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Gender relations and health research: a review of current practices Bottorff, Joan L; Oliffe, John L; Robinson, Carole A; Carey, Joanne Dec 13, 2011

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RESEARCH Open AccessGender relations and health research: a review ofcurrent practicesJoan L Bottorff1*, John L Oliffe3, Carole A Robinson1 and Joanne Carey2AbstractIntroduction: The importance of gender in understanding health practices and illness experiences is increasinglyrecognized, and key to this work is a better understanding of the application of gender relations. The influence ofmasculinities and femininities, and the interplay within and between them manifests within relations andinteractions among couples, family members and peers to influence health behaviours and outcomes.Methods: To explore how conceptualizations of gender relations have been integrated in health research ascoping review of the existing literature was conducted. The key terms gender relations, gender interactions, relationsgender, partner communication, femininities and masculinities were used to search online databases.Results: Through analysis of this literature we identified two main ways gender relations were integrated in healthresearch: a) as emergent findings; and b) as a basis for research design. In the latter, gender relations are includedin conceptual frameworks, guide data collection and are used to direct data analysis.Conclusions: Current uses of gender relations are typically positioned within intimate heterosexual coupleswhereby single narratives (i.e., either men or women) are used to explore the influence and/or impact of intimatepartner gender relations on health and illness issues. Recommendations for advancing gender relations and healthresearch are discussed. This research has the potential to reduce gender inequities in health.Keywords: gender relations, gender, femininities, masculinities, health, illness experiencesIntroductionHealth is affected by macro-level influences includingsocial structures and institutions which shape the expec-tations of women and men, and the way their lives areorganized [1]. To understand health practices and illnessexperiences it is increasingly recognized that accountingfor gender is vital [2,3]. Gender, defined as the sociallyprescribed and experienced dimensions of femininityand masculinity in society, is evident in the diverse waysindividuals engage in health behaviours [2].In men’s health literature, hegemonic masculinity hasbeen associated with risk taking behaviours that com-promise health and illness outcomes [4-8]. Conceptuali-zations of masculinities have also been used to examinean array of issues such as men’s depression [9,10], pros-tate cancer [11] and testicular cancer [12]. Men’s dietbehaviours and food choices [13-16], tobacco use pat-terns [17] as well as help-seeking behaviours [18-20]have also been described in relation to masculinities. Incontrast to the uptake of masculinities in men’s healthresearch, Lyons [14] points to the dearth of researchthat examines how femininities influence health experi-ences despite decades of work examining women’shealth issues. Researchers who have begun to examinefemininity in relation to women’s health practices havetended to treat femininity as a uniform concept [21,22].Understanding the diversity of femininities that influ-ence women’s health experiences and behaviours is at anascent stage.Although there have been promising developments inaccounting for gender influences in health research, theconcepts of masculinity and femininity for the most parthave been delinked despite the social constructionistpremise that gender is relational. Further, this researchhas been predominantly premised on assumptions ofassociations between femininity and women, and* Correspondence: joan.bottorff@ubc.ca1School of Nursing, University of British Columbia’s Okanagan Campus, 3333University Way, Kelowna, BC V1V 1V7, CanadaFull list of author information is available at the end of the articleBottorff et al. International Journal for Equity in Health 2011, 10:60http://www.equityhealthj.com/content/10/1/60© 2011 Bottorff et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited.masculinity and men rather than integrating genderstructures that suggest a continuum of experiencebetween men and women, and evolving forms of socialrelations of gender that influence health [23]. Whileaccounting for a range of social determinants includingrace, social class, and sexual identity has rendered moresophisticated understandings of men’s and women’shealth, health behaviours need to be understood in thecontext of men’s and women’s interactions on both per-sonal and institutional levels [6,14]. There is strong evi-dence that gender relations both within and betweenmen and women strongly influence