A gender transformative approach to

NCDs: experience from the WHO

European Region

Webinar 3 November 2017

Isabel Yordi Aguirre, Gender adviser, WHO Europe

WHO European Region53 Member States, 886 Million people

Policy framework

Beyond the mortality advantage

2016

Women’s health in Europe

• 70% of the 14 million over 85 are women and this age group will be 40 million in 2050

• 15 years difference in average estimate life expectancy (70-85)

• Main two causes of death are cardiovascular diseases and cancers

• Women spend 12 years in ill health

Strengthening governance for women’s health and well-being

Eliminating discriminatory values, norms and practices that affect the health and well-being of women and girls

Tackling the impact of gender and other social, economic, cultural and environmental determinants

Improving health systems responses to women’s health and wellbeing

A transformative agendaLi

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Beyond premature mortality

Objectives of the men’s health initiative

To contribute to reduce premature mortality of men and improve their health and wellbeing across the life-course through a masculinities approach

To reduce inequalities between men of all ages across the region and within countries

To improve gender equality by engaging men in fatherhood, in unpaid care, in preventing violence and in sexual and reproductive health

Using the evidence!• Risk-taking behavior across the life-course (tobacco, alcohol, violence,

sexual behavior, nutrition and physical activity)

• Impact of intersectionalities with other determinants of health

• Well-being (life satisfaction, depression and suicide)

• Health-seeking behavior across the life-course

• Responses from the health services across the life-course

• Manifestation and impact of disease: biological differences, care needs, family and social impact

Making it transformative

Men more active than women; as adolescents and even

bigger difference as adults, why?

• women’s role as caregiver, less time due to house chores; less physical hobbies; outdoors activates not safe, lack of resources to join gym.

• Health promotion messages use gender-biased language (e.g. “screen-time” to describe sedentary behavior)

• Pressures around physical appearance; pressures on what sports that are appropriate (not too girly and not too masculine)

Boys are more obese, girls are more often on diet

• Women and girls: overweight as unattractive; unrealistic perceptions of body image (constant diets, exercising chronically)

• Perceived masculine behaviour: high-energy food, meat, eating fast and large portion

• Perceived feminine behaviour: low-calorie food, avoid eating too much, not like to eat in front of others, drive for thinness, fear of rejection due to body image

• Men have less control over their diet as women are more often responsible for food preparation

• Growing acceptability that men care for their body image and nutrition

Source: Facts and figures on healthy ageing and long-term care (Rodrigues/Huber/Lamura, 2012)

A focus on gender and informal care

Unpaid care work in Europe

(OECD, 2014)

Women: 4-5 hrs/day

Men: 2-2,5 hrs/day

Minimum set• Using the existing evidence on differences exposure, manifestation,

treatment and outcomes, impact on use of services, and on service delivery

• Addressing gender based barriers into public health training and continuing education

• Gender transformative health promotion

• Challenging unbalance of paid and unpaid

• Challenging gender inequities and bias in the health workforce

• Engaging and working with individuals and communities in transformative approaches to policy and practice

Transforming