>>WELCOME TO
THE MEASUREMENT AND METHODS
SESSION.
OUR SESSION TODAY WILL BEGIN
WITH PRELIMINARY REMARKS FROM
OUR SESSION CHAIR DR. ANITA RAJ
FOLLOWED BY 3 PRESENTATIONS AND
WHAT I AM SURE WILL BE A ROBUST
PANEL DISCUSSION.
PLEASE FEEL FREE TO ASK
QUESTIONS USING THE Q&A BOX AND
IF YOU'RE ON VIEDMANIOY CAST
USING THE FEEDBACK FORMS.
DR. ANITA RAJ IS CHANCELLOR
PROFESSOR OF SOCIETY AND HEALTH
AT THE UC SAN DIEGO, SHE IS A
DOCTOR AT THE DEPARTMENT OF
MEDICINE AND EDUCATION STUDIES
AND SHE IS THE DIRECTOR OF THE
CENTER ON GENDER EQUITY AND
HEALTH.
HER RESEARCH INCLUDING BOTH
EPIDEMIOLOGICAL AND INTERVENTION
STUDIES FOCUSES ON SEXUAL AND
REPRODUCTIVE HEALTH, MATERNAL
AND CHILD HEALTH, WOMEN'S
ECONOMIC EMPOWERMENT AND GENDER
INEQUALITIES INCLUDING GENDER
BASED VIOLENCE AND EARLY FORCED
MAR CANCER CENTER.
DR. RAJ'S BIOAS WELL AS ALL 5 OF
OF OUR SPEAKERS TODAY WILL BE
FOUND IN THE LINK IN THE CHAT.
SO I WILL HAND IT OVER TO YOU
DR. RAJ.
>>THANK YOU.
I WILL GO AHEAD AND START THE
SESSION.
SO I'M EXCITED TODAY TO GET TO
PARTICIPATE IN THIS MEASURE AND
METHODS ON GENDER ISSUES AND
STRUCTURAL SEXISM AND IN
PARTICULAR OUR TOPICS NEAR AND
DEAR TO MY HEART AND I THINK
IT'S VERY EXCITING TO SEE THE
LEVEL OF INTEREST ACROSS THE
FIELD AND AMONG YOU PARTICIPANTS
TODAY.
SO I WILL GIVE BACKGROUND ABOUT
SOME OF THE WORK WE'VE DONE AT
THE CENTER OF GENDER EQUITY AND
HEALTH IN THE AREA OF
MEASUREMENT AND METHOD TO
PROVIDE SOME FRAMING FOR THE
PRESENTATIONS YOU WILL WILL BE
SEEING TODAY.
WE'RE A RESEARCH CENTER AT THE
UNIVERSITY OF CALIFORNIA SAN
DIEGO AND I'M GOING TO TALK A
LITTLE BIT ABOUT WHY MEASURES
AND METHODS MATTER FOR THIS
WORK, HOW DO WE CONCEPTUALLY
CONSIDER EMPOWERMENT IN THE
PROCESS OF MEASURING SEXISM,
GENDER EQUITY, WHAT IS EMERGE
WHICH IS A PLATFORM WE HAVE AND
WHERE DO WE GO FROM HERE AND AT
WHICH POINT I WILL CARRY TO THE
PRESENTERS FOR THE DAY.
OKAY, SO WHY DO MEASURES AND
METHODS MATTER.
SO 1 OF THE KEY REASONS THAT WE
FEEL THAT THIS IS A VERY
IMPORTANT ISSUE IS THAT THERE
IS--THERE IS CONCERNS ABOUT THE
SCIENTIFIC CREDIBILITY OF THE
WORK WE DO AND WITHOUT THAT
CREDIBILITY, WITHOUT THAT
RECOGNIZED CREDIBILITY AND VALUE
FOR OUR WORK, WE CANNOT HAVE
THAT WORK BE USED FOR POLICY AND
PRACTICAL CHANGE.
WE ALSO CANNOT ADVANCE THAT WORK
SCIENTIFICALLY SO IT'S REALLY
IMPORTANT THAT WE ORGANIZE AND
WE'RE ABLE TO EFFECTIVELY SHOW
OUR SCIENCE.
WE ALSO SEE AN OVERRELIANCE ON
GENDER DESEGREGATED DATA GENDER
AND EQUITY BUT NOT NECESSARILY
TAPPING INTO ISSUES SUCH AS
STRUCTURAL SEXISM OR INEQUITABLE
GENDER NORMS.
AND SO THIS REALLY SPEAKS TO THE
FACT THAT WE NEED TO BE TAPPING
INTO THESE EMPOWERMENT
CONSTRUCTS.
AND THEN ON TOP OF THAT, WE HAVE
MANY, MANY GAPS IN THE FIELD
WITH REGARD TO MEASURES THAT WE
AND CONCEPTS, CONSTRUCTS THAT WE
WANT TO MATTER FROM THIS TEXT.
SO IT'S IMPORTANT, TIMELY AND IT
WILL BE EVOLVING AS SOCIETY'S
CHANGE.
NEXT SLIDE.
SO I'M NOT GOING TO GO THROUGH
THIS IN GREAT DETAIL, THERE'S A
POSTER THAT WE HAVE ON THIS BUT
WE DID CREATE AS PART OF OUR
PROCESS, AN EMPHASIS ON WHAT ARE
THE MEASURABLE CONSTRUCTS OF THE
EMPOWERMENT PROCESS WITH A
RECOGNITION THAT EMPOWERMENT IS
BUILT ON THE MISSION OF SOCIAL
HIERARCHYS AND THAT THE PROCESS
OF EMPOWERMENT AND TO MOVE
BEYOND THE HIERARCHICAL
EXPECTATIONS OR RESTRICTIONS OR
BACKLASH FACED BASED ON NORMS
AND THAT THE PROCESS IS AFFECTED
BY BOTH WHAT IS INTERNAL TO THE
INDIVIDUAL OR MOBILIZING GROUP
SEEKING EMPOWERMENT AS WELL AS
EXTERNAL CONTEXT.
DISP WE DID THIS PRIMARILY TO
MAKE SURE WE ARE ABLE TO SUPPORT
RESEARCHERS BROADLY IN THE FIELD
AND WE BELIEVE THAT RESEARCHERS
SHOULD BE EXPANDING AND THINKING
THROUGH THESE YOU KNOW
CONSTRUCTS IN BIGGER AND MORE
CONTEXTUALIZED WAY TO INSURE WE
ARE MEASURING WHAT WE WANT TO
MEASURE TO CAPTURE WHAT
EMPOWERMENT MEANS IN THE LIVES
OF WOMEN AND GIRLS, MEN AND BOYS
FROM DIVERSE BACKGROUNDS AND
EXPERIENCES.
SO WHAT IS EMERGE?
I WILL JUST RAPIDLY SAY THAT
EMERGE IS A PLATFORM THAT WAS
DEVELOPED BY OUR TEAM TO BRING
TOGETHER GENDER EMPOWERMENT
MEASURES.
I WANT TO PROFILE A FEW ASPECTS
OF THAT SO EMERGE IS--WELL, YOU
WILL GET A URL TO BE ABLE TO GET
TO THIS, BUT--IME SORRY, A QR TO
GET TO THIS BUT IT'S BASICALLY
THAT WE HAVE A REPOSITORY OF NOW
OVER 900 MEASURES.
IT'S VISITED BY MORE THAN A
THOUSAND RESEARCHERS AND
IMPLEMENTERS CONDUCTING SURVEY
RESEARCH ON GENDER QUALITY AND
EMPOWERMENT ABOUT A THIRD OF OUR
PEOPLE VISITING WILLING ARE FROM
LMICs, WE HAVE ABOUT 400
REGISTERED USERS AND WE HAVE
READY TO USE MODULES IN A
VARIETY OF GENDER EMPOWERMENT
MEANS WHICH IS LIKE WOMEN'S
ECONOMIC EMPOWERMENT, FAMILY
PLANNING.
THERE IS A NETWORKING ELEMENT OF
THIS AND ULTIMATELY IT IS
DESIGNED TO TAKE THE TYPES OF
SCIENCE WE WILL SEE TODAY AND
MAKE SURE IT IS FREELY AVAILABLE
AND OPEN ACCESS FOR THE WORLD
BECAUSE IT'S REALLY--THIS IS
ROOTED IN THE NOTION OF
DEMOCRATIZING KNOWLEDGE AND
BUILDING A COMMUNITY OF
RESEARCHERS THAT CAN SHARE THE
WORK EFFECTIVELY.
S WHAT DO WE DO?
THE PLATFORM OBVIOUSLY IT'S
DESIGNED TO STRENGTHEN THE
GENDER EMPOWERMENT FOLK UTIONED
MEASURES AND INCREASE THE USE OF
VALIDATED MEASURES THROUGH THIS
AVAILABILITY, BUT ALSO TO
SUPPORT THE DEVELOPMENT AND
IMPROVE DIVERSITY EQUITY AND
INCLUSION OF SURVEY RESEARCHERS
GLOBALLY, SO, 1 OF THE THINGS
THAT I THINK WE'RE REALLY MOVING
THE FIELD FORWARD WITH A LOT OF
THE CONSTRUCTS AND
UNDERSTANDING, BUT WE DEFINITELY
WANT TO BE BUILDING OUT A
BROADER ARRAY OF RESEARCHERS
THAT REPRESENT THE DIVERSE
COMMUNITIES IN WHICH WE WORK.
SO AGAIN, IT WAS DESIGNED TO DO
THIS AND WE HAVE THIS PLATFORM
THAT ALLOWS US TO UNDERSTAND
WHAT WE HAVE AVAILABLE AND WHERE
THE GAPS ARE AND I JUST WANT TO
HIGHLIGHT THIS IS ACTUALLY DATA
DIRECTLY.
WE HAVE A DASHBOARD THAT UPDATES
DAILY AS NEW MEASURES GO IN AND
YOU CAN SEE THE AREAS OF GENDER
EMPOWERMENT MEASURES WHICH HAVE
ADVANCED, AND CAN YOU SEE BASED
ON THAT LIGHTEST LEVEL, WHAT IS
ADVANCED MORE RECENTLY, SO I
WANT TO HIGHLIGHT A COUPLE OF
THINGS FOR YOU WHICH IS SRH IS
REALLY MOVING MNCH IS REALLY
NOT.
ECONOMIC EMPOWERMENT, WE'RE NOT
SEEING IT IN LEGAL AND POLITICAL
ASEMPOWERMENT.
SO TO THAT END WE REALLY WANT TO
HIGHLIGHT THESE GAPS SO THAT WE
CAN SUPPORT RESEARCHERS TO KNOW
HOW THEY CAN FILL GAPS AND MOVE
THE FIELD FORWARD.
SO I'M NOT GOING TO GO THROUGH
THIS BUT JUST TO SAY THAT THIS
IS VERY QUANTITATIVE IN NATURE
AND REALLY WAS FOCUSED ON SURVEY
MEASURES BUT ANYTHING WE DO, I
THINK YOU WILL SEE THIS IN THE
PRESENTATION TODAY WOULD BENEFIT
FROM AN INCLUSION OF CERTAINLY
MORE COMPREHENSIVE MEASURES
AVAILABLE AT SCALE BUT ALSO
TRIANGULATION OF THE SURVEY DATA
WITH ECOLOGICAL DATA AND REALLY
USING THESE DATA TO OFFER MORE
INSIGHT FOR POLICY AS WELL AS
INTERVENTION.
SO I THANK YOU.
THAT'S KIND OF THE FRAMEWORK.
THAT'S THE QR CODE IF YOU WANT
TO JOIN US, WE WOULD EALLY
ENCOURAGE TO YOU BECOME AN
EMERGE MEMBER AND I WANT TO HAND
IT NOW TO TALKING
ABOUT--OOPS--EXCUSE ME 1-SECOND.
TALKING ABOUT WHAT WE WILL HEAR
TODAY SO NOW WE KNOW THERE'S A
LOT OF GAPS, THAT THERE'S NOT
THE HIGHER INCASSULATION, WE
WILL HEAR ABOUT GENDER MEASURES
MARGINALIZATION BASED ON GENDER
AND THE FINDINGS OF THESE
MEASURES IN TERMS OF ASSOCIATION
HELT OUTCOMES--MULTIDIMENSIONAL
MEASURE DESIGNED TO CAPTURE HOW
INTERPERSONAL AND INSTITUTIONAL
ASPECTS OF GENDER ARE
INTERSECTING.
SO I AM VERY PLEASED TO HAND IT
OFF.
YOU CAN SEE THE SPEAKERS HERE
AND I WILL TURN IT OVER TO
DR. MORGAN FELDMAN AND
DR. BETHANY EVERETT, OVER TO YOU
BOTH TO HEAR ABOUT YOUR GREAT
PRESENTATION TODAY.
THANK YOU.
>>WE'RE ACTUALLY STARTING WITH
DR. PILOTE.
