EVIDENCE-BASED PUBLIC HEALTH POLICY AND PRACTICE

The incorporation of gender perspective into Spanish health surveys

Izabella Rohlfs^1,2,4, Carme Borrell^1,3,4,5, Lucia Artazcoz^1,3,4 and Vicenta Escribà-Agüir^1,4,6

¹ Gender and Health Research Network (RISG)
² University of Girona, Girona, Spain
³ Agància de Salut Pública, Barcelona, and Epidemiology and Public Health Centres Network, Spain
⁴ CIBER Epidemiología y Salud Pública (CIBER ESP), Spain
⁵ Pompeu Fabra University, Barcelona, Spain
⁶ Valencian School for Health Studies (EVES). Generalitat Valenciana, Valencia, Spain

Correspondence to:
Dr Izabella Rohlfs, Universitat de Girona, Departament d’Infermeria, Campus Girona Centre, C/Emili Grahit, 77, 17002 Girona, Spain; izabella.rohlfs{at}udg.edu

Background: Most studies into social determinants of health conducted in Spain based on data from health surveys have focused on social class inequalities. This paper aims to review the progressive incorporation of gender perspective and sex differences into health surveys in Spain, and to suggest design, data collection and analytical proposals as well as to make policy proposals.

Methods: Changes introduced into health surveys in Spain since 1995 to incorporate gender perspective are examined, and proposals for the future are made, which would permit the analysis of differences in health between women and men as a result of biology or because of gender inequalities.

Results: The introduction of gender perspective in health surveys requires the incorporation of questions related to family setting and reproductive work, workplace and society in general to detect gender differences and inequalities (for example, domestic work, intimate partner violence, discrimination, contract type or working hours). Health indicators reflecting differential morbidity and taking into account the different lifecycle stages must also be incorporated. Analyses ought to be disaggregated by sex and interpretation of results must consider the complex theoretical frameworks explaining the differences in health between men and women based on sex differences and those related to gender.

Conclusions: Analysis of survey data ought to consider the impact of social, political and cultural constructs of each society. Any significant modification in procedures for collection of data relevant to the study of gender will require systematic coordination between institutions generating the data and researchers who are trained in and sensitive to the topic.

Abbreviations: ENS, Encuesta Nacional de Salud; EOD, experience of discrimination; SESPAS, Spanish Association of Public Health and Health Administration

Keywords: gender; social inequalities in health; health surveys; social class

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