health outcomes.For example, individuals who are married engage inmore healthful behaviours, report healthier psychologicaland physical well being, and lower mortality rates com-pared to divorced, separated, widowed, or single indivi-duals [23,24]. Although marriage is associated withimproved health for women and men, its beneficialeffects seem to be higher for men. Married men livelonger than single men, and widowed men’s life expec-tancy is significantly shortened following the loss oftheir partners [25-27]. In contrast marriage seems toprotect women’s health by increasing financial stability[25]. However, married women are more vulnerablethan men to negative outcomes of dysfunctional rela-tionships including intimate partner violence. Possibleinfluences underpinning these discordant relationshipsinclude feminine ideals around nurturing others and lin-kages between masculinity and men’s disregard for self-health. A gender relations approach recognizes theimportance of gender dynamics and the circumstancesunder which they interact to influence health opportu-nities and constraints. More than a decade after Scho-field, Connell, Walker, Wood, and Butland [4]advocated for increased attention to gender relations bysignalling some designated pathways for “doing” genderrelations and health research, there appears to be lim-ited uptake of gender relations by health researchers.The arguments supporting the use of gender theory inhealth research are compelling - the potential for betterscience, providing the basis for more effective healthcare and reducing health disparities [28]. Since genderrelations is a cornerstone of gender theory, a scopingreview of the empirical literature to describe develop-ments in integrating gender relations in health researchis needed to take stock of efforts to incorporate genderrelations and provide direction for future research.In what follows we review the theoretical develop-ments that underpin our understanding of gender rela-tions, review published studies to examine the ways inwhich the concept of gender relations has been inte-grated into health research, and offer recommendationsfor how the field might be advanced.Theorizing Gender RelationsFeminist scholars have made significant contributions toconceptualizing gender relations as a set of relationshipsto address critiques of static and binary constructions ofgender and to re-establish gender as socially constructedand relational. They have also advanced understandingsof the complex diversity within and across genders byincorporating analysis of other social relationshipsincluding class, ethnicity and racialization, and theirimpact at various ages to acknowledge and anchor thecontext-specific influences that underlie genderdynamics [29,30].One of the most influential voices in theorizing genderrelations has been that of the Australian sociologist Rae-wyn Connell [31-33]. While Connell first wrote abouthegemonic masculinity and corresponding emphasizedfemininity in 1987, it was the former concept that gar-nered most attention, particularly in men’s healthresearch. Connell advanced the theory that masculinitiesand femininities play out at a societal level, and whilethere are diverse and multiple forms, all are shaped bythe structural influences wherein men dominate women.In recognizing the gender hierarchy, hegemonic mascu-linity was conceptualized as an idealized masculinitythat subordinates other masculinities and femininities[31,34].Although Judith Butler [35] theorizes that heterosex-ual desire unites masculine and feminine in a binaryand hierarchical relationship, others position genderrelations as part of recurring patterns embedded ininterpersonal relationships, culture, and social structuresand organizations that permeate all aspects of everydaylife. Connell [32], for example, conceptualizes genderrelations as being part of dynamic social life performedthrough daily interactions and practices, whereby indivi-dual actions collectively constitute and re-create prevail-ing understandings and enactments of masculinities andfemininities but not in a uniform way. She describesfour interconnected structures of gender relations: pro-duction relations reflected in sexual divisions of labour;power relations evident in the positioning of men as thedominant class in societal discourses and in the exerciseof imperial powers; emotional relations that include theinfluence of hegemonic patterns and relationships in avariety of contexts (e.g., households, workplace); andsymbolic representations of gender in society [33,36]Howson’s [37] work is an important contribution togender relations, extending Connell’s framework bydescribing categories of masculinities and femininities asemerging in response to hegemonic masculinity. A plur-ality of masculinities - complicit, marginalized, sub-ordi-nate and protest are proposed to