Using a Gender‐Responsive Approach to Generate Policy, Systems, and Environmental Changes to Improve Women's Health

• DOI: http://doi.org/10.1002/wmh3.236
• Published date: 01 September 2017
• Date: 01 September 2017

Using a Gender-Responsive Approach to Generate

Policy, Systems, and Environmental Changes to

Improve Women’s Health

Jodi Burke, Wendy Lombard, Laurie Lachance, Patrick Kelly, Margaret Wilken,

and Sandra Waddell

Community coalitions have proven to be an effective mechanism for identifying and addressing

social determinants of health. This project mobilized the Inkster Partnership for a Healthier

Community (IPHC) coalition, bringing together diverse organizations, and community residents in

Inkster, MI to collaboratively develop a strategic plan to address health inequities revealed in a

community health needs assessment (CHNA). The coalition designed a multi-faceted, gender-

responsive approach designed to increase social connectedness as a means to improve health and

foster well-being among women in the community. The approach included three core strategies: (i)

providing health literacy mentoring, (ii) using community health workers (CHWs) and lay health

educators to increase opportunities for access to and use of community health resources and self-

management programs, and (iii) publicizing targeted health messages intended to positively

inf‌luence gender norms related to women’s health. Emphasis was also placed on instituting policy

systems and environmental (PSE) changes to promote sustainable community health improvements.

Initial implementation outcomes indicate that a gender-responsive approach to community health

improvement initiatives is a promising model for how coalitions can purposefully adapt and evolve

to incorporate gender-based considerations into programmatic and PSE change efforts that equitably

benef‌it all residents.

KEY WORDS: gender-responsive approach, social determinants of health, policies

Introduction

Gender has been recognized as an important social deter minant of health

(SDOH) (Ashida & Heaney, 20 08; Men, Frieson, Sochea t, Nirmita, & Mony,

2011; Phillips, 2005), e specially for women in vul nerable communities where

the day-to-day burdens o f managing their lives is a crit ical factor in chronic

disease prevention and hea lth management. Gender i s def‌ined as “the socially

constructed characte ristics of women and men such as n orms, roles, and

World Medical & Health Policy, Vol. 9, No. 3, 2017

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doi: 10.1002/wmh3.236

#2017 Policy Studies Organization

relationships of and bet ween groups of women and men. These attributes can

inf‌luence people’s susceptibility to different health conditions and dis eases and

affect their enjoyment o f good mental, physical he alth, and well-being. Th ey

also have bearing on access t o and uptake of health servi ces, and on the health

outcomes experienced throughout the life-course” (Wor ld Health Organizatio n,

2016). The Off‌ice on Women ’s Health (OWH) def‌inition of gender-based

approach is one that addr esses gender norms, rol es, attributes, and behav iors

that are identif‌ied by the co mmunity as impacting tr eatment, access, and

overall health (Alexa nder & Walker, 2015).

Research has demonstrated a link between gender, stress, and health status

(Samuel-Hodge, Skelly, Headen, & Carter-Edwards, 2005; Sarkadi & Rosenqvist,

2002; Whittemore, D’Eramo Melkus, & Grey, 2005). The primary caregiving role

that women maintain in their families often renders them vulnerable to the

stresses and tension in others’ lives as well as their own (Samuel-Hodge et al.,

2005; Sarkadi & Rosenqvist, 2002; Whittemore et al., 2005). When women have a

chronic illness, such as diabetes, their role strain becomes even more burdensome.

Perceived barriers associated with multiple caregiving roles negatively impact

feelings of well-being, sense of control, and level of competence (Samuel-Hodge

et al., 2005). Therefore, gender has the potential to complicate the “lifestyle” steps

needed to effectively manage chronic conditions and their risk factors.

Social connectedness has been described in the literature as “a signif‌icant and

pervasive determinant of health and well-being” that can help mitigate the effects

of other determinants of health (Berkman, 2000; Gallant, 2003; Healthy San

Francisco, 2003; Minnesota Department of Health, 2010; Rosland, Heisler, & Piette,

2012; Wilson et al., 1986). Social connectedness refers to the quality, strength, and

extent of individuals’ relationships with others (their social networks), and how

those relationships benef‌it the individual as well as society (through social support

derived from social networks) (Hernandez & Blazer, 2006; Ministry of Social

Development: The Social Report, 2010). Studies have demonstrated that individuals

with strong social connectedness and healthy relationships enjoy a higher quality

of life and contribute to better functioning, vibrant communities (Baum, 1999;

Kasper & Pearson, 1995; Minnesota Department of Health, 2010).

There is growing evidence that women at all stages of life need social support

for optimum health (DeVault, 1994). An examination of published articles found

that, “Perhaps, the most common f‌inding across the different chronic diseases

and conditions reviewed is the importance of social support. ... Women were less

likely to receive support, leading to less positive coping” (Vlassoff, 2007).

Therefore, efforts to address gender inf‌luences on women’s health should strive

to increase opportunities for incorporating the supportive aspects of social

connectedness into health-promoting interventions.

The value of working with a community coalition to identify and tackle

SDOH has been extensively described in the literature (Butterfoss, Goodman

& Wandersman, 1993; Clark et al., 2010; Minkler & Wallerstein, 2004; Wolff,

2001). Coalitions are integral in bringing together individuals and organiza-

tions with diverse backgrounds and experience to address complex problems,

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