, OH, OKAY, SO WE WILL START
WITH DR. PILOTE OF Mc GILL AND
OVER TO YOU DR. PILOTE.%
>>OKAY, SO I GUESS YOU UPLOAD
MY SLIDES?
>>YOU SHOULD SEE AN ARROW ON
YOUR END WHERE YOU CAN ADVANCE
YOUR SLIDES, IF NOT I CAN DO IT
FROM MY END.
>>YEAH, GO AHEAD.
>>OH YES, I SEE IT THERE.
ALL RIGHT, HERE WE ARE.
GOOD AFTERNOON OR GOOD MORNING,
WHEREVER YOU ARE EVERYONE OR
GOOD EVENING.
I AM LOUISE, PILOTE AND I'M A
CLINICIAN SCIENTIST AND CLINICAL
EPIDEMIOLOGIST AND ALSO A
PRACTICING GENERAL INTERNIST AT
THE RESEARCH INSTITUTE AT
Mc GILL UNIVERSITY HEALTH
CENTER AND I'M PLEASED TO BE
INVITED AND TO LISTEN TO ALL MY
COLLEAGUES ABOUT ISSUES OF
MEASUREMENTS AND METHODS AS IT
RELATES TO GENDER.
I HAVE NO CONFLICTS TO DISCLOSE.
SO THE LEARNING OBJECTIVES AND I
THINK MY PIECE IN THERE IS TO
LEARN ABOUT INTEGRATING SEC AND
GENDER RELATED FACTORS IN HEALTH
RESEARCH.
TO LEARN FROM EXAMPLES OF
INTEGRATING GENDER IN
PERSPECTIVE OR RETROSPECTIVE
COHORT STUDIES AND THEN TO LEARN
ABOUT EXAMPLES WHERE GENDER
METHODS WHEN IT COMES TO HEALTH
RELATED OUTCOMES.
SO I'M PRESENTING ON BEHALF OF
THE GOING FORWARD CONSORTIUM
WHICH IS THE CONSORTIUM MADE UP
OF ABOUT 30 INVESTIGATORS ACROSS
5 COUNTRIES AND IT'S VERY
DIVERSE AND VARIOUS GENDER
EXPERTISE AND THEN WE'VE BEEN
REALLY TRYING TO WORK HARD ON
INTEGRATING GENDER AND MEASURING
IT AND THEN TRYING TO FIND ITS
IMPACT ON HEALTH OUTCOMES.
SO OUR OVERARCHING AIM IS TO
INTEGRATE SEX AND GENDER
DIMENSIONS IN APPLIED HEALTH
RESEARCH AND TO EVALUATE THE
IMPACT ON CLINICAL SUBSTANTIVE
OUTCOME AND PATIENT REPORTED
OUTCOME AND THIS IS RELATED TO
NONCOMMUNICABLE DISEASES.
SO WHEN WE FIRST STARTED THIS
WORK, WE HAD 30 COHORTS MADE UP
OF 30 MILLION PATIENTS AND THEN
WE WERE FOCUSING ON 4 MAIN
CLINICAL AREAS, BUT WE
WERE--REALLY FOCUSED AND WANTED
TO REALLY UNDERSTAND HOW WE WERE
GOING TO MEASURE GENDER.
SO I'M GOING TO SHARE THIS
EXPERIENCE WITH YOU AND THIS WAS
ACTUALLY COMMENTED IN A
PUBLICATION FOR METHODS FOR
PERSPECTIVELY INCORPORATING
GENDER AND HEALTH SCIENCE
RESEARCH.
I'M GOING TO SHOW YOU A LITTLE
BIT, THE METHODS IN THERE THAT
ARE SCRIBED AND THEN I WILL SHOW
YOU THE APPLICATION WHICH
ACTUALLY WAS A STUDY IN WHICH
THE METHODS WAS ACTUALLY
INSPIRED.
O WHEN WE THINK ABOUT GENDER
AND GENDER MEASUREMENT, THE
GENDER FACTORS THAT ARE AT THE
INDIVIDUAL LEVELS THAT RELATE TO
GENDER IDENTITY, GENDER ROLES,
AND THEN THERE'S ALSO THE
INTERPERSONAL LEVEL, GENDER
RELATIONS AND THEN WE GO INTO
THE DEFINITION OF THOSE IN THE
COMMUNICATOR BUT THEN THERE'S
ALSO THE POPULATION OF SOCIETAL
LEVELS MEANING INSTITUTIONALIZED
GENDER, SO AN INDIVIDUAL, YOU
KNOW HAS ALL THESE LEVELS OF
GENDER IN THEM AND THE QUESTION
IS WHETHER DEPENDING, YOU KNOW
HOW THIS PERSON IS DESCRIBED OR
LIVES OR IS, WITH ALL THESE
VARIOUS FACETS, HOW THEY LIVE
WITH HEALTH AND DISEASE WHEN IT
COMES.
SO THE FIRST STEP IS REALLY TO
WONDER WHETHER GENDER IS
RELEVANT.
SO IT'S RELEVANT IF IT INVOLVES
UNITS AND IN FACT, MORE AND MORE
NOW WE'RE QUESTIONING WHETHER
IT'S RELEVANT WHEN IT INVOLVES
ANIMALS AND WEALTH, BUT THIS IS
INVOLVED IN THE FIELD.
THEN THE NEXT STEP IS WE NEED TO
WONDER IF WE HAVE A QUESTION,
FOR EXAMPLE, WE'RE INTERESTED IN
SMOKING AND LUNG CANCER.
WE NEED TO WONDER IS IT BIOLOGY
OR GENDER AND WHICH GENDER THE
SCALES MAIN TO THE RELATIONSHIP,
SO IT RELATES TO A QUESTION OF
IDENTITY, ROLES, BEHAVIORS, FOR
EXAMPLE, YOU KNOW THE SMOKING,
THE SOCIAL ASPECTS OF IT, THE
INFLUENCE IT MIGHT HAVE
DEPENDING ON OUR VOWELS IN
SOCIETY, DOES THAT INTERFERE
WITH THE RISK OF DEVELOPING LUNG
CANCER TO POTENTIATE SMOKING.
GENDER RELATIONS ARE THE SAME
WAY, THEY REALLY INVOLVE THE
RELATIONSHIP IN WHICH WE'RE
INTERESTED TO INVESTIGATOR AND
THEN YOU KNOW THE UNEQUAL
DISTRIBUTION OF POWER, RESOURCES
OPPORTUNITIES IN SOCIETY BASED
ON GENDER OF A PERSON.
DOES IT REALLY INFLUENCE THE
ASSOCIATION WE WANT TO STUDY
BETWEEN SMOKING AND CANCER AS AN
EXAMPLE.
SO WHEN WE HAD THE RESEARCH
QUESTION, WE HAVE TO QUESTION
WHETHER THESE FACTORS, YOU KNOW
COME INTO PLAY.
AND THEN, YOU KNOW WE WANT TO BE
MORE SPECIFIC AND THEN IDENTIFY
WHICH VARIABLES MAY ENTER THE
RELATIONSHIP OF INTEREST AND CAN
BE COLLECTED SO, YOU KNOW AGAIN
CONSIDER SPECIFIC GENDER RELATED
VARIABLES THAT ARE RELEVANT TO
THE POPULATION, CONSIDER WHETHER
ANY GENETIC RELATED VARIABLE MAY
DIRECTLY OR INDIRECTLY AFFECT
THE ASSOCIATION AND THEN REALLY
BUILD THE CONCEPTUAL FRAMEWORK
WHERE WE THINK HOW THESE
RELATIONSHIP WILL OCCUR AND THE
[INDISCERNIBLE] WE CALL IT
COMPONENT FACTORS AND MODIFYING
FACTORS AND MODERATING FACTORS.
AND THEN WE GO AND COLLECT.
AND THEN YOU WILL SEE THAT IN
OUR EXPERIENCE, THAT CAN COME UP
WITH A VERY LARGE FACTOR AND
THEN WE MAY WANT TO TRY TO
REDUCE THAT AND DEPENDING
WHETHER WE'RE REALLY INTERESTED
IN SEPARATING THE EFFECT OF
BIOLOGY VERSUS, YOU KNOW THE
KIND OF BIOLOGICAL SEX VERSUS
THE SOCIAL SEX IF YOU LIKE,
GENDER FACTORS IF YOU WANT TO
REMOVE THEM OR NOT AND FINALLY,
YOU COORDINATE THEM INTO
STATISTICAL ANALYSIS AND AS I
SAID BEFORE IT CAN AFFECT THE
OUTCOME, SORE THE MAIN EFFECT
AND THEN WE HAVE TO INVESTIGATOR
MOW THE GENDER OF FACTORS MAY
ACTUALLY MODIFY THE IMPACT OF
[INDISCERNIBLE].
SO FOR EXAMPLE, IF WE'RE LOOKING
AT SEX DIFFERENCES, DOES, YOU
KNOW BEING A PARENT AS A GENDER
RELATED FACTOR AS A GROW FACTOR,
DOES IT REALLY POTENTIATE THE
EFFECT OF SMOKING IN LUNG CANCER
AND THEN THAT SPEAKS TO EXPLORE
INTERACTION TERMS.
SO THIS WAS KIND OF A BRIEF
OVERVIEW OF THE METHODS THAT THE
GOING FORWARD KIND OF DESCRIBE
IN THIS PAPER AND IT WAS BASED
ON THAT STUDY WHERE AS A GROUP A
FEW YEARS AGO, WE WANTED, WE
DEVELOPED A COMPOSITE MEASURE OF
GENDER AND IT'S ASSOCIATED
ASSOCIATION WITH RISK FACTORS IN
MAISHTS WITH MATURITY, BUT I
WANT TO TAKE YOU TO THIS BECAUSE
THIS IS KIND OF THE STRUGGLES
THAT WE HAD WHEN WE WANTED TO
LOOK AT WHETHER, YOU KNOW SEX
DIFFERENCES EXIST IN PATIENTS
WITH THE HEART ATTACK AND THEN
IN TERMS OF THE OUTCOME, WHY IS
IT THAT THE OUTCOME MIGHT BE
DIFFERENT.
AND THAT CAME, ACTUALLY I'M A
CLINICIAN AND I SAW A 34
YEAR-OLD WOMEN IN THE CLINIC WHO
SUFFERED FROM A HEART ATTACK AND
THEN AFTER THAT HER QUALITY OF
LIFE AND HER PSYCHOLOGICAL
RESPONSE WERE REALLY DRAMATIC.
SHE HAD NOT COME OUT OF HER
HOUSE FOR 2 YEARS BECAUSE SHE
WAS AFRAID THAT YOU KNOW SHE
WOULD DIE AWAY FROM HER
CHILDREN.
SO I WAS REALLY SURPRISED THAT%
YOU KNOW SHE WOULD HAVE A HEART
ATTACK AT THE YOUNG AGE BUT THEN
I WAS ALSO IMPACTED BY HER
PSYCHOLOGY RESPONSE.
SO WHAT WERE THE FACTORS THAT
WERE BUILDING THAT?
SO WE BUILD THIS CONCEPTUAL
FRAMEWORK THAT IS MADE UP OF
RISK FACTORS, SOCIOLOGICAL
DEMOGRAPHIC FACTORS, SOME
BIOLOGICAL FACTORS THAT MAY
AFFECT THE PRESENTATION IN YOUNG
PEOPLE, BUT ALSO HAD THE
BIOMEDICAL FACTORS, PSYCHOSOCIAL
FACTORS AND INSTITUTIONAL
RESPONSE MAY ALSO AFFECT THE
OUTCOME.
SO, THEN, YOU KNOW WE WANTED TO
SEE HOW WE COULD MEASURE THAT IN
A COHORT OF PATIENTS THAT
SUFFERED A HEART ATTACK IN
CANADA, 1500 AND SO PATIENTS AND
THEN WE'RE WONDERING HOW WE WILL
MEASURE GENDER, WHAT IS GENDER.
SO I SPOKE TO YOU BEFORE ABOUT
THE CONSTRUCT OF GENDER THAT WE
ACTUALLY MODELED OURSELVES AS,
SO THE ROLES, IDENTITY,
RELATIONS, IN GENDER AND THEN WE
WENT FOR THESE FACTORS AND WE
WENT WITH THE LITERATURE AND
SAID, OKAY, LET'S IDENTIFY SOME
OF THESE FACTORS, YOU KNOW SOME
OF THESE MEASURES AND I GIVE YOU
SOME EXAMPLES, LATER ON, THAT
HAVE BEEN SHOWN TO BE DIFFERENT
BETWEEN MALE AND FEMALES.
IN TERMS OF THEIR PREVALENCE BUT
HAVE BEEN SHOWN AT LEAST IN THE
LITERATURE TO HAVE HAD SOME--A
DIFFERENT IMPACT IN TERMS OF THE
MAGNITUDE.
SO THERE WAS KIENTD OF AN
INTERACTION BETWEEN THOSE
FACTORS.
AND YOU KNOW BEING A MALE OR
FEMALE IN TERMS OF THE
ASSOCIATION OF THE OUTCOMES.
