sex and gender influence behaviours, relationships and overall health in constantly changing ways over the lifecourse.

Governments, the private sector, not-for-profit organizations, educational institutions, communities and individuals must all broaden their perspectives and check their preconceptions to ensure that Canada is taking advantage of opportunities to plan, deliver and develop effective interventions that take sex and gender into account. Sex- and gender-based analysis (SGBA) can be used to tailor programs, policies and interventions in a careful and respectful manner to help reduce health inequalities.

Fostering a shared vision and collective action

Working across sectors and jurisdictions, society must foster collective will and leadership to co-ordinate efforts to ensure that all Canadians are respected and given the opportunity to fully participate in society. The goal is to support a population that is as healthy as possible for as long as possible.

Too often, sex- and gender-based stereotyping can increase the health risks for individuals. Addressing the health inequalities that prevent individuals from achieving the best health possible will require compassion, openness, time, patience, resources and collaboration, but is an investment worth making.

Building on the evidence

Given the importance of sex and gender in shaping health and well-being, it is essential that they be considered in the development, implementation and evaluation of research, programs and policies. Too often, they are either not factored into these areas or else generic characteristics and scenarios about men and women are used that assume a “one size fits all” approach. This overly simplistic tactic risks producing evidence that is incomplete or misleading. Targeted programs for women and/or men should be reconsidered to encompass the diversity of the population and avoid division.

In addition, more data on sex and gender and the effectiveness of programs are required. It is important to consider sex and gender in all research activities, and not just health research. This requires improved capacity to capture the information needed to identify trends, future concerns and the effectiveness of initiatives, interventions and strategies that incorporate sex and gender. Though broad consideration of sex and gender across sectors supports an understanding of the complexities and interactions of health determinants, behaviours and outcomes, it requires the development of analytical tools in research and surveillance to properly investigate these complexities.

Applying a sex and gender lens to research, policy and programs raises awareness and allows professionals to identify differences and challenge assumptions about health. Due to the dynamic nature of the sex and gender continuum, evaluating outcomes must be a continuous process that considers the broader range of health determinants. Having robust evaluations will allow for better identification of trends and areas where efforts should be focused. Understanding whether a program works – and why – improves its effectiveness.

Challenges remain in translating and disseminating the results of sex- and gender-based research and programming. To make progress, it is important that researchers avoid generalization and develop sex- and gender-specific indicators. Having the appropriate data and evidence is important for policy makers, public health practitioners and communities who are planning health interventions and programs, which is why looking broadly and finding applicable results from studies is an important and ongoing challenge.

Making a Difference

Opportunities to prevent illness and promote health can be introduced through initiatives and interventions that consider the diverse needs, including sex and gender, of Canadians. Making the effort to reflect sex and gender considerations in research and policy is important for Canada to continue to improve health outcomes.

Moving forward, Canada can learn, adapt and build on successes. However, it will be important to ensure that efforts are neither undertaken in isolation nor limited to one-time projects with short-term impacts. Sex and gender, and their influence on health, are relevant to all Canadians. As a society, Canada can better incorporate sex- and gender-related issues in public health to influence the effectiveness of health promotion and disease prevention efforts. Collectively, Canada has the capacity to understand and address the specific issues of our diverse population to ensure that all Canadians have the opportunity to live as healthy a life as possible.