The Impact of Gender Norms on Health

Two Brown School researchers contributed their scholarship and expertise to the recently published Lancet Series on Gender Equality, Norms, and Health — a collection of six papers that provides new analysis and insights into the impact of gender inequalities and norms on health, and the opportunities that exist within health systems, programs, policies, and research to decrease inequalities and transform restrictive norms. 

The series calls the global health community to action, stressing the critical need to recognize and take effective actions to address gender inequalities and restrictive gender norms, and their intersections with other social disparities, in order to improve health for all. 

Jessica Levy, associate professor of practice, co-authored the study, “Improving Health with Programmatic, Legal, and Policy Approaches to Reduce Gender Inequality and Change Restrictive Gender Norms,” which investigates three key ways of reducing gender disparities: gender transformative health programming (which are programs that actively seek to transform norms and improve health); large-scale laws and policies; and actions related to governance. The authors found that high-quality gender-transformative programs that impacted multiple health outcomes and were sustainable and scalable:

• Involved multiple stakeholders across multiple levels
• Used multisectoral action, recognizing the importance of reaching beyond the health sector
• Employed diversified programming, strategically combining activities that reinforce one another and address issues from multiple perspectives
• Fostered critical awareness and participation among affected community members, encouraging participants to become active agents in shaping their own health

Furthermore, through examination of data and outcomes from nearly 100 countries, the authors found that policy approaches such as tuition-free primary education and paid parental leave both transform norms and improve community health. When these programs successfully promote gender equality, they are seen to extend average life expectancy by approximately two years for women and one year for men.

“Increasing gender equality in political representation by, for example, having more women and gender minorities at the table and giving them voice, makes all of this possible,” Levy said.

Lindsay Stark, associate professor, co-authored another article in the Series: “Gender Norms and Health: Insights from Global Survey Data.” The case study she co-led compared Nigerian communities where working outside of the home was, and was not, a norm for women. They found that women who defied communal norms by working outside of the home faced higher rates of intimate partner violence than did women workers in less restrictive communities, which highlights that those who transgress social gendered norms may face serious health repercussions. 

“This finding has important implications for processes of empowerment,” Stark said. “Acknowledging the complexity of the relationships between individual behavior and social norms, and understanding how discordance between the two might give rise to unintended negative outcomes for women and girls, is critical for developing truly gender-equitable policies and programs.” 

Overall, the six case studies in the Series demonstrate that gender norms are complex, and can have multiple differing and context-specific health consequences for people over the course of their lives. Gender nonconformity or transgression is particularly harmful to health when it triggers negative sanctions. These truths mean that effective gender-transformative policies must be designed with cultural sensitivity.