#LancetWomen: A Gender Reckoning in Research
The Lancet recently published a #LancetWomen theme issue that explores the institutional and systemic barriers women face in science, medicine, and global health. I was greeted at the New York launch event at Columbia University in early February by a room full of familiar faces, champions of gender equality and women’s empowerment. They were women I’d seen in attendance and heard speak at other events, such as the Women Leaders in Global Health Conference that was held last November in London. It was a room to be reckoned with.
Jocalyn Clark, an Executive Editor of The Lancet, succinctly stated one of the key messages of the day: “The fight for gender equality is everyone’s responsibility.” Gender and sex in health science and practice have been systemically understudied, underreported, and underfunded. Women are poorly represented in research as both practitioners and study participants, which has limited the development of successful health interventions and technologies. Gender-equitable health outcomes and innovation will not be possible without addressing the structural issues that limit diversity and purposefully integrating sex and gender across the research continuum.
Over the course of the afternoon, speakers called upon institutional leaders in health and medicine to be catalytic in the use of gender transformative approaches in their work in order to make meaningful progress toward improving global health through the integration of gender equality. Such approaches directly address bias, discrimination, and inequity and challenge the power relations that perpetuate sexism and inequality.
A recurring theme in the #LancetWomen issue and among speakers at the launch was the importance of intersectionality, the acknowledgment that social groups – “women” as a category – are not homogenous and contain marginalized identities that experience disproportionate inequities. In The Lancet viewpoint, Why it must be a feminist global health agenda, Dr. Sarah Davies and colleagues asserted, “Gender advocacy must promote inclusive participation and data collection to identify where discrimination and barriers to inclusion exist.”
At the launch event, Dr. Rosemary Morgan, Assistant Scientist at Johns Hopkins Bloomberg School of Public Health, quoted Kimberlé Crenshaw, Professor of Law at UCLA and Columbia Law School and a pioneer of intersectionality, in her presentation: “When you can’t see a problem, you can’t solve it.” Terry McGovern, Chair of the Heilbrunn Department of Population and Family Health at the Columbia University Mailman School of Public Health, similarly emphasized the need to incorporate the context of women’s lives, i.e., the political determinants of women’s health, into research. It is incumbent upon the research community to support more and better data that will bring visibility to overlooked populations and improve targeting and efficacy of health interventions.
Sharmila Mhatre, Deputy Director of the Public Health Program at the Open Society Foundations, drew attention to an alarming trend – that the vast majority of funding is granted to researchers and practitioners in the Global North to study and impart change in the Global South, deepening inequity and power imbalances. In Feminism is for everybody, The Lancet editorial board similarly revealed that most of the submissions to the #LancetWomen theme issue came from high-income countries, highlighting the dearth of support for research from low- and middle-income countries, i.e. the Global South.
The responsibility of funders
In an analysis of global gender data, Dr. Geordan Shannon and colleagues concluded, “The current gender reckoning in science, medicine, and global health highlights both missed and future opportunities, [and] the need to situate gender analyses in the context of political influences and structural inequalities...”
FSFW is using its platform to identify opportunities to expand the gender evidence base and facilitate the inclusion and advancement of women in health science, as evidenced by the strong gender perspective woven into our Health, Science, and Technology requests for proposals (RFPs). Our RFPs (closing April 18, 2019) pose questions such as:
- How do we more effectively characterize smoker populations based on the relevant biological, psychological, socioeconomic, and historic factors, including sex and gender dimensions, in order to improve cessation and tobacco harm reduction interventions?
- What are the changes beyond epidemiology and public health policy, such as gender roles and norms, that have contributed to significant decreases in the prevalence of smoking in some countries?
- What are new innovations in undertaking cohort studies that provide better, faster, and more gender-inclusive insights?
- What are best practices in risk and harm communications that address the gendered nature of access to information and health care?
Like The Lancet and its many supporters, we, as funders, are moving “beyond a measurement revolution to an accountability revolution—one that is based on respect and realization of universal human rights to ensure that scientific research is universally beneficial,” as eloquently stated by Dr. Sarah Hawkes and colleagues in the #LancetWomen issue.