operate in relation tohegemonic masculinity. In addition, Howson proposesBottorff et al. International Journal for Equity in Health 2011, 10:60http://www.equityhealthj.com/content/10/1/60Page 2 of 8three femininities that function in relation to hegemonicmasculinity: emphasised, ambivalent and protest. Thisconceptualization of gender relations challenges con-structs of masculinity and femininity as binary oppositesamid highlighting the diversity within the gender cate-gories, and the relational gender dynamics in society.In summary, these theoretical frames provide a usefulstarting place for examining gender relations in healthand hold implications for study designs. First, the rela-tional quality of gender occurs in the interface: i)between masculinities/femininities, ii) among masculi-nities, and iii) among femininities. Second, the relationalinteractions can occur across, as well as with, the micro-or interpersonal level and the larger macro- or struc-tural level. Third, conceptualizing gender as relationalimplies an ongoing, interactive dynamism that is subjectto change over time. Forth, gender relations varyaccording to place such that local geo-political condi-tions are also significant in generating diversity. Genderrelations, therefore, can help us move beyond the dyadicbinary gender order that has predominated in healthresearch.Approaches to Gender Relations and HealthResearchWe conducted a scoping review of existing healthresearch to explore the ways gender relations havebegun to be taken into account to provide a descriptionof current approaches and provide directions for futureresearch. The key terms gender relations, gender interac-tions, relations gender, and partner communication wereused to search online databases including CINAHL, Psy-chINFO, PubMed, and Sociological Abstracts (1999-2009). Two reviewers independently screened 811abstracts, and identified 95 potentially relevant manu-scripts. The full manuscripts were retrieved andreviewed in relation to criteria for inclusion. Manu-scripts were included if they were published, peer-reviewed empirical reports (all types of research) wherethe primary focus was health and explicit references togender relations were included in the conceptual frame-work, study design, or findings. We excluded studies oflabour markets and other social structures that reflectgender relations in society when the objectives of theresearch were not explicitly linked to health. Alsoexcluded were articles that used the term “gender rela-tions” but focused on sex differences or sex-roles. Tenempirical papers met the inclusion criteria. In January of2010, another search of the CINHAL, PUBMED, Psy-chINFO, and Sociological Abstracts was conductedusing combinations of the terms masculinit*, femininit*,couple intervention, gender, gender relations and health.This elicited another four articles that met inclusioncriteria.In group meetings, the authors reviewed the manu-scripts, and compared and contrasted the approachesused to incorporate the influence of gender relations.Through this analysis we identified two main ways gen-der relations were integrated in health research: a) asemergent findings; and b) as a basis for research design.In the latter, conceptualizations of gender relations wereincluded in conceptual frameworks, guided data collec-tion and were used to direct data analysis.a. Gender Relations as an Emergent FindingGender relations was a concept used by some research-ers as a way to interpret their data and in these casesgender relations emerged as a key finding. The contribu-tion of these studies in furthering our understanding ofgender relations varied. In some studies, gender rela-tions emerged as a broad inductively derived findingrather than a nuanced gendered perspective and wasneither informed by, or integrated with, the theoreticalliterature. While in other studies rich descriptions of thegender dynamics that emerge out of everyday interac-tions were provided.For example, de Vera [38] conducted an ethnographicstudy to explore factors influencing birth spacing amongseven rural Filipino couples using interviews conductedseparately with husbands and wives, and supplementarydata sources. One of the socio-cultural factors identifiedto influence birth spacing, labelled as “gender relations,”describes the lack of communication between husbandand wife, and culturally prescribed gender roles forwomen as wife and mother. Although some new insightswere gained in this study, the concept of gender rela-tions was not explored in an in-depth way using avail-able data.In a second example, Avotri and Walters [39] inter-viewed 75 Ghanaian women and found that “relation-ships with men” was a main theme linked to healthproblems, and integral to the structure of their lives.The findings were richly detailed and focused on threesub-themes: a) gender division of labour