SO THAT'S HOW WE SORT OF
SELECTED THOSE FACTORS SO FOR
GENDER ROLES, YOU KNOW THIS IS A
LIST OF FACTORS THAT WE ACTUALLY
MEASURED AND WE USE THE ALREADY
VALIDATED SCALES AND THEN FOR
GENDER IDENTITY WE USE THE BEM
SCALE WHICH IS VERY
CONTROVERSIAL BUT WHEN YOU LOOK
AT THAT, IT IS MEASURING A LOT
OF PERSONAL ATTRIBUTES THAT ARE
ADDITIONALLY DESCRIBED TO MALES
OR FEMALES BUT THAT IS A WAY OF
MEASURES ATTRIBUTES IN TERMS OF
LIKE COMPETITIVENESS AND YOU
KNOW ATTRIBUTES LIKE THAT THAT
ARE SOMEWHAT GENDERED AND THEN,
YOU KNOW OTHER FACTORS THAT ARE
ALSO RELATED TO IDENTITIES, AND
THEN WE MEASURED GENDER
RELATIONS ON THIS, I'M LISTING
THEM HERE AND THEN SOME
INSTITUTIONAL GENDER LIKE
PERSONAL INCOME AND LEVEL OF
EDUCATION, THEY ARE THOUGHT
ABOUT BEING SOCIOECONOMIC STATUS
BUT THEY REALLY ARE GENDERED,
YOU KNOW CONSTRUCTS IN OUR
SOCIETY AS ANITA JUST DESCRIBED
TO US PREVIOUSLY.
SO WE HAVE ALL THESE FACTORS AND
THERE WERE MANY, MANY AND THE
OUTCOMES, FOR EXAMPLE MORTALITY
IN THIS YOUNG POPULATION IS NOT
THAT HIGH, SO WE RAN A PRINCIPLE
COMPONENT ANALYSIS TO REALLY
IDENTIFY THE FACTORS THAT
EXPLAIN THE VARIATION MODES AND
THEN WITH THESE REMAINING
FACTOR, WE REDUCE EVEN MORE IN
HERE, AND WE RAN A LOGISTIC
REGRESSION WHERE WE PUT SEX AS A
DEPENDENT VARIABLE, AND THESE
ARE THE FACTORS OF ALL THE 34
GENDER RELATED FACTORS WE HAD
INITIALLY THAT REMAIN TO BE
ASSOCIATED WITH BEING A MALE OR
FEMALE AND AGAIN, YOU KNOW--IN
THAT, YOU KNOW REPORT THAGOREAN
YOU'RE MALE OR FEMALE, IN THAT,
YOU KNOW THERE'S IDENT I
RELATIONS AND ALL THAT, SO THIS
WAS THE CLOSEST MEASURE THAT WE
HAD OF GENDER, YOU KNOW RECEIVED
THE VARIOUS RISK FACTORS ARE
ASSOCIATE WIDE GENDER.
BUT THAT GIVES US A COLLECTION
ESTIMATE AND THEN WE WERE--WE
WERE CURIOUS TO SEE IF WE PUT
EVERYTHING TOGETHER, CAN
WE--[INDISCERNIBLE] SCORE.
SO IN FACT, YOU KNOW WE DESIGN A
SCORE AND THEN IT WENT FROM A 0
TO HUNDRED WHERE 0 IS THE NUMBER
THAT TYPICALLY ASCRIBED TO BEING
MALE, ALTHOUGH IT'S NOT SEX
SPECIFIC NECESSARILY AS WE CAN
SEE HERE AND THEN A HUNDRED, YOU
KNOW WAS THE OPPOSITE DIRECTION
AND SO IN THAT POPULATION AS YOU
CAN SEE, THE KIND OF GENDER
ROLE, YOU KNOW, RELATIONS AND
THE GENDER, THE SPECIFIC
COMPONENTS OF THE FACTORS WE HAD
MEASURED, FOR THE WOMEN, YOU
KNOW IT WAS QUITE A--YOU KNOW
WIDE SPREAD DISTRIBUTION WHERE
FROM MALES IT'S A BIT MORE
SKEWED TO THE LEFT AND THEN
WE'VE SINCE DONE THIS WITH OTHER
POPULATION AND IT'S NOT
SURPRISING THAT DEPENDING ON THE
AGE OF THE POPULATION THAT YOU
ARE STUDYING, YOU KNOW IT IS
SOMETHING THAT FLUCTUATES BUT
THE IDEA FOR US TO HAVE A STORY
THAT WE REALLY WANTED TO
DISASSOCIATEIATE AS MUCH AS
POSSIBLE BIOLOGY IF YOU LIKE
FROM SOCIOLOGY, SO THEN WE COULD
ACTUALLY LOOK AT WHAT IS
PREDICTING OUTCOMES AFTER ACUTE
CORONARY SYNDROME BUT FIRST AND
FOREMOST ALSO WHAT IS PREDICTING
ADDITIONAL RISK FACTORS.
SO THESE ARE RISK FACTORS FOR
HEART DISEASE AND LET'S JUST SAY
HYPERTENSION AS AN EXAMPLE F. WE
HAVE A MODEL WE JUST HAVE THE
CORE, ASSOCIATED WITH THE HIGHER
RISK OF HYPERTENSION, IF YOU
HAVE FEMALE, IT IS IN THE YOUNG
POPULATION, BUT IF WE DO A
MULTIVARIANT MODEL WHERE WE HAVE
THE GENDER SCORE HERE ADJUSTING%
FOR SEX, YOU KNOW THE GENDER
SCORE REMAINS ASSOCIATED WITH
THE HIGHER RISK OF HYPERTENSION
WHEREAS, YOU KNOW THE SEX
[INDISCERNIBLE] SO SUGGESTING
WHEN YOU LOOK AT MALES AND
FEMALES SEPARATELY THE RISK OF
HYPERTENSION IS CERTAINLY VERY
MUCH RELATED TO THE GENDERED
FACT ORPS THAT THE PERSON WAS
EXPOSED TO OR GENDER IDENTITY IN
THE ROLES AND SO ON.
PROBABLY MORE SO THAN BIOLOGY.
SO THEN IN TERMS OF OUTCOME WE
WANT TO LOOK AT THE RISK OF
HAVING A RECURRENT ADMISSION,
AND IF YOU ONLY LOOK AT MEN AND
WOMEN, THERE WERE NO DIFFERENCES
BUT IF YOU ADD THE THIRD TIE OF
THE GENDER, THEN YOU HAD THE
THIRD SCORE OF HAVING ATTRIBUTES
AND ROLE AND RELATIONSHIP AND
THIS IS MORE TO WOMEN IN
SOCIETY, THE RISK WAS INCREASED
AND THEN IF YOU LOOK AT THE
MULTIVARIANT EQUATION, YOU KNOW
AGAIN, INDEPENDENT OF SEX, THE
RISK OF HAVING A SECOND EVENT,
ANOTHER HEART ATTACK AFTER FIRST
1 WAS MUCH HIGHER IF YOU HAD A
FEMININE GENDER SCORE.
INDEPENDENT OF OTHER RISK
FACTORS, ACTUAL LYE.
SO PEOPLE HAVE QUESTION JUDGE A
SCORE OR WHY NOT INDEPENDENT
FACTORS?
SO DEPENDING ON YOUR QUESTION,
AND DEPENDING ALSO ON THE
FREQUENCY OF EVENTS, YOU KNOW
YOU CANNOT ALWAYS LOOK AT, YOU
KNOW A PANOPLY OF GENDER RELATED
FACTORS.
SO HERE WE LOOK AT THE
ASSOCIATION BETWEEN THOSE
FACTDORS AND RECEIVING A
PRECEDURE AFTER AN INFARCT, AND
THEN WE LOOK AT GENDER RELATED%
FACTORS BECAUSE THESE GENDERS
ARE RECEIVING MUCH MORE COMMON
IN THE POPULATION AND WE FOUND
THAT SOME FACTORS FOR EXAMPLE,
RESPONSIBILITY FOR HOUSE WORK,
BE IT MAN OR WOMAN, YOU WERE
MUCH LESS LIKELY TO HAVE A
CARDIAC CATHETERIZATION AND THEN
TO HAVE ANOTHER PCI AFTER THE
EVENT.
AND THEN IN TERMS OF THE
PERSONALITY ATTRIBUTE, IT'S
INTERESTING ALSO, MAYBE YOU'RE
AGGRESSIVENESS OR LACK THEREOF
WAS ASSOCIATED WITH HAVING MORE
OR LESS LIKELY TO RECEIVE A
NONPRIMARY DCI AFTER THE
INFARCT.
SO THIS WAS AN EXAMPLE OF HOW WE
ACTUALLY DESIGNED THE STUDY AND
HOW WE WENT ABOUT, YOU KNOW
MEASURING GENDER AND THEN HOW WE
WENT ABOUT, YOU KNOW TESTING THE
ASSOCIATION WITH THE OUTCOME,
YOU KNOW WHILE, YOU KNOW
DISASSOCIATING THE SEX OF THE
PERSON.
SO NEXT, YOU KNOW WE WANTED TO
ACTUALLY SEE, YOU KNOW HOW WE
COULD ACTUALLY, YOU KNOW LOOK AT
THE EECT OF GENDER FACTOR IN
RETROSPECTIVE COHORT STUDIES, WE
HAVE TONS OF DATA, TONS OF
POPULATION BASED COHORTS, TONS
OF BIOLINKS.
THERE'S TONS OF COHORT THAT ARE
MADE AVAILABLE.
AND PEOPLE SAY YEAH BUT THEY
DIDN'T MEASURE GENDER.
AND THEN GOING FORWARD
CONSORTIUM WE WILL PUT ALL THOSE
COHORTS TOGETHER AND LOOK AT THE
EFFECT OF GENDER SO WE WANTED TO
HAVE A FRAMEWORK FOR DOING SO.
AND YOU KNOW GENDER,
UNFORTUNATELY, IS NOT ALWAYS
MEASURED BUT YOU KNOW SOMETIMES
IT'S NOT CALLED GENDER BUT
THEY'RE GENDER RELATED FACTORS
THAT ARE ACTUALLY MEASURED.
SO THE FIRST THING THAT WE DID
WAS WE--WE KIND OF CREATED THE
WISH LIST OF, YOU KNOW A BROAD
LIST OF GENDER RELATED FACTORS
THAT PEOPLE COULD LOOK FOR WHEN
THEY HAVE, YOU KNOW A COHORT
THAT THEY HAVE ACCESS TOO AND
THESE WERE AGAIN, YOU KNOW IN
RELATIONSHIP WITH THE 4
CONSTRUCT OF GENDER MEASUREMENT
THAT I DESCRIBED BEFORE.
AND THEN OF COURSE, YOU KNOW,
THE SECOND STEP IS THE
DEFINITION OF OUTCOMES OF
INTEREST, AND AGAIN FYOU ARE
GOING TO DO A STUDY, THIS IS THE
HYPOTHESIS DRIVEN APPROACH THAT
CERTAIN GENERATED FACTORS WOULD
BE ASSOCIATE WIDE OUTCOME AND
THEN YOU WOULD CHOOSE THOSE IN
FUNCTIONAL CANNED WHAT.
AND THEN YOU BUILD A FINAL LIST
OF VARIABLE AND THEN OF COURSE
GENDER FOR VARIOUS JURISDICTION.
THEN YOU KNOW WE TO HARMONIZE
THE VARIABILITY THE RULE GOING
FORWARD WAS TO SAY, THERE
ARE--YOU KNOW THERE'S SEVERAL
DIFFERENCES, HOW DO WE EXPLAIN
SEX DIFFERENCES WITH THE GENDER
FACTORS BUT THE MAGNITUDE OF THE
FACTORS DOES IT DEFER TO WHERE
YOU LIVE, SO THAT REQUIRED
MERGING VARIOUS COHORTS FROM
VARIOUS COUNTRIES.
SO THAT WENT--THEN THIS IS SOME
OF THE COHORTS WE HAVE
AVAILABLE, AND THEN IN THE
MIDDLE HERE--IN LISTED HERE ARE
ALL KIND OF GENDER RELATED
FACTORS AND THEN, AND THEN THIS
IS KIND OF THE WISH LIST AND
THEN WE WENT WENT INTO THE
VARIOUS DATABASES TO SEE WHAT
WAS MEASURED AND THEN
[INDISCERNIBLE].
SO JUST TO FINISH, I WANT TOIVE
GO YOU AN EXAMPLE OF THE LOOKING
AT AN EXISTING DATABASE, THIS IS
THE UK BIOBANK AND WE LOOK AT
THE IMPORTANCE OF SEX AND GENDER
FACTORS IN COVID INFECTION.
AT THAT TIME, THERE WAS NO SEX
DATA AND NO 1 WAS LOOKING AT
GENDER.
SO THE UK BIOBANK IS A LARGE
COHORT, 500,000 PATIENTS AND
THEY LINK THE COHORT WITH THE
TEST RESULT FOR COVID.
