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UBC Theses and Dissertations

Sex, gender and health promotion : assessing the potential for health promotion interventions to address health and gender inequities Pederson, Ann Patricia


As a field, health promotion has largely ignored how sex and gender contribute to one’s capacity to increase control over and improve one’s health—the very essence of health promotion. This dissertation urges health promoters to adopt an intersectional view of sex and gender as determinants of health and to develop interventions with explicit attention to improving gender equity. Doing so positions health promotion to improve social as well as health outcomes. To develop this argument, I use intersectional theory to inform: an historical account of the development of health promotion and documentary review of key health promotion charters; an overview of reviews of interventions to increase physical activity, reduce smoking, and limit alcohol consumption among women; and a qualitative study of older women’s involvement in physical activity. Using criteria for gender-sensitive interventions articulated by the World Health Organization, the overview of reviews suggests that, to date, programs to address women’s physical activity and substance use are more likely to be gender-specific—aimed at women—than to be gender-sensitive. Building on this limited range of health promotion programs, I outline a conceptual framework to illustrate that health promotion could reduce gender-related health inequities by transforming gender-related norms, roles, and relations. I illustrate the need for and possibilities of such a framework with examples of social marketing messages directed at women and girls. I then present the findings of a qualitative study of older women’s engagement in physical activity with a gender lens. Though aware of the importance of physical activity for health, the women were motivated to be active to maintain their indepedence and function, rather than by health concerns, which can be understood as reflecting gendered expressions of resistance to the stigma associated with aging and disability—and their challenges to femininity. Informed by the framework on gender-transformative health promotion, programs could increase older women’s involvement in physical activity by aligning with older women’s priorities—stressing how being flexible, strong, and fit can contribute to women’s ability to live independently and pursue personal priorities—and simultaneously working to fight ageism, sexism, and barriers to participation.

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Attribution-NonCommercial-NoDerivatives 4.0 International