characterizedby heavy responsibilities, limited control, and lack ofaccess to resources; b) women’s insecurity and vulner-ability in their relationships with men where partnerexpectations were high and power or control was verylow; and, c) physical and verbal abuse emergent withinintimate relationships. The qualitative findings capturedcoexisting relational dependency and vulnerability lead-ing to health problems for the women, and illustratedhow gender relations could be used to explain thewomen’s health issues.The descriptive study by Avotri and Walters [39], andothers like it, in which gender relations emerges as akey concept or finding have the potential to advanceour knowledge of gender relations in several ways. First,Bottorff et al. International Journal for Equity in Health 2011, 10:60http://www.equityhealthj.com/content/10/1/60Page 3 of 8linking descriptions of everyday social practices withhow gender relations is enacted and the dense socialcontext in which they emerge has the potential toenhance our understanding of gender regimes [40], andthe processes by which gender influences health. Sec-ond, these emergent gender relations findings sensitizeresearchers to the central role of gender relations inhealth and the potential advantages of applying theoreti-cal frameworks of gender relations to future studydesigns.b. Gender Relations as a Basis for Research DesignGender relations have also been explicitly operationa-lized in health research as a conceptual framework toshape problem formulation, data collection methods anddata analysis approaches and tools. Each is described inmore detail in the following sections.Gender Relations as a Conceptual FrameworkThere are examples in the literature where researchersexplicitly set out to examine the link between genderrelations and health. In these studies, frameworks toconceptualize gender relations were foundational tostudy design. Most researchers drew on empirical litera-ture to develop their own conceptual frameworks andincluded gender relations among a number of other fac-tors. For example, Carter [41] was concerned with theinfluence of community context on household genderrelations in rural Guatemala in an exploration of deci-sion making about health matters. Drawing on findingsfrom qualitative studies regarding contextual factorsinfluencing gender relations, the research team devel-oped a conceptual framework for this study. Using thisapproach, gender relations were conceptualized as socialinteractions, grounded in power dynamics between menand women in intimate partnerships, and affected byindividual characteristics and contextual variables athousehold and community levels.Other researchers developed conceptual frameworksdrawing on conceptualizations of masculinities and fem-ininities. Evans et al. [42] for example, focused on gen-dered dimensions of African Nova Scotians’ experienceswith breast and prostate cancer. The conceptualizationof gender relations underpinning this study focused onmasculinities, femininities, and the hegemony of idea-lized masculinity with its implications for sex-specificcancer care. In a similar way, Landstedt, Asplund, andGadin [43] drew on the work of Connell [31,44] andwere concerned with masculinities, femininities, powerrelations, and the reciprocal influence between genderpractices and societal structures in positioning theirstudy of adolescent mental health.It is noteworthy that none of the studies provided aclear definition of gender relations as part of the con-ceptual framework underpinning this research.Nevertheless, such efforts to integrate the concept ofgender relations within conceptual frameworks haveserved, in part, to foreground gender relations in healthresearch. In contrast to these approaches, there are afew studies that have made explicit use of gender rela-tions theory to anchor their research [45-47]. In each ofthese studies, Howson’s schema was used to advancegender relations as a conceptual foundation and thepathways reflected in Howson’s work were used to pur-posefully guide methodological approaches to data col-lection and analyses as well as the discussion of thefindings.Gender Relations: Developments in Data CollectionThe integration of gender relations in health researchhas prompted important developments in quantitativeand qualitative data collection methods to enhance thepotential for examining the relationship between genderas a social dynamic and health.Quantitative researchers have used a variety ofapproaches to measure gender relations including com-binations of commonly used socio-structural variables.In an examination of gender relations at a society level,Chun, Khang, Kim, and Cho [48] hypothesized that gen-der inequities in Korean society might explain women’shigh morbidity, despite increasing prosperity in thecountry as a whole. The influence of gender relationswas