ASK JUST QUICKLY, I'M SHOWING
YOU HOW WE HAD ACCESS TO ABOUT
1300 COVID POSITIVE PEOPLE AND
3100 COVID NEGATIVE PEOPLE AND
THEN WE LOOKED AT YOU KNOW
VARIOUS FACTORS RELATED
INCLUDING GENDER RELATED
VARIABLES, AND WE DID THIS TO
SPECIFY ANALYSIS AND WE LOOK AT
MACHINE LEARNING, SIDE MACHINE
LEARNING FOR THE BEST MODEL AND
JUST TO SHOW THAT YOU KNOW WHEN
YOU DO SEX CLASSIFIED DAT WE
FIND THAT MAJOR FACTORS
ASSOCIATED WITH INFECTION WERE
MORE GENDER RELATED FOR FEMALES
AND MORE BIOLOGICAL RELATED FOR
MALES, AND THIS WAS IMPORTANT AT
THE TIME BECAUSE IT KIND OF GAVE
GUIDANCE IN TERMS OF VACCINATION
PRIORITIES WHICH WERE MADE
BIOLOGICALLY MALE
[INDISCERNIBLE] BUT THROUGH THE
PANDEMIC PEOPLE STARTED TO LACK
AT [INDISCERNIBLE], AND INCOME
AND WHERE PEOPLE LIVE AND
POVERTY AND TO LOOK AT THOSE
GROUPS.
SO JUST TO CLOSE, INTEGRATING
SEX AND GENDER RELATED FACTORS
IN HEALTH RESEARCH UNDERSTANDING
OF FACTORS AND MEASURE GENDER
ROLES RELATIONS AND IDENT AND
INSTITUTIONALIZED GENDER.
A HYPOTHESIS DRIVEN APPROACH IS
IMPORTANT.
WE SHOWED THAT YOU THAT OUTCOME
IN YOUNG PEOPLE WITH HEART
DISEASE AND REALLY GENDER
DEPENDENT AND THEN IN COVID AS
WELL, THE GENDER MATTERED FOR
FEMALES WHEREAS BIOLOGY WAS MORE
IMPORTANT FOR MALES IN TERMS OF
RISK OF INFECTION.
SO I THINK I'M OUT OF TIME.
BUT I'M GOING TO LIVE YOU WITH
THIS MEET THE METHODS SERIES
THAT YOU CAN LOOK UP ON THE CHR
WEBSITE TO GET MORE INFORMATION
ON THE METHODS THAT WE HAVE
FOLLOWED AND THAT I PRESENTED
TODAY.
THANK YOU.
>>THANK YOU THAT WAS EXCELLENT,
WE WILL GO TO OUR NEXT SPEAKERS
NOW WHICH I BELIEVE WILL BE
DR. --NO IT'S SCHIEBINGER AND
NEILSEN.
>>I'M SORROW, I DON'T KNOW HOW
I GOT THIS WRONG, I WON'T GAMBLE
I WILL SAY THAT, DR. SCHIEBINGER
AND NEILSEN WILL PRESENT ON HOW
PERSONAL AND INTERPERSONAL
ASPECTS OF GENDER INTERSECT.
THEY CALL IT THE GASV MEASURE.
OKAY, THANK YOU AND OVER TO YOU
COLLEAGUES.
>>THANK YOU VERY MUCH.
AND I WANT TO THANK OUR NIH
HOSTS FOR JUST A MARVELOUS
MEETING.
IT'S BEEN A MARVELOUS DAY AND
I'M HOPING FOR EVEN MORE IN THE
FITTURE.
SO I DIRECTED THE GENDER--I'M
LONDA SCHIEBINGER, AND I AM
PRESENTING WITH DR. NEILSEN.
THIS WAS PRODUCED THROUGH A
LARGE INTERNATIONAL
COLLABORATION INVOLVING THE
EUROPEAN UNION, THE U.S.
NATIONAL SCIENCE FOUNDATION, AND
STANFORD UNIVERSITY AND THE WORK
THAT MATHIAS AND I ARE
PRESENTING TODAY IS PART OF THIS
LARGER PROJECT.
SO TODAY, WE ARE REPORTING--SEE
IF I CAN GET THE SLIDES.
WHOA, NOW I HAVE TOO MANY
SLIDES.
THERE WE ARE, TODAY WE ARE
REPORTING ON OUR 2021 PAPER
GENDER RELATED VARIABLES FOR
HEALTH RESEARCH.
THIS WORK WAS DEVELOPED THROUGH
AN INTERDISCIPLINARY
INTERNATIONAL TEAM FROM THE
U.S., CANADA, EUROPE AND SOUTH
KOREA.
AND OUR INSTRUMENT SEEKS TO
DEVELOP THEORETICALLY ROBUST
GENDER RELATED VARIABLES FOR USE
IN CLINICAL AND POPULATION
RESEARCH INCLUDING LARGE SCALE
HEALTH SURVEYS, AND IT'S GEARED
TOWARD WESTERN POPULATIONS,
ALTHOUGH IT HAS BEEN TRIED ALSO
IN SOUTH KOREA.
ACCORDING TO THE NIH AS YOU
KNOW, BOTH SEX AND GENDER PLAY A
ROLE IN HEALTH AND DISEASE.
IN JANUARY 2016 THE NIH MANDATED
SEX AS A BIOLOGICAL VARIABLE
WHERE RELEVANT AND IN PUBLICLY
FUNDED RESEARCH AND IN THIS
PAPER WE ARGUE FOR GENDER AS A
SOCIOLOGICAL CULTURAL
VARIATIONSIABLE IN HUMAN
RESEARCH TO COMPLEMENT SABV.
SO WELL AHEAD OF THE NIH THE
CANADIAN INSTITUTES OF HEALTH
RESEARCH HAVE CALLED EXPLICITLY
FOR BOTH SEX AND GENDER ANALYSIS
SINCE 2010 AND THE EUROPEAN
COMMISSION SINCE 2020 REQUIRES
SEX, GENDER AND INTERSECTIONAL
ANALYSIS IN ALL PUBLICLY FUNDED
RESEARCH WHERE RELEVANT.
FUNDING AGENCIES EXPECT NEEZ
EFFORTS TO INCREASE THE PACE OF
NEW DISCOVERIES, DIMINISH AREAS
OF EXTRAPOLATION AND MITIGATE
DIVERSE EVENTS IN THE PIPELINE.
OUR INSTRUMENTS IS DESIGNED TO
SHED LIGHT ON HOW SPECIFIC
GENDER RELATED BEHAVIORS AND
ATTITUDES CONTRIBUTE TO HEALTH
AND DISEASE PROSASSESSESS
IRRESPECTIVE OF OR IN ADDITION
TO GENDER AND SEX IDENTITY.
USE OF THESE VARIABLES SUCH AS
CLINICAL TRIALS MAY HELP US
UNDERSTAND IF GENDER PLAYS A
SIGNIFICANT ROLE AS TREATMENT
EFFECT MODIFIERS WHICH MAY NEED
TO BE FACTORED INTO THE
TREATMENT DECISION MAKING.
SO WE DESIGNED OUR STUDY TO
CAPTURE 3 DIMENSIONS OF GENDER
AND THESE ARE QUICKLY GENDER
NORMS.
THESE ARE THE UNSPOKEN CULTURAL
RULES THAT SILENTLY AND AT TIMES
NOT SO SILENTLY POLICE BEHAVIOR.
GENDER NORM THOSE THINGS THAT
PRESS IN ON PEOPLE ARE PRODUCED
THROUGH INSTITUTIONS SUCH AS THE
WORKPLACE, THE FAMILY,
INSTITUTIONAL POLICIES, STATE
AND FEDERAL LAW, NATIONAL AND
GLOBAL CULTURES.
SO THESE NORMS INFLUENCE THE
HEALTH THEN OF INDIVIDUALS.
THE NEXT IS GENDER RELATED
TRAITS AND THIS REFERS TO HOW
INDIVIDUALS AND GROUPS PERCEIVE
AND PRESENT THEMSELVES AND HOW
THEY ARE PERCEIVED BY OTHERS.
GENDER RELATED TRAITS ARE
CULTURE AND CONTEXT SPECIFIC AND
THEY CHANGE OVER TIME.
AND THEN THIRDLY, WE DO GENDER
RELATIONS, THIS REFERS TO THE
SOCIAL RELATIONS BETWEEN
INDIVIDUALS WITH DIFFERENT
GENDER IDENTITIES OR GENDER
RELATED TRAITS.
WELL, METHODS FOR ANALYZING SEX
ARE INCREASINGLY WELL
UNDERSTOOD, METHODS FOR
ANALYZING GENDER ARE NOT, MUCH
EXCELLENT LITERATURE HAS BROADLY
EXAMINED GENDER AND HEALTH BUT
WE LACK SYSTEMATIC MEASURES AND
METHODS FOR ASSESSING HOW GENDER
RELATES TO HEALTH.
THERE EXISTS NO GOLD STANDARD
FOR GENDER AND I TAKE THAT TO BE
1 OF THE PURPOSES OF THIS
MEETING.
THIS IS PRECISELY WHAT WE WERE
HOPING TO CONTRIBUTE TO WITH
THIS PAPER.
SO INSTRUMENTS TO MEASURE GENDER
ABOUND.
THERE IS NO SHORTAGE.
WHAT WE'RE CONCERNED ABOUT IS
THAT PIs TAKE INSTRUMENTS OFF
THE SHELF TO PLUG INTO THEIR
CLINICAL TRIALS.
MANY OF THESE INSTRUMENTS ARE
OUTDATED AND LIKELY TO LEAD TO
ERRONEOUS CONCLUSION, 1
POPPAULAR INSTRUMENT IS THIS BEM
SEX ROLE INVENTORY FROM 1974 AND
I WILL SAY A BIT MORE ON THAT IN
A MINUTE.
SO IMPORTANTLY, OUR INTEREST WAS
PIQUED BY A 2007 PAPER THAT
REPORT THAD MEN WITH HIGHER
FEMININITY SCORES HAVE HAD LOWER
RISKS FOR CARDIO--FOR CORONARY
HEART DISEASE AND ALSO BY
DR. PILOTES, CANADIAN STUDY IN
2015 WHICH WAS WHEN WE STARTED
IT SHOULD JUST BEEN PUBLISHED
AND YOU JUST HEARD ABOUT IT, IT
WAS VERY INSPIRNG AND IT TOOK
US MANY YEARS TO DEVELOP OUR
WORK AS WELL.
SO WE WERE INTERESTED IN HOW THE
STUDY REDUCED GENDER TO THESE
BIPOLAR SCORES DERIVED FROM 7
RELEVANT FACTORS SHOWN HERE AND
THEN YIELDED A GENDER SCORE ON A
SPECTRUM FROM FEMININITY TO
MASKUE LYNNITY AS YOU HEARD.
AND SO, 1 PROBLEM HERE IS THAT
SEVERAL OF THE MEASURES USED IN
THE STUDY ARE NO LONGER VALID
AND SPECIFICALLY THIS BEM SEX
ROLE INVENTORY WAS DEVELOPED
HERE AT STANFORD WHERE I'VE BEEN
TEACHING FOR 18IERS.
IT WAS DEVELOPED IN 1974 WHEN
THE STUDENT POPULATION WAS
PREDOMINANTLY WHITE, WEALTHY,
AND HIGHLY ATHLETIC.
WE SEND STUDENTS REGULARLY TO
THE OLYMPICS SO WE CONSIDERED
THIS MEASURE NUMBER 1
UNREPRESENTATIVE AND NUMBER 2
REALLY VERY MUCH OUT OF DATE.
AND SECONDLY IN OUR VIEW,
REDUCING GENDER TO MASKUE
LYNNITY AND FEMININITY AND
NONCONFORMITY IS NOT KD--SALLY
ENOUGH TO PROMOTE WHAT SPECIFIC
MEASURES PROMOTE OR HARM HEALTH.
SO INSPIRED BY THESE STUDIES WE
AT STANFORD LAUNCHED A NEW STUDY
AND OUR INNOVATIVE APPROACH
MOVES BEYOND BINARY NOTIONS OF
MASKUE LYNNITY AND FEMININITY, I
WOULD LIKE TO GET RID OF THOSE
CULTURAL BOXES ALTOGETHER, AND
WE DO THIS BY CAPTURING
VARIABLES THAT CAPTURE SPECIFIC
SOCIAL BEHAVIORS RELATED TO
GENDER.
AND NUMBER 2 OUR OPROACH
CAPTURES 3 DIMENSIONS OF GENDER
NORMS, RELATED TRAITS AND
RELATIONS THAT I DISCUSSED
EARLIER AND 3, WE ADOPT A
MULTIDIMENSIONAL UNDERSTANDING
THAT SEEKS TO CAPTURE HOW
INTERPERSONAL AND INTRA PERSONAL
INSTITUTIONAL ASPECTS OF GENDER
INTERSECT TO SHAPE A PERSON'S
HEALTH AND ILLNESS AND IN THIS
APPROACH WE THINK FOR THAT
STATISTIC.
