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What Counts in Health Research? Who's Counted in Health Research? Making Research Count
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What Counts and Who's Counted in Women's Health Research?
We need both adequate concepts of women’s health and appropriate tools for measuring them in order to understand and evaluate interventions intended to benefit women. For example, women’s health has traditionally been conceptualized in terms of reproductive issues. A more adequate conceptualization includes women’s physical, mental, emotional and social well-being, and an understanding that health arises in a social world and physical environment that includes sex (biology), gender (social roles), work, race and culture—among other things—and the interactions among these factors. "New paradigms, methods, and measurement tools are urgently needed to expand the frontiers of women’s health," [1] says the Michigan Initiative for Women’s Health, one of the many voices arguing for the development of new research tools and approaches to women’s health research. In this issue, two articles discuss aspects of what counts (and what is still missing) in measurements of women’s health with respect to sex and gender. Colleen Reid suggests that traditional measures of women’s and men’s socioeconomic status, paid and unpaid work, and childrearing activities have lagged behind conceptualizations, particularly since the introduction of the determinants of health perspective. Reid argues that measurements must be revised to reflect the complexity and diversity of women’s and men’s lives today. In the second article, Shelly Abdool and Bilkis Vissandjée describe the features of a system of "gender-sensitive indicators" that would more adequately measure women’s health. They offer criteria for the selection of these indicators. Not only do we require new, appropriate measures, we also need to ensure that they reflect the diversity of the Canadian population. Catherine Frazee’s article on the Canadian Biotechnology Strategy draws attention to the measurements that inform health research and policy making. She questions the notion of the "ideal citizen" that underpins the Strategy, suggesting it implicitly excludes people with disabilities. In contrast, another article describes the work of Connie Deiter and Linda Otway who use specific research methods to include the participation of Aboriginal women, an often-neglected group. Researchers Anne Fenety, Carol Putnam and Charlotte Loppie describe the methodological challenges of including a new group of women workers in an occupational health study. In new, non-unionized and rapidly growing industries such as call centres, partnerships between industry and health researchers, which could facilitate the participation of workers, are largely untried. In thinking about how to advance sex- and gender-sensitive research, we note that the British Columbia Centre of Excellence for Women’s Health has released "Fusion," a model for integrated health research. Developed in consultation with members of the women’s health community, the "Fusion" approach helps to assure relevance and inclusivity, encourage multidisciplinarity, integrate sex and gender, share paradigms and foster policy relevance. In an article that advocates for the continuing need for gender-based analysis to assess the effects of health policies and programs on women and men, Karen Grant diagnoses the current situation as afflicted with "The Red Queen Syndrome." Like Alice in Alice in Wonderland—running as fast as she can to stay in the same place—women’s health researchers face a prevailing resistance to the inclusion of gender in health research. Several of these authors argue that most of health research today is "gender neutral" and ignores the possibility of differences in the health of women and men. The evidence is mounting that such research is not at all "gender neutral" in terms of its effects. This issue of the Research Bulletin challenges health researchers and policy makers to make sure that what, how, and who we count in research reflect a comprehensive understanding of the many factors that influence health and illness, and the many people we may exclude or include depending upon the methods and concepts we choose. Ann Pederson NOTES |
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