measured indirectly using existing survey datarelated to socio-structural determinants and includedmarital status, living arrangements, education, occupa-tion, and employment status. Marital status, for exam-ple, was conceptualized as an important socio-structuralfactor that negatively influenced women’s health in apatriarchal culture pointing to the obligations associatedwith women’s gendered roles and the “double burden”of working, married women [48]. Others have used mea-sures specifically designed to assess dimensions of gen-der relations. For example, Hunt [49] used the BEM SexRole Inventory to examine “gender-related” experiencesand health among two cohorts of women. Carter [41],on the other hand, designed four questions to “measuredirectly some aspects of gender relations and husbands’authority” in the aforementioned study of Guatemalanwomen. The questions focused on who keeps (guards)money for household expenses, who decides whichhealth care provider to see when sick, what medicine ispurchased, and what food to buy.Other health researchers have used qualitative datacollection approaches to examine the influence of gen-der relations. Semi-structured individual interviews havebeen used by some researchers. Bottorff et al. [50] usedHowson’s [37] framework of gender relations as a con-ceptual lens for examining heterosexual couples’ tobaccouse patterns. Adopting parallel semi-structured inter-views with women and their male partners, theBottorff et al. International Journal for Equity in Health 2011, 10:60http://www.equityhealthj.com/content/10/1/60Page 4 of 8researchers asked participants to describe their interac-tions with their partners, and whether these interactionsundermined or promoted tobacco reduction. Inter-viewers encouraged participants to provide examples ofwhat might be overheard by someone listening to theirconversations with partners related to smoking. Indivi-dual interview data with male and female partners werethen brought together using dyad summaries to con-struct couple-level data related to interaction patternsand to facilitate an analysis of gender relations and com-parisons within and between couple dyads [49,50].Focus groups have also been used as a means to betterunderstand gender relations in the context of normsrelated to sexual practices and HIV protection in severalAfrican locations [24,25,51]. These studies involved menand women in same-sex focus group interviews usingsimilar questions to facilitate data comparisons. Ndindaet al. [24] were explicit about how they framed focusgroup questions to explore gender relations (e.g., Whogenerally decides on the use of contraception, condomuse and child bearing in a sexual relationship? Can awoman say no to sex?). In Tolhurst et al.’s [26] investiga-tion of how “gendered dynamics” within intra-householdbargaining influenced seeking health care for children inthe Upper Volta region of Ghana, focus group data weresupplemented with a variety of qualitative and participa-tory methods including role-plays, pile-sorting exercises,community mapping, and wealth/wellbeing ranking exer-cises, key informant interviews, in-depth individual inter-views and critical incident interviews.Evans et al. [42] made use of both mixed and single-sex focus groups to describe the influence of genderedand cultured relations on experiences of breast andprostate cancer among Africans living in Nova Scotia,Canada. In this study, focus group questions directlyaddressed gender relations: “What is the role of menand women in your community? What does being mas-culine and feminine mean to you? How has canceraffected how your body works/looks? How has canceraffected your relationship with your partner, family,friends, and community?"(p. 262) [42].These studies illustrate that approaches to gender rela-tions data collection are diverse and emergent. Efforts toinclude the voices of both men and women in studies ofheterosexual gender relations are evident and point theway for exploration of other forms of gendered relations.There is also a need to develop measures of gender rela-tions, and the current reliance on qualitative approaches,while reflecting the early stage of development in thefield, might also garner gender relations items for inclu-sion on survey questionnaires.Gender Relations as an Analytical ToolQualitative researchers have made explicit use of con-ceptualizations of gender relations as analytical tools.We describe three studies to highlight this methodologi-cal approach.Bottorff et al. [47] interviewed women about thesmoking practices of their men partners in the contextof pregnancy and the postpartum. Howson’s [37] frame-work was used as an analytical tool for questioning andinterpreting women’s narratives to examine how theyconstructed men’s behaviors in relation to smoking andmasculinity, and the way that they positioned theirefforts to