NUMBER 2, EACH VARIABLE CAN BE
CORRELATED WITH SEX SOC YEE
ECONOMIC STANDING SUCH AS
EDUCATIONAL BACKGROUND, INCOME,
PHYSICAL CHARACTERISTICS SUCH AS
BODY MASS INDEX, AND OTHER
SOCIAL DETERMINANTS OF HEALTH.
AND NUMBER 3, THESE GENDER
RELATED VARIABLES CAN ALSO BE
CORRELATE WIDE OTHER BEHAVIORS,
OFTEN COLLECTED IN OTHER DATA
SETS SUCH AS LEVELS OF EXERCISE,
SMOKING BEHAVIORS, AND DIET.
SO I NOW TURN IT OVER TO
DR. NEILSEN.
>>THANK YOU LONDA, WE STARTED
IN 15 AS LONDA MENTIONED WITH A
SYSTEMATIC SEARCH FROM 1975-2015
WHERE WE REVIEWED NEARLY 3000
ARTICLES AND NUMEROUS BOOKS TO
CONSTRUCT A COMPREHENSIVE LIST
OF TYPICAL GENDER
CHARACTERISTICS THAT WE USED IN
PREVIOUS STUDIES.
AND IN DEVELOPING OUR PROPOSED
LIST OF GENDER RELATED
VARIABLES, WE COLLECTED ALL
TRAITS AND CHARACTERISTICS USED
TO MEASURE GENDER IN 74 EXISTING
SCALES.
THREE SCALES CAPTURED DIFFERENT
ASPECT OF GENDER NORMS, 31
SCALES CAPTURED 31 ASPECTS
GENDER RELATED STRAIGHTS AND 40
SCALES CAPTURED ASPECTS OF
GENDER RELATIONS.
SO THIS PROCESS YIELDED 11
GENDER RELATED VARIABLES AND OUR
IDEA WAS THAT EACH BEHAVIOR
SHOULD BE SCORED ON HIS OWN AND
WE MEASURED EACH WITH
APPROXIMATELY 3-5 ITEMS.
AND THE CONTENT VALIDITY OF THE
QUESTIONNAIRE WAS EXPRESSED BY A
PANEL OF EXPERTS INCLUDING
LOUISE THAT PRESENTED EARLIER
AND WE ALSO CARRIED OUT
COGNITIVE INTERVIEWS WITH ON
SOCIOLOGICAL DEMOGRAPHIC
VARIABLES.
AND BETWEEN MAY 2017-JANUARY 18,
WE RAN THE QUESTIONNAIRE IN 3
U.S. SAMPLES.
PARTICIPANTS WERE RECRUITED
THROUGH SURVEY ONLINE PLATFORMS,
MODEL CITIZEN LITHIC AND
MECHANICAL AND THEN WE USED A
REGISTRY THROUGH THE STANFORD
HOSPITAL.
SO LET ME BRIEFLY SHOW YOU THE
SAMPLE CHARACTERISTICS HERE.
OUR SAMPLES I WOULD SAY ARE LESS
DIVERSE IN TERMS OF ETHNICITY
THAN THE U.S. GENERAL
POPULATION, SAMPLE 1 IS SOMEWHAT
YOUNGER THAN THE GENERAL U.S.
POPULATION AND SAMPLES 2 AND 3
ARE A BIT OLDER AND IF WE LOOK
AT THE STANFORD REGISTRY,
ESPECIALLY IT'S IMPORTANT TO
NOTE THAT THE EDUCATIONAL
ATTAINMENT HERE IS LARGER THAN
IN THE 2 OTHER SAMPLES.
IN THE SURVEYS WE ALSO ASKED
ABOUT BIRTH, SEX, SELF-REPORTED
GENDER AND SEXUAL ORIENTATION
AND THE SAMPLES HAD GOOD BALANCE
ON THESE MATTERS BUT VERY FEW,
USED THE RESPONSE OPTIONS FOR
GENDER, SEX AND FLUIDITY.
SELF-SPECIFIED GENDER CATEGORIES
IN OUR DATA COLLECTION HERE.
SO SINCE WE WANT TO DEVELOP A
MESSAGE HERE WE INTENDED TO SORT
OF TRIM THE QUESTIONNAIRE AND
CLARIFY THE UNDERLYING
RELATIONSHIPS BETWEEN THE ITEMS
THAT WERE DEVELOPED TO CAPTURE
OUR 11 GENDER VARIABLES AND FOR
THAT PURPOSE WE USED EXPLORATORY
FACTOR ANALYSIS FIRST OF ALL SO
WE EXAMINE 45 ITEMS CONCERNS
GENDER NORMS, GENDER RELATED
TRAITS AND GENDER RELATIONS IN A
JOINT FACTOR STRUCTURE AND WE
FOUND AN OPTIMAL FACTOR SOLUTION
THAT CONSISTED OF 35 ITEMS
DISTRIBUTED ON 7 FACTORS.
SO, NEXT WE SUBMITTED THE ITEMS
RETAINED IN THIS EXPLORATORY
FACTOR ANALYSIS TO CONFIRMAT ORY
FACTOR ANALYSIS AND FURTHER TRIM
SOLUTION OF 25 ITEMS EXHIBITED
GOOD FIT TO THE DATA IN OUR
FIRST SAMPLE AND WE CROSS
VALIDATED IT, IN THE 2 OTHER
SAMPLES WHERE WE ALSO FOUND GOOD
FIT TO THE DATA.
SO THROUGH EXPLORATORY AND
CONFIRMATORY ANALYSIS, WE END UP
WITH--WE END UP WITH 2 FACTORS
THAT CAPTURE GENDER NORMS THAT'S
CAREGIVER STRAIN AND WORK
STRAIN.
WE HAVE 3 FACTORS THAT KACCT
TININE PATHWAY UPPER GENDER
RELATED TRAITS, THAT WOULD BE
RISK TAKING, EMOTIONAL
INTELLIGENCE AND INDEPENDENCE.
AND FINALLY 2 FACTORS THAT
CAPTURE GENDER RELATIONS AND
THOSE ARE SOCIAL SUPPORT AND
DISCRIMINATION.
AND HERE YOU SEE SOME SAMPLE
ITESTIMONIES FROM EACH OF THESE
DIFFERENT FACTORS.
SO WE USE RAYKOV'S POLE FOR
CONSISTENCY OF EACH FACTOR, YOU
MAY [INDISCERNIBLE] THE ALPHA AS
A SIMILAR WAY OF LOOKINGA THE
THIS SO IF YOU HAVE A ROLE OF
0.7 IT'S CONSIDERED ACCEPTABLE
AND WE HAVE 6 FACTORS THAT ARE
CONSIDERED GOOD OR ACCEPTABLE
CATEGORS AND THEN BELOW THOSE IS
AND THAT INDICATES THAT WORK
NEEDS TO BE ON DONE ON THIS
PARTICULAR MEASURE.
SO NEXT WE EXAMINE THE RELEVANCE
OF THE GENDER RELATED VARIABLES,
SORT OF IN ALLOWING FOR MORE
FINE GRAINED ANALYSIS OF
DIFFERENCES IN SELF-REPORTED
HEALTH CHARACTERISTICS AND TO DO
THIS, WE CALCULATE MEAN ITEM
SCORES FOR EACH OF THE FACTORS
AND WE USE THEM AS PREDICTORS IN
REGRESSION MODELS AND SOME OF
THE ASSOCIATIONS WITH HEALTH
OUTCOMES THAT WE ASSESS HERE
ISSUE MEASURED WITH NEGATIVE BI
NOAMIA REGRESSIONS AND OTHERS
ARE MEASURED WITH LOGISTIC
REGRESSIONS.
SO, WE CARRIED OUT REGRESSION
ANALYSIS FOR EACH SAMPLE
SEPARATELY, BUT HERE WE COMBINE
FOR THIS PRESENT ANTICIPATION
AND ALSO AS A FINAL RESULT IN
THE PAPER, WE COMBINE 2 OF THE 3
SAMPLES WHERE WE COLLECT TD
HEALTH OUTCOMES IN ORDER TO
OBLIGATIONS STAIN A HIGHER
STATISTICAL POWER FOR ESTMAIOF
THING THESE RELATIONSHIPS AND
THIS ANALYSIS ADJUSTS FOR SEX,
ETHNICITY, PERSONAL INCOME
LEVEL, EDUCATION LEVEL, BIRTH
YEAR AND OF COURSE ALSO STUDY
SAMPLE.
SO THIS FIGURE, YOU SEE HERE IT
SHOWS THE ASSOCIATIONS OF 7
GENDER VARIABLES AND BIOLOGICAL
SEX WITH NUMBER OF DAYS WITH
POOR PHYSICAL HEALTH, POOR
MENTAL HEALTH AND ACTIVITY
LIMITATIONS WITHIN THE PAST 30
DAYS AND AS YOU CAN SEE,
CAREGIVER STRAIN AND
DISCRIMINATION ARE ASSOCIATE
WIDE LOWER PHYSICAL
HEALTH--YEAH, MENTAL HEALTH AND
ALSO ACTIVITY LEVELS.
AND IN CONTRAST IF WE LOOK AT
SOCIAL SUPPORT, IT'S ASSOCIATE
WIDE BETTER MENDAL HEALTH AND
ACTIVITY LEVELS WHEREAS RISK
TAKING IS ASSOCIATED ALSO WITH
BETTER MENTAL HEALTH.
THE REMAINING ASSOCIATIONS HERE
HAVE 99 CONFIDENCE INTERVALS
THAT SPAN THE LINE OF NO
DIFFERENCE SO THESE RESULTS ARE
INCONCLUSIVE.
SO THIS REPORT HERE IS
SELF-RATED HEALTH STATUS,
SMOKING, VAPING, BINGE DRIRKING
AND BODY MASS INDEX AND
CAREGIVER STRAIN DISCRIMINATION
AND MALE SEX ARE ASSOCIATED WITH
FAIR OR POOR SELF-RATED HEALTH
IN THESE LOGISTIC MODELS.
RISK TAKING AND SOCIAL SUPPORT
WE FIND PREDICT VERY GOOD OR
EXCELLENT SELF-RATED HEALTH IF
WE LOOK AT SMOKING, WE FIND THAT
CAREGIVERS STRAIN WORK STRAIN,
RISK TAKING AND MALE SEX ARE
ASSOCIATED WITH SMOKING AND WORK
STRAIN DIGS KRIM NATION AND MALE
SEX ARE ASSOCIATE WIDE VAPING.
FINALLY AND I'M SORRY FOR GOING
THROUGH THIS FAST BUT ITIVE GOES
YOU AN IDEA OF THE SOAKERS HERE,
FINAL WORK STRAIN DISCRIMINATION
AND MALE SEX, SORRY, CAREGIVER
STRAIN, LOW LEVELS OF RISK
TAKING AND DISCRIMINATION, ARE
ASSOCIATED WITH OVERWEIGHT IN
THE FINAL 1 HERE, YEP.
SO TO BRIEFLY SUMMARIZE THESE
FINDINGS, SUGGESTS I WOULD SAY
THAT THE GENDER RELATED
VARIABLES PERTAINING TO NORMS,
IF WE LOOK AT THE RESULTS BUT
ALSO TO RELATIONS, SO THAT WOULD
BE CAREGIVER STRAIN AND WORK
STRAIN RELATED TO NORMS AND
DISCRIMINATION AND SOCIAL
SUPPORT RELATED TO RELATIONS
HAVE STRONGER CORRELATIONS WITH
THE SELF-RATED HEALTH MEASURES
THAN THE VARIABLES PERTAINING TO
GENDER RELATED STRAIGHTS PERHAPS
WITH RISK TAKING AS AN EXCEPTION
HERE AND THAT SUGGESTS THAT
INSTITUTIONAL ASSPEBTINGS OF
GENDER MAY BE MORE IMPORTANT
THAN INDIVIDUAL TRAITS AND
CHARACTERISTICS IN SHAPING
HEALTH AND DISEASE PROCESSES IN
THESE TYPES OF MEASURES.
AND OUR STUDY OF COURSE HAS SOME
LIMITATIONS, MOST IMPORTANTLY,
THERE WERE DEVELOPED AND TESTED
IN NONPROBABILITY SAMPLES.
TWO OF THEM ARE RECRUITED ONLINE
AND THEY'RE ONLY TESTED IN THE
U.S. FOR NOW.
WE HAVE ONGOING WORK OUR
COLLEAGUES HAVE WHERE WE TESTED
THE SAME IN OTHER COUNTRIES BUT
IMPORTANTLY ALSO THESE
ASSOCIATIONS THAT WE SHOW HERE
SHOULD NOT BE UNDERSTOOD AS
REFLECTING CAUSALITY.
THIS ANALYSIS FOR CROSS
SECTIONAL AND CONFOUNDING OR
EVEN REVERSE CAUSALITY COULD NOT
BE EXCLUDED AND YOU COULD
IMAGINE SCENARIOS WHERE HEALTH
CONDITIONS ACTUALLY ALSO AFFECT
OUR GENDER MEASURES WE PRESENT
HERE.
BUT ACKNOWLEDGING THESE
LIMITATIONS, I THINK THAT OUR
ANALYSIS SUGGESTS THAT ANALYZING
GENDER RELATED VARIABLES IN
CONJUNCTION WITH BIOLOGICAL SEX
MAY ALLOW FOR NEW INSIGHTS INTO
HEALTH AND DISEASE PROCESSES AND
WE SEE A KEY ADVANTAGE IN THAT
WE MAKE NO ASSUMPTIONS HERE
ABOUT MASKUE LYNNITY AND
FEMININITY AND PERHAPS THESE ARE
A BIT LIMITING IF THE GOAL IS TO
CAPTURE GENDER ALL ITS
COMPLEXITY.
SO IF WE TAKE ME AS AN EXAMPLE,
A MAN AS A CAREGIVER, I HAVE A 6
YEAR-OLD, 4 YEAR-OLD AND NEW
BORN IN THE HOUSE.
IF I EXHIBIT CARE GIVING
BEHAVIOR, THIS IS NOT A FEMININE
BEHAVIOR WE WANT TO BED CARE
GIVINGAsA I SEPARATE ASPECT
HERE.
SO REDUCING THE GENDER RELATED
VARIABLES TO FEMININITY AND
MASKUE LYNNITY SCORES WE WOULD
GIVE LIMITED GUIDANCE TO
INTERVENTIONS AND WILL AS WE SEE
IT, REDUCE RATHER THAN IMPROVE
THE PRECISION OF WHAT'S GOING ON
HERE.
SO FINALLY, WE HAVE
INTERNATIONAL COLLEAGUES IN THE
NETHERLANDS PORTUGAL, KOREA AND
SPAIN THAT ARE TRYING TO
VALIDATE OUR SAMPLES IN THESE
COUNTRIES AND WE HOPE TO SEE
FURTHER TRANSLATIONS AND
VALIDATIONS FOR OTHER LANGUAGES
AND CULTURES IN THE NEAR FUTURE.
THANKS SO MUCH FOR YOUR
ATTENTION.
>>THANK YOU, THAT WAS
INCREDIBLY INTERESTING, AND I'M
EXCITED BECAUSE I THINK I WILL
HAVE THE RIGHT SPEAKERS THIS
TIME, OUR NEXT SPEAKERS WILL BE
DRS. PH ILBIN AND EVERETT, AND
THEY WILL FOCUS ON INSTRUCTURAL
FACTORS AND WOMEN'S HEALTH
LOOKING AT POLICY AND
DEMOGRAPHIC DATA.
CONFIRM YOU HAVE CONTROL OVER
THE SLIDES, PLEASE.
>>YEP.
>>PERFECT.
THANK YOU.
>>GREAT.
SO THANK YOU SO MUCH FOR
EVERYBODY, FOR COMING TO OUR
PRESENTATION TODAY, TITLED
STRUCTURAL FACTORS IN WOMEN'S
HEALTH AND A HUGE THANK YOU TO
THE ORGANIZERS AS WELL.
SO I'M GOING TO START WITH AN
OVERVIEW OF POLICY RESEARCH, AND
THEN DR. EVERETT WILL PRESENT A
SPECIFIC STUDY TO FLUSH OUT
CHALLENGES AND HOW THE FIELD IS
MOVING FORWARD.
SO STRUCTURAL FACTORS REGULATE
NEARLY ALL ASPECTINGS OF OUR
LIVES AND THESE FACTORS INCLUDE
POLICIES WHICH EXPLICITLY
EKINGULATE HEALTH AS WELL AS
BROADER SOCIAL POLICIES AND I
WILL GIVE EXAMPLES OF BOTH OF
THESE DURING THE TALK.
STRUCTURAL FACTORS INCLUDE
UNIVERSAL POLICYINGS THAT
INCLUDE EVERYBODY SO THINKING
ABOUT ECONOMIC POLICIES FOR
EXAMPLE, AND ALSO TARGETED
POLICIES SO THOSE THAT AFFECT A
SPECIFIC POPULATION SUCH AS
NONDESCRIMINATION POLICIES OR
MARRIAGE OR QUALITY OR
IMMIGRATION.
AND POLICIES ARE PARTICULARLY
IMPORTANT BECAUSE THEY SERVE AS
SYMBOLIC MARKERS OF WHO IS
ALLOWED TO INHABIT A GIVEN SPACE
ACCESS A SERVICE OR BECOME A
FULL MEMBER OF SOCIETY.
AND POLICIES HAVE A DIRECT AND
LARGE SCALE IMPACT ON THE
PUBLIC'S HEALTH MUCH MORE THAN
CHANGING INDIVIDUAL LEVEL
BEHAVIOR WHICH IS WHY IT'S
IMPORTANT TO THINK ABOUT HOW WE
USE EVIDENCE TO INFLUENCE POLICY
CHANGE.
IN ADDITION POLICIES ARE PASSED
ACROSS MULTIPLE LEVELS INCLUDING
FEDERAL STATE AND CITY LEVEL AND
THIS MEANS THAT LOCAL POLICIES
CAN COUNTERACT FEDERAL POLICIES
AND WE'VE SEEN THIS IN
IMMIGRATION POLICIES IN
SANCTUARY CITIES AND NOW IN
RESPONSE TO ROE V. WADE TO LIMIT
WAYS FOR REROUGH ATOM DUCTIVE
REETS.
AND POLICIES ARE MULTISECTOR SO
THINKING ABOUT SCHOOL LEVEL OR
CLINICAL GUIDE LINES SUCH AS HIV
SCREENING GUIDELINES AS A FORM
OF POLICY.
AND THEN LASTLY AND MOST
IMPORTANTLY POLICIES ARE
MODIFIABLE THROUGH SUSTAINED AND
ORGANIZED COLLECTIVE ACTION AND
THIS HIGHLIGHTS THE NEED TO BOTH
CREATE AN EVIDENCE BASED TO SHOW
WHICH POLICIES TO TARGET AND
ALSO WHICH TO COLLABORATE WITH
KEY STAKEHOLDERS AND SUPPORTING
POLICIES THAT IMPROVE DAILY LIFE
FOR INDIVIDUALS AND COMMUNITIES.
SO I'M GOING TO QUICKLY
HIGHLIGHT COMMON APPROACHES TO
XOL POETIC WILL SEE RESEARCH IN
ORDER TO SHOW HOW SOME OF THESE
STILL HAVE CHALLENGES WITH THE
WAY MEASUREMENT IS DONE AND HOW
THE WORK DISCUSSED TODAY MAYING
ABLE TO ADDRESS SOME OF THESE.
SO FIRST POLICY RESEARCH OFTEN
TAKES A NARROW DEFINITION OF
WHAT CONSTITUTES A STRUCTURAL
FACTOR OR POLICY, HOWEVER IN OUR
WORK SPECIFICALLY WHAT
DR. EVERETT WILL DISCUSS IN THE
SESSION AND THAT OF OTHERS HAS
INCORPORATED OTHER DRIVEWAYS
SUCH AS ATTITUDES CLINICAL GUIDE
LINEUPS POLITICAL DETERMINANTS
OF HEALTH AND FUNDING STREAMS.
SECOND MUCH OF THE POLICY
RESEARCH AND PUBLIC HEALTH USES
BINARY MOLL PEE EXPOSURE
MEASURES, SO JUST MEANING
WHETHER A POLICY EXISTS HOWEVER
THIS APPROACH OFTEN FAILS TO
CAPTURE NUANCE VARIATION AROUND
POLICY DETAILS AND VARIATIONS IN
IMPLEMENTATION.
THIRD MUCH OF THE CURRENT POLICY
RESEARCH TAKES A 1 POLICY 1
OUTCOME APPROACH, SO EXAMPLE OW
A KAN--KANA BUSINESS PROGRAMS
POLICY AFFECTS KAN--KANA
BUSINESS PROGRAMS USE AND IT
FAILS TO CAPTURE 2 THINGS.
FIRST IT'S THAT POLICIES HAVE
UNINTENDED AND SPILL OVER
EFFECTS NOT TARGETED BY THE
POLICY AND SECOND THIS APPROACH
FAILS TO CAPTURE THE FACT THAT
THE POLICY CLIMATE INTO WHICH A
SINGLE POLICY CAN PASS CAN VARY
FROM STATE TO STATE SO OTHER
POLICIES MAY BE SIMULTANEOUSLY
AFFECTING THE OUTCOME OR
RELATIONSHIPS WE'RE SEEING
BETWEEN 1 POLICY AND SINGULAR
OUTCOME.
AND THEN LASTLY POLICY RESEARCH
OFTEN FOCUSES ON WHETHER THERE'S
POLICY AND OUTCOME AOPPOSE TO
EXPLORING THE NECKANISM THROUGH
WHICH THIS OCCURS AND WHEN WE'RE
LOOKINGA THE STATE POLICY
BECAUSE THERE'S A LOT THAT CAN
HAPPEN BETWEEN SPHAIT POLICY AND
AN INDIVIDUAL OUTCOME.
SO INTEGRATING QUALITY METHODS
IS PARTICULARLY IMPORTANT
BECAUSE THAT CAN HIGHLIGHT WHAT
THOSE PATHWAYS OR MECHANISMS ARE
AND ALSO WHERE WE CAN INTERVENE
WHEN WE'RE WAITING FOR POLICIES
TO BE PASSED TO MAXIMIZE HEALTH
EQUITY.
SO 1 OF THE MOST IMPORTANT
DECISIONS IN POLICY RESEARCH IS
DETERMINING WHAT THE EXPOSURE IS
AND HOW TO CATEGORIZE IT, SO
HISTORICALLY POLICY RESEARCH HAS
USED A BINARY YES NO MEASURE OF
WHETHER A POLICY EXISTS AND THIS
FAILS TO CAPTURE IMPORTANT
NUANCES THAT COULD AFFECT STUDY
FINDINGS SO THINKING ABOUT
MEDICAL KAN--KANA BUSINESS
PROGRAMS POLICYs AS AN EXAMPLE
WE OFTEN SAY YES OR NO A STATE
HAS IT OR DOESN'T BUT THERE ARE
MANY VARIATIONS ACROSS STATES
SUCH AS THE NUMBER OF PLANTS
SOMEBODY CAN HAVE AT HOME, HOW
CHALLENGES IT IS TO OBTAIN A
KAN--KANA BUSINESS PROGRAMS
LICENSE OR HOW A DISPENSEARY IS
NEARBY AND THAT COMPLICATES
POLICIES.
ANOTHER WORK I WANT TO SHARE
COMES FROM IMMIGRATION POLICIES
WHERE WE FOUND THAT WHETHER OR
NOT A STATE ALLOWED DRIVER'S
LICENSES FOR UNDOCUMENTED
IMMIGRANTS BUT WHETHER STATES
ALLOWED IT, WHAT DID IT HAVE IT
OR WHETHER THEY DEPARTMENT
ALLOW.
SO IT'S HARD TO CATEGORIZE IT AS
TO WHETHER YES OR NO DECISION
THAL MAY HELP FIND DIFFERENCES
WE FOUND ACROSS DATAET ISS
BECAUSE THESE ARE NOT
COMPREHENSIVELY CAPTURING WHAT'S
HAPPENING ON THE GROUND.
SO NOW I'M GOING TO USE EXAMPLES
FROM MY OWN WORK TO GIVE A BRIEF
OVERVIEW OF HOW WE CAN ADDRESS
THESE CHALLENGES.
SO THIS MAP SHOWS KAN--KANA
BUSINESS PROGRAMS POLICIES AND
INITIAL FOCUS AND RESEARCH SHOWS
KAN--KANA BUSINESS PROGRAMS USE
AND RESEARCH OVERALL AND LOOKING
AT POTENTIAL DIFFERENCE LIKE AGE
ISSUES SEXUAL IDENTITY AND
GENDER AND I WANT TO HIGHLIGHT
THE IMPORTANCE OF LOOKING AT
THESE DIFFERENTIAL IMPACTS BY
THINGS LIKE SEXUAL IDENTITY
BECAUSE OVERALL THOSE
DIFFERENCES MAY BE MASKED
BECAUSE POPULATIONS ARE MUCH
SMALLER SO IN WORK WITH
COLLEAGUESA THE COLUMBIA FOR
EXAMPLE, WE FOUND THAT MEDICAL
CANNABIS POLICIES HAD A
DIFFERENTIAL IMPACT BY PATTERNS,
SEXUAL IDENTITY AND GENDER MOST
NOTABLY AMONG BISEXUAL WOMEN.
