Medicine
Unconscious Bias

New research explores how gender norms affect health outcomes

“Rigid gender norms and gender inequalities drive ill health for women, men, girls and boys, and contribute to poverty,” Gary Darmstadt observed in his Clayman Institute Faculty Research Fellows presentation, “Investigating relationships between gender norms and health.”

Darmstadt, a professor of neonatal and developmental medicine in the department of pediatrics at the Stanford University School of Medicine, presented his ongoing research on how culturally-specific gender norms are possible causes of poor health outcomes. His research, taking place through multiple collaborations with teams of researchers in Brazil, South Africa, the UK and the USA, aims to gather and analyze existing global data to gain new insights into relationships between gendered social norms, gender inequalities and health behaviors and outcomes. 

Darmstadt presented at the Clayman Institute the research that he is leading with more than 70 co-authors across five continents to develop a series of five papers aimed for publication in the peer-reviewed medical journal The Lancet, in 2019. The first paper concentrated on defining and summarizing the history of gender norms and links to health and global development. Papers two through four will analyze health data and evaluations of health system programs and policies; and the fifth paper will advance a call to action to global institutions to prioritize efforts to address gender gaps and biases in health care.

In his research presentation, Darmstadt explained how understandings of health become gendered, beginning in the home, and in social communities that regulate gendered norms and behaviors. “Structures, social relations, and processes define men and women as different in socially significant ways and justify inequality on the basis of that difference,” he said. 

One restrictive gender norm that Darmstadt highlighted in his presentation was the discrimination against adolescent girls who leave the confines of their home by attending school or working, especially in communities where such activities are not the norm for young girls. Girls may want to go to school, he noted, and the government may legislate girls’ legal access to education; yet, gender bias creeps in at the community level, affecting girls’ ability to attend school. While it may be legal for adolescent girls to study and work, the social code betrays otherwise: girls who seek education or employment may put themselves at risk of physical and psychological harm. Darmstadt articulated this as the “discordance in individual versus group attitudes and behaviors,” which can lead to gender policing and gender violence against girls and women who step outside socially sanctioned norms. The consequences of this violence, he elaborated, can include psychological illnesses like depression and the development of other physical health ailments.

While policies that promote gender equality in both private and public spaces can promote more pro-equality attitudes and behaviors, the aforementioned discordance produces a real, quantifiable difference that has significant effects on people’s health, which compounds into adulthood. It is through research that scholars like Darmstadt can quantify and articulate these disadvantages faced by girls and women when it comes to their health. 

According to Darmstadt, the goal of his research is to “inspire new conversations, new partnerships, and new methods of analysis that change practices and move people to action across health and development sectors.” He hopes that the information newly available from his research—and which will soon appear in The Lancet—will lead to new hypotheses about potential ways in which to intervene to advance gender equality and health for all.