influence men’s smoking.Another study drawing on Howson’s [37] and Schip-pers [27] theorizing in gender relations focused on howmasculinities and femininities were operationalizedamong heterosexual couples in relation to food and dietin the context of prostate cancer [45]. Individual semi-structured interviews with men and their women part-ners were analyzed to identify and understand how gen-der relations in heterosexual couples influenced men’sdiets.Additional advantages of using a gender relationsapproach are reflected in a study by Oliffe et al. [46]that examined men’s depression through interviews withmen who were formally diagnosed and/or self-identifiedas depressed, and their female partners. In this studyeach couple was assigned a particular gender relationscategory inductively derived from an analysis of the waydepression-related couple interactions played out. Forexample, “trading places,” embodied by most couples,was a pattern in which men were prepared to stay athome and assume domestic responsibilities whilewomen took on ‘breadwinning’ responsibilities. Such anarrangement permitted men to manage their depressionat home, avoid seeking professional help, and concealthe losses and deficits that depression posed for theirmasculinity. The study, drawing on Howson’s [37] fra-mework, concluded that examining hegemonic feminin-ity (the feminine aspects of idealized heterosexualrelationships) as well as pariah femininities (hegemonicmasculine characteristics or practices that, when embo-died by women, are simultaneously stigmatized and fem-inized), and male femininities was well founded [27].DiscussionDespite the growing attention to gender relations bytheorists, the relatively small body of empirical healthresearch that explicitly and purposefully incorporatesgender relations suggests that this field of research is ata beginning stage. When researchers acknowledge theimportance of gender relations to health practices andexperiences, the degree to which they define and engagewith gender relations varies considerably. In addition, itis noteworthy that the studies included in this reviewwere predominantly focused on health behaviours andon interpersonal interactions rather than the influenceBottorff et al. International Journal for Equity in Health 2011, 10:60http://www.equityhealthj.com/content/10/1/60Page 5 of 8of meso/macro level representations of gender relationson health. Although it is possible that other population-based gender studies were not identified, this may be areflection of the nascent stage of the research. The lackof consistent language regarding gender relations mayhave also limited the number of papers included in thisreview. We often found that while the term ‘gender rela-tions’ was used, gender relations was not directlyaddressed in the research. Some authors used sex andgender interchangeably, and while some defined gender,the concept of gender relations was rarely clearly articu-lated. Nevertheless, this review provides useful insightsinto this emerging area of research and points to keyareas where developments are needed.Conceptual clarity in the use of gender relations isclearly needed to strengthen health research. Recentefforts to use gender relations theoretical frameworks asa conceptual basis for research and to guide data collec-tion and analysis are promising and afford momentumand direction for advancing the field. However, the con-cept of femininities in health research needs more atten-tion along with broader considerations about whatconstitutes ideals in the context of gender relationsbetween and among men and women. In this way, per-petuating the binary conceptualization that positionsmen and women as opposites might be avoided by pay-ing attention to what, as well as how, specific relationswork for and against health and well-being.Although gender relations has featured most promi-nently in ethnographic work dedicated to understandinghealth practices in developing countries, the potentialfor studying men’s and women’s health behaviour inwestern societies and in micro yet increasingly globa-lized contexts is ever present. Wherever this research isconducted, gender relations and health studies will bestrengthened by ensuring that diverse perspectives areincluded. The study of interactional patterns betweenand among women and men does not adequately distilgender relations unless a gendered perspective is taken.For example, in studies of gender relations in house-holds the perspective of both partners is required, andresearch must extend beyond heterosexual couples toinclude same-sex relations and other types of family andpeer relations. Although the identification and use ofstandard indicators for gender relations would allowresearchers to account for gender relations (e.g., as aconfounder or independent variable) in survey research,the complex, social terrain