AND THE SECOND PIECE I WANT TO
HIGHLIGHT IS THE LOOK AT SPILL
OVER EFFECTS OF POLICIES NAMELY
WHETHER POLICIES HAVE POLICIES
OUTSIDE OF THE STATED INTENTIONS
AND SO INSTANCE THINKING ABOUT
THE PORTIONS.
SO WE THINK ABOUT HOW KAN--KANA
BUSINESS PROGRAMS AFFECTS OTHER
SUBSTANCE USE SO THINKING ABOUT
ALCOHOL OR OPIOID USE AND I ALSO
FOUND THAT PROMOTE CAN IMPROVE
MENTAL OUTCOMES AMONG NATION AND
MINORITY YOUTH BECAUSE THEY WERE
LESS LIKELY TO GET JAILED OR
ARRESTED FOR CANNABIS POSSESSION
OR USE.
SO FOR EXAMPLE, THIS MAP SHOWS
VARIATIONS IN STATE LEVEL POLICY
CLIMATE SPECIFIC TO JEKS JUL AND
GENDER MINORITY INDIVIDUALS, AS
I NOTED IT'S IMPORTANT BECAUSE
THEY ONLY LOOK AT THE SINGULAR
POLICY WE MAY MISS THE FACT THAT
POLICIES IN THE BACKGROUND VARY
ACROSS STATES AND MAY AFFECT THE
SAME OUTCOME OF INTEREST.
SO TO GIVE AN EXAMPLE, I HAVE
EXPLORED HOW SCHOOL BASED
POLICIES AND PRACTICES THAT
YOUNG PEOPLE AFFECT SEXUAL
BEHAVIOR AND THESE POLICIES CAME
FROM THE CDC'S HEALTH PROFILES
AND YOU CAN SEE VARIATIONS
ACROSS JURISDICTIONS ON THE MAP.
AND WE THEN LINK THESE ON TO THE
USUAL RISK BEHAVIOR SURVEY AND
FOUND THAT YOUNG PEOPLE IN
STATES WITH MORE RESTRICTIVE
SCHOOL BASED POLICIES, WERE LESS
LIKELY TO USE CONDOMS AND SEXUAL
IDENTITY MODIFIED THESE
RELATIONSHIPS.
SO MODIFYS AN EXAMPLE TO LOOK AT
A 1 POLICY OUTCOME APPROACH,
THINK ABOUT DIFFERENTIAL IMPACTS
AND THINK ABOUT STRUCTURAL
FACTORS MORE BROADLY SO THINKING
ABOUT POLICIES AND PRACTICES
WITHIN SCHOOLS.
IN ARK DITION TO A POLICY
CLIMATE, SO IMMIGRATION POLICIES
AND THAT CLIMATE IT'S IMPORTANT
TO THINK ABOUT HOW POLICIES
INTERSECT.
AND SO IN THE LAST SLIDE, I
TALKED ABOUT HOW SCHOOL BASED
POLICIES AFFECT SEXUAL AND
GENDER MINORITY YOUTH BUT MANY
POLARIZEDEES AFFECT THEM.
SO WE DEVELOPED THIS BASED ON 30
SEXUAL AND GENDER MINORITY IN
YOUTH IN NEW YORK AND 30
STAKEHODERS FROM ACROSS THE
U.S. TO BETTER UNDERSTAND HOW IT
AFFECTS THEIR HEALTH AND WELL
BEING.
AND AS YOU CAN SEE FROM THIS
MODEL WITH SEXUAL AND GENDER
MINORITY IN THE MIDDLE, THEY
TARGET PEOPLE BASED ON SEXUAL
GENDER IDENTITY AND UNIVERSAL
POLICIES MORE GENERALLY SO IT'S
REALLY IMPORTANT TO THINK ABOUT
THESE BROADLY.
SO NOW I'M GOING TO MOVE TO
SHOWING A FIGURE THAT WE
DEVELOPED THAT SHOWS HOW WE GET
FROM THESE POLICIES HO HEALTH
OUTCOMES.
SO I KNOW THERE'S A LOT GOING ON
OUT HERE BUT WHAT I'M TRYING TO
GET ON THIS RECK TANGLE AT THE
TOP, THINK OF THAT FIGURE UP
THERE AT THE TOP.
THERE ARE THESE DIFFERENT
PATHWAYS WE FOUND THROUGH STIGMA
AND STRESS, SOME THAT REGULATED
ACCESS TO MATERIAL RESOURCES,
INSTITUTIONAL SUPPORT AND SOCIAL
INCLUSION AND THESE WORKED
PRIMARILY IN THE AREAS OF
HOUSING EDUCATION AND EMPLOYMENT
THESE POLICIES AND OUTCOMES AND
FOCUSES ON HOW THE POLICY
AFFECTS OUTCOME AND THESE CAN
HELP PROVIDE A CLEAR RATIONAL
FOR WHAT YOUR POLICY EXSEIZURE
SHOULD BE, AND SO WHEN WE FIND
AN OUTCOME THERE'S SO MANY
THINGS HAPPENING IN THE
BACKGROUND THAT WE NEED TO
CONSIDER.
SO I WILL END BRIEFLY WITH 2
SUMMARY SLIDES, 1 ON
QUANTITATIVE WORK AND 1 ON
QUALITATIVE WORK.
SO THINKING ABOUT THE POLICY
CLIMATE I'M NOT SAYING WE SHOULD
IGNORE MY WORK ON POLICIES, AND
THEN ALSO LOOK AT OVERALL
POLICIES SO WE CAN FIGURE OUT
WHICH 1S TO TARGET FOR
INTERVENTIONS BUT I THINK IT'S
IMPORTANT TO THINK OF BOTH AND
OBVIOUSLY THE WORK WE DO ON A
STATE LEVEL POLICY USES DAILY
BASIS THEA SETS THAT SHOULD BE
IDLY WEIGHTED AT THE STATE LEVEL
AND INCLUDE ALL 50 STATES BUT
MANY OF THESE ARE COLLECTED BY
FEDERAL AGENCIES THAT ARE NOT
DESIGNED FOR RESEARCH AND DON'T
INCLUDE THE VARIABLES WE THINK
ARE IMPORTANT SO FOR EXAMPLE,
THE NATIONAL DATA SET ON
IDENTITY AND THESE DATA SETS CAN
BE HARD TO WACHOVIA ASSESSES SO
THE NATIONAL SUBJECT--THAT
FBI, BUT THAT CHALLENGES THE WAY
WE DO RESEARCH.
AND SO JUSTLY FOR THE LAST SLIDE
I WILL END BY NOTING THE
IMPORTANCE OF QUALITATIVE
RESEARCH IN POLICY RESEARCH BOTH
BECAUSE WE NEED TO THINK ABOUT
THE PATHWAYS THROUGH WHICH THESE
POLICIES MATTER AND IT ALSO
GIVES VOICE TO THE POPULATIONS
WE STUDY.
THE OTHER IMPORTANT THING ABOUT
QUALITATIVE RESEARCH IS IT CAN
HELP US UNDERSTAND WHETHER AND
HOW POLICIES ARE IMPLEMENTED AND
ENFORCED BECAUSE IN OUR
QUANTITATIVE MODELS WE HAVE TO
MAKE ASSUMPTIONS ABOUT THINGS
EQUALLY BUT WE KNOW THAT'S NOT
THE CASE AND LASTLY I WANT TO
PUT IN A PLUG FOR EXPLORING
RESEARCH TO EXPLORE CAUSAL
ASSOCIATIONS AND UNPACK THEM AND
ALSO IN TANDEM THOSE CAN BETTER
HELP ADVOCATE FOR POLICIES THAT
WILL REALLY SUPPORT THE PEOPLE
AND AFFECT CHANGE IN ORDER TO
REALLY ADVANCE HEALTH AND WELL
BEING FOR THE INDIVIDUALS THAT
WE WORK WITH.
>>THANK YOU MORGAN FOR THAT
OVERVIEW.
I WILL BE TALKING ABOUT 1
CONCEPT AND A PAPER PUBLISHED
EARLIER THIS YEAR THAT CALLED
ATTENTION TO THE WAY THAT
SYSTEMIC IN LGBTQ POPULATIONS
ARE AFFECTED NOW IF YOU'VE BEEN
PAYING ATTENTION TO THE NEWS
THIS YEAR'S BEEN AN AWFUL 1 FOR
TRANSGENDER PEOPLE, QUEER PEOPLE
AND ANYONE FOR A CAPACITY FOR
PREGNANCY.
IN TERMS OF LGBTQ LEGISLATION,
IT'S IMPOSSIBLE TO KEEP UP WITH
EVERY DISCRIMINATORY LAW ACROSS
THE COUNTRY.
LAST YEAR WAS A RECORD PRAIKING
YEAR FOR GRIEWSING
DISCRIMINATORY BILLS AND THIS
YEAR IS SET TO SHATTER THAT
RECORD AND JUST A FEW MONTHS
AGO, THE SUPREME COURT
OVERTURNED THE 50 YEAR PRECEDENT
OF ROW V. WADE BANNING OR
RESTRICTING ABORTION IN MANY
STATES.
HOWEVER IT'S IMPORTANT TO NOTE
THAT ABORTION ACCESS HAS BEEN
CURTAILED ACROSS THE COUNTRY
RENDERING IT IN REALITY
INACCESSIBLE FOR MANY PEOPLE
EVEN IN PLACES WHERE IT IS STILL
LEGAL.
UNTIL RECENTLY THESE 2 FIELDS
HAVE LARGELY BEEN SILOED FROM
EACH OTHER.
PREGNANCY CONTRIBUTION AND
ABORTION RESEARCH HAS RARELY
INCORPORATED LGBTQ POPULATIONS
AND VICE VERSA.
SO MY PERSONAL RESEARCH OVER THE
LAST SEVERAL YEARS HAS TRIED TO
BRIDGE THESE 2 FIELDS TOGETHER
TO DEMONSTRATE THE OBSTETRICAL
AND GYNECOLOGICAL HEALTH NEEDS
OF SEXUAL MINORITY WOMEN AT THE
STRUCTURAL LEVEL, HOWEVER, THESE
FIELDS CONTINUE TO RESEPARATE.
IN THE FIELD OF LGBT HEALTH BY
HATZENBUEHLER, SOCIAL CLIMATES.
AND AS WE HEARD THIS MORNING
FROM TRISH HOMAN'S AWRPGS THAT
STRUCTURAL SEXISM IS COMPOSED
POLITICAL, CULTERALITY AND
ECONOM SYSTEMS THAT FAVOR MEN'S
ACCESS TO POWER AND RESOURCES.
--AND PRIVILEGES MEANT TO ACCESS
POWER AND RESOURCES.
GIIVE INHERENT LINKS BETWEEN
JEBDER AND SEXUALITY, THESE
SYSTEMS REINFORCE 1 ANOTHER AND
SHAPE MEN AND WOMEN'S ROLES IN
THE WO, FORCE AND HOPE, THEY
CANNOT OPERATE INDEPENDENTLY OF
EACH OTHER AND SOME THEORORRISTS
HAVE GONE TO ARGUE THAT
SEXUALITY IS THE LINCHPIN OF
GENDER IN EQUALITY.
NOW, WHILE REPUBLICAN
LEGISLATORS CANNOT BE STEEPED IN
FEMINIST THEORY THEY KNOW THIS.
A CLEAR EXAMPLE OF THIS IS THE 2
DAY MEETING PRIOR TO THE
POPULATION OF THE ASSOCIATION OF
AMERICA, IT FOCUSED ON ABORTION
RESEARCH AND THIS LAST YEAR IT
WAS IN ATLANTA.
THE HOSTS DID WORK AT THE
CAPITOL AND THEY HAD BEEN AT THE
CAPITOL LATE BEFORE FIGHTING TO
KEEP ANOTHER ABORTION RELATED
BILL OFF THE BOOKS.
THEY WERE ULTIMATELY SUCCESSFUL
WHICH IS GREAT, HOWEVER, THE
LEGISLATORS DECIDED THAT INSTEAD
OF THWARDING THEIR ABORTION BILL
THEY WOULD INSTEAD PASS A BAN ON
KEEPS TRANSGENDER KIDS FROM
PLAYING SPORTS.
THEY SEE THESE 2 ISSUES ON THE
SAME PLAYING FIELD AND TO
SATISFY THEIR BASE AND ADVANCE
THEIR AGENDA, ATTACKS ON
ABORTION AND TRANSGENDER KIDS
ACHIEVED THE SAME GOAL TO
MAINTAIN AND ENFORCE A SYSTEM
THAT PRIVATE SECTOR EDGE WELL
LISTS CISGENDER AND HETEROSEXUAL
MEN AHEAD OF ALL OTHER GROUPS.
SO EARLIER THIS YEAR WITH MYSELF
AND MY CO AUTHORS DR. PH ILBIN
AND OTHERS WE PUBLISHED A PAPER
IN THE JOURNAL OF DEMOGRAPHY
THAT SOUGHT TO CLAIRIFY THE
THOUGHT THAT STRUCTURAL SEXISM
AND STIGMA ARE ROOTED IN THE
SAME SYSTEM OF OPPRESSION.
HETEROPATRIARCHY, HIGHLIGHTS HOW
MALE DOMINANCE IS CENTRAL TO THE
ORGANIZATION OF A CAPITALIST
SOCIETY AND FOLLOWING KD--SALLY
WAWE INCORPORATE THE USE OF
HETEROGENEOUS ORY AND ALLOWS US
TO INTERROGATE THE ROLE OF
HETEROSEXUALITY.
SO FOR THIS STUDY ISSUES, WE
USED ALL 5 WAVES OF DATA FROM
THE NATIONAL LONGITUDINAL DATA
FROM ADOLESC TONIGHTAD, HEALTH.
IT'S A POPULATION BASED
LONGITUDINAL DATA SET THAT BEGAN
IN 1994 AND HOW 5 WAVES OF
INFORMATION ON PREGNANCY
HISTORY, SEC JUL ORIENTATION,
BIRTH OUTCOMES AND CONTEXTURAL
FACTORS.
WE FOCUSED ON BIRTH OUTCOMES
BECAUSE FIRST THE UNITED STATES
LAGS COMPARED TO COMPARABLE
COUNTRIES IN TERMS OF OUR
MATERNAL AND INFANT HEALTH.
THERE'S REGIONAL VARIATION IN
TERMS OF STRUCTURAL PARTICIPATE
IN A TRIAL REORCH EXPE BIRTH
OUTCOMES AND BIRTH OUTCOMES HAVE
BEEN SHOWN TO BE SENSITIVE TO
CONTEXT.
THE LONGITUDE OF THE DATA SET IS
IMPORTANT IN SO FAR IT ALLOWS US
TO CORRECTLY TIME, ORDER, OUR
MEASURES, AND ADJUST FOR
SOCIOLOGICAL DEMOGRAPHIC
CHARACTERISTICS PRIOR TO OR AT
THE TIME OF BIRTH INCLUDING
EDUCATION, INSURANCE STATUS,
RELATIONSHIP STATUS AND AGE.
SO FOR THE CREATION OF OUR
SCALE, WE PULLED CONTEXTURAL
MEASURES FROM 3 RELATED DOMAINS,
STRUCTURAL SEXISM, WHICH YOU
HEARD ABOUT IN DR. HOMAN'S
PRESENTATION EARLIER TODAY WHICH
CAPTURES THE SOCIAL AND CULTURAL
CLIMATE, FAMILY PLANNING
POLICIES SO WE CAPTURED MULTIPLE
DIMENSIONS OF ABORTION ACCESS
AND STIGMA AND LGB RELATED
POLICIES THAT CAPTURE POLICY
LEVEL DISCRIMINATION.
AND YOU WILL NOTICE THAT SAME
SEX MARRIAGE IS ON HERE AS PART
OF OUR SKILL THAT IS BECAUSE
THIS WAS MEASURED FROM THE 2007
AND 2008 PRIOR TO THE
LEGALIZATION OF SAME SEX
MARRIAGE AT THE FEDERAL LEVEL.
SO I WILL TURN TO RESULTS AND
THESE FROM OUR FULLY ADJUSTED
MODELS AND YOU CAN SEE A CLEAR
RELATIONSHIP BETWEEN OUR MEASURE
OF STRUCTURAL HETEROPATRIARCH
EXPE BIRTH OUTCOMES.
SO AS STRUCTURE AFFAIRS TEAM
LEADER HETEROPATRIARCHY
INCREASES SO DOES PRETERM BERGT
AND PREDERM BIRTH WEIGHT GOES
DOWN.
WE DID NOT FIND A ISHT ACTION
BETWEEN STRUCTURAL PATRIARCHY
THAT SUGGESTS FOR OUR DATA AND
THIS OUTCOME OUR MODEL HAS
NEGATIVE IMPLICATIONS FOR BIRTH
OUTCOMES REGARDLESS OF THE
WOMEN'S SEXUAL IDENTITY.
WE HAVE PRELIMINARY EVERYDAYS
THAT LOOKS AT THE LINKS BETWEEN
STRUCTURAL HETEROPATRIARCHY AND
AND MATERNAL HYPERTENSION, CAN
YOU SEE THE AS WILL SCALE GOES
UP, THE RISK OF MATERNAL
HYPERTENSION ALSO INCREASES.
SO OUR RESULTS HAVE SEVERAL
IMPLICATIONS WE THINK FOR
DEMOGRAPHIC RESEARCH.
FIRST WE FOUND A HIGH LEVEL OF
CORRELATION BETWEEN OUR
INICATORS SEXISM, FAMILY
PLANNING AND LGBT MEASURES.
THESE SCHOLARS CLAIM THE
INTERCONNECTED NATURE OF SEX
GENDER OPPRESSION.
THE PREVIOUS WORK ALLUDED THAT
THE FORMS ARE IMPLICATED IN
REPRODUCTION OF QUALITY AT THE
INTERFORTUNAL LEVEL, OUR
DOCUMENTED FINDINGS FIND THESE 3
SYSTEMIC QUALITIESA THE
INSTITUTIONAL LEVEL.
AS THE IMPACT SHOWS AREY SULTS
ON INDIVIDUAL HEALTH, WE NEED TO
THINK OF IDENTITY BASED STIGMA
BUT AS PART OF A LARGER SYSTEM
OF DISCROSS EXAMINE NATION.
OUR RESULTS ALSO CONTRIBUTE TO
THE GROWING WORK THAT SHOWED
THAT [INDISCERNIBLE] AND STIGMA
PREDICT FAMILY PLANNING
OUTCOMES.
IN THE BEST CASE, THIS CAN
PROVIDE AN OPPORTUNITY TO
ADDRESS UNDERLYING HEALTH
DISPARITIES AND IMPROVING THE
HEALTH AND WELL BEING DURING A
PERIOD OF PREGNANCY HAS RNT
IMPLICATIONS FOR THE LONG-TERM
HEALTH OF THE PREGNANT PERSON
AND THE INFANT.
NOW LIKE MANY SECONDARY BASIS,
THERE ARE LIMITATIONINGS TO THIS
WORK.
AS MANY DEMOGRAPHY AND HEALTH
RESEARCHERS KNOW WE DON'T GET TO
CONTROL THE CONSISTENCY OR
CONTENT OF DEMOGRAPHIC SURVEYS
OR THE CONTEXTURAL MEASURES THAT
ARE ATTACHED.
IN THIS CASE WE DIDN'T HAVE ANY
MEASURES RELATED TO GENDER
IDENTITY POLICY.
SO ALL THESE TRANSGENDER ATTACKS
ON TRANSGENDER PEOPLE WE WERE
NOT ABLE TO INCORPORATE THOSE
INTO THE MEASURE BASED UPON THE
CONTEXTURAL LEVEL BASED ON WHAT
WAS AVAILABLE TO US.
WE KNOW THERE'S A HIGH
CORRELATION BETWEEN ATTACKS ON
LGB PEOPLE AND GENDER MINORITIES
SO, WE EXPECT IF ANYTHING THESE
WOULD COORDINATE REALLY WELL
WITH OUR SCALE.
THE OTHER THING IS WE DO NOT
HAVE A MEASURE OF GENDER
IDENTITY INCLUDE INDEED THIS
SURVEY, GENDER IDENT WAS ASKED 5
WAY 5, THERE WERE ONLY 17
PREGNANCY TO PEOPLE WHO REPORTED
THEIR GENDER AS BEING OTHER OR
MISSING GENDER IDENTITY WHICH
ISN'T VERY INFORMATIVE.
WE DON'T ALWAYS GET TO CONTROL
THE SCALE AND THE CONSISTENCY AT
WHICH OUR CONTEXTURAL MEASURES
WERE INCLUDED.
SO IN OUR CASE SOME OF THESE
MEASURES WERE--AT THE COUNTY
LEVEL VERSUS STATE LEVEL AND
THEY WERE NOT ALWAYS MEASURED
CONSISTENCY OVERTIME, WE DID
HOWEVER RESTRICT OUR SAMPLE TO A
NONMOVER GROUP, WHICH IS 70% OF
THE POPULATION, WHICH MAY SEEM
SHOCKING TO MANY ACADEMICS WHO
HAVE TO MOVE SEVERAL POINTS IN
THEIR LIFE, HOWEVER MOST OF OUR
SAMPLE DID NOT MOVE AND OUR
MODELS WERE ROBUST TO THIS MORE
STRINGENT SPECIFICATION.
>>MOVING FORWARD, WE NEED TO
CONTINUE TO INTEGRATE SEXUAL AND
GENDER MINORITY POPULATIONS INTO
REPRODUCTIVE HEALTH RESEARCH AND
VICE VERSA.
FINDING GOOD MEASURES OF SEXUAL
ORIENTATION AND GENDER IDENTITY
IN REPRODUCTIVE HEALTH SURVEY
REMAINS A CHALLENGE TO SAY THE
LEAST.
AND AS WE CONTINUE TO NAVIGATE A
CHALLENGE--A CHANGING LEGAL
LANDSCAPE WE SHOULD KEEP IN MIND
THAT THE REPEALING OF ROW V.
WADE AND THE CONTINUE'S PUSH FOR
POLICIES THAT DISCRIMINATE
AGAINST SEX AND GENDER
MINORITIES WILL HAVE A
DISPROPORTIONATE NEGATIVE IMPACT
OF PEOPLE OF COLOR AND THIS IS
WHAT [INDISCERNIBLE] TALKS ABOUT
WITH WE ARGUES THAT WE LIVE IN A
WHITE SUPREMACIST WHITE
PATRIARCHICAL HIERARCHY.
IMPROVE ON THE PATRIARCHY BOTH
THEORETICALLY AND METHOD
LOGICALLY IS REALLY IMPORTANT
AND I LOOK FORWARD TO YOUR
QUESTIONS AND COMMENTS.
>>OH AND THANK TO YOU OUR
FUNDERS AND COLLABORATORS LISTED
HERE.
>>THANK YOU SO MUCH, WE ARE
ABOUT 15 MINUTES BEFORE TIME AND
UP I WANT TO MAKE SURE PEOPLE
HAVE THE OPPORTUNITY TO ASK
THEIR QUESTIONS.
I'M JUST GOING TO GO DIRECTLY TO
WHAT'S BEEN PUT IN ONLINE AND
FOR ANYBODY ELSE IF YOU WANT TO
ADD YOUR QUESTIONS FEEL FREE AND
FOR THE PRECEPTORS IF YOU
WOULDN'T MIND ANSWERING
QUESTIONS SO WE WON'T GET TO
EVERYBODY'S; SO FROM REBECCA
SLEEPER CAN YOU COMMENT ON HOW
THE RELATIVE INFLUENCE OF GENDER
VARIABLES CHANGES WITH AGE OR
DOESN'T CHANGE?
WOULD ANY OF OUR SPEAKERS LIKE
TO ANSWER THAT?
WHAT'S THE ROLE OF AGE IN GENDER
INFLUENCES YOU SEE?
>>THIS IS LOUISE, I CAN ANSWER
THAT.
IF YOU LOOK FOR EXAMPLE AT
GENDER ROLES, OKAY, A YOUNG
PERSON YOU KNOW WITH CHILDREN
HAS DIFFERENT ROLE THAN AN OLDER
PERSON WITHOUT CHILDREN.
LET'S TAKE A WOMAN IN THIS
SITUATION, YOU KNOW, THE
RELATIONSHIP BETWEEN THE
PERSON'S AIMING AND THEIR ROLE
WILL BE VERY DIFFERENT.
OLDER WOMEN IN OUR SOCIETY TO BE
MORE CAREGIVERS, ALTHOUGH WE
KNOW MEN ARE TOO BUT GIVEN THAT
WOMEN LIVE LONGER THEY'RE MORE
LIKELY TO BE CAREGIVERS.
SO THAT CERTAINLY WILL HAVE AN
IMPACT ON THEIR HEALTH AND THEN
AT THE YOUNGER AGE THERE WILL BE
LOTS OF, YOU KNOW MULTIPLE TASK,
MULTITASKING, EXPECTATIONS AND
ALL THAT [INDISCERNIBLE] FAMILY
SO YES, FOR SURE, AGE AND THE
AND RELATION, YOU KNOW WILL VARY
WITH AGE.
>>OKAY, SO THANK YOU
DR. PILOTE.
COULD WE FOR ANY OF THE
PANELISTS COULD YOU DISCUSS HOW
YOU CONCEPTUALIZE GENDER
ATTRIBUTES IN TRAITS IN YOUR
MEASUREMENTS, DIFFERENTLY FROM
GENDER STEREOTYPES AND THE WAYS
YOUR MEASURMENTS MAY CHALLENGE
OR REINFORCE THE STEREOTYPES.
>>WELL, MAYBE I WILL START ON
THAT 1.
SO GENDER TRAITS, GENDER
IDENTITY, ALL THESE THINGS, WORK
WITH STEREOTYPES IN A CULTURE.
THERE IS SOMETHING CALLED