Gender myths in global health
Authors: Sarah Hawkes, Kent Buse
Journal: The Lancet Global Health (2017)

We commend The Lancet Global Health and in particular Zohray Talib and colleagues (June, 2017)1Talib Z Burke KS Barry M Women leaders in global health.Lancet Glob Health. 2017; 5: e565-e566Summary Full Text Full Text PDF PubMed Scopus (28) Google Scholar for drawing attention to the paucity of women leaders in global health and the agenda they advance to achieve gender equality. Nonetheless, the authors lead with a persistent “gender myth”2Cornwall A Harrison E Whitehead A Gender myths and feminist fables: the struggle for interpretive power in gender and development.Dev Change. 2007; 38: 1-20Crossref Scopus (174) Google Scholar when they claim that “women carry a disproportionate burden of disease”. The first major exercise to estimate the Global Burden of Disease in 1990 established the fact that “Females have about a 10 percent lower disease burden per 1000 population than males for the world as a whole.”3World BankWorld development report 1993: investing in health. Oxford University Press, New York1993Crossref Google Scholar More recent analyses found that women have approximately 45% of the global burden of disease, and that men have lower life expectancies and have gained the least from decreases in mortality rates since 1970.4Hawkes S Buse K Gender and global health: evidence, policy, and inconvenient truths.Lancet. 2013; 381: 1783-1787Summary Full Text Full Text PDF PubMed Scopus (157) Google Scholar We believe that much of this poor health is driven by gendered differences in health behaviours and risks (eg, in numbers of people smoking, using alcohol, and having road injuries) rather than by differences of biological sex (figure). We absolutely support the goal of achieving gender equality in global health leadership. We abhor the reality that women face multiple discriminations in virtually every sphere of life. Nonetheless, we insist that health policy and practice must be evidence based, including the actual evidence of the gendered nature of health behaviours and associated risks of disability, morbidity, and death. Persistent misrepresentations of the evidence around gender and health do no one any health-related favours in the long term. We declare no competing interests. Women leaders in global healthIt is disappointing and rather ironic to note the lack of gender parity in leadership positions in the field of global health. Women carry a disproportionate burden of disease, comprise a large portion of the global health workforce, and in many leading universities make up the majority of global health students, even up to 84% as reported by one university.1,2 Yet, among the top 50 universities in the USA, women hold just over a third of global health faculty positions and a quarter of directorships in global health centres. Full-Text PDF Open AccessGender myths in global health – Authors' replyWe thank Sarah Hawkes and Kent Buse for their remarks on our Comment.1 They are correct in saying that men in post-transition countries bear a greater global burden of disease and live shorter lives than that of women. However, the reverse is true in the poorest of countries where, for example, maternal mortality remains very high.2 Moreover, although women live longer, they tend to have more debilitating chronic conditions, and self-reported health is worse in women worldwide.3,4 Full-Text PDF Open Access