in which gender relationsemerge is likely to require multi-dimensional measuresdeveloped for application to specific societal and culturalcontexts.The integration of gender relations in health researchwill also be advanced through sharing the details abouthow this work is and can be done. We often found thatdescriptions of data collection methods aimed specifi-cally at capturing gender relations were missing or lim-ited to a sentence or two. Difficult to determine, forexample, in qualitative studies was how gender relationswere captured through specific interview questions orobservations. Methodological challenges reside here, andneed to be acknowledged and addressed. If we takedirection from contemporary theorists that gender rela-tions are multiple and have components of hegemonyand power dynamics, recognizing when these dynamicsinfluence data collection is also important to modifyingapproaches to ensure the safety of vulnerable partici-pants (e.g., partner conflict and/or abuse). Althoughconjoint interviews provide an opportunity to observegender relations, there may be situations where theseinterviews place individuals at risk [52].Theorists have identified locations or settings wheregender relations might be best studied. For instance,gender as relational experience occurs on personal andintimate levels as well as on cultural and institutionallevels [4,6,53]. This suggests that gender relations andhealth studies can and should occur in diverse locationsand contexts to more fully apprehend the multiplicityand patterns within productions of gender relations andtheir influence on health.ConclusionsGender relations are an exciting and emergent area inneed of more attention from health researchers.Health-related behaviours do not operate in isolationand need to be understood in the context of interac-tions within and between men and women across per-sonal, interpersonal and institutional levels. A betterunderstanding of gender relations and health inresearch and policy will have direct implications forhealth interventions and guide decisions about whethergroup, dyadic or single point programs are likely to beeffective. In addition, this research has great potentialto challenge relational patterns that are so often taken-for-granted and contribute to reducing gender inequal-ities in health.AcknowledgementsThis research was supported through funding from the Canadian Institutesof Health Research (Institute of Gender and Health) for the InvestigatingTobacco and Gender (iTAG) project (Grant #GTA-92065) as well as careersupport for Dr Oliffe in the form of a Canadian Institutes of Health Researchnew investigator award and Michael Smith Foundation for Health Researchscholar award.Author details1School of Nursing, University of British Columbia’s Okanagan Campus, 3333University Way, Kelowna, BC V1V 1V7, Canada. 2Centre for Social, Spatial andEconomic Justice, University of British Columbia’s Okanagan Campus, 3333University Way, Kelowna, BC V1V 1V7, Canada. 3School of Nursing, Universityof British Columbia’s Vancouver Campus, 302-6190 Agronomy Road,Vancouver, BC V6T 1Z3, Canada.Bottorff et al. International Journal for Equity in Health 2011, 10:60http://www.equityhealthj.com/content/10/1/60Page 6 of 8Authors’ contributionsJB lead this project, participated in the study design and conduct of theresearch, and contributed to preparation of the manuscript. JO participatedin study design and data analysis, and contributed to preparation of themanuscript. CR participated in study design and data analysis, andcontributed to preparation of the manuscript. JC performed the literaturesearches and data extraction, and assisted with preparation of themanuscript. All authors read and approved the final manuscript.Competing interestsThe authors declare that they have no competing interests.Received: 11 July 2011 Accepted: 13 December 2011Published: 13 December 2011References1. Johnson JL, Oliffe JL: Gender and community health. Community HealthNursing: A Canadian perspective Toronto, Canada: Pearson; 2012, 300-310.2. 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Ethnos 1996, 61:157-176.doi:10.1186/1475-9276-10-60Cite this article as: Bottorff et al.: Gender relations and health research:a review of current practices. International Journal for Equity in Health2011 10:60.Submit your next manuscript to BioMed Centraland take full advantage of: • Convenient online submission• Thorough peer review• No space constraints or color figure charges• Immediate publication on acceptance• Inclusion in PubMed, CAS, Scopus and Google Scholar• Research which is freely available for redistributionSubmit your manuscript at www.biomedcentral.com/submitBottorff et al. International Journal for Equity in Health 2011, 10:60http://www.equityhealthj.com/content/10/1/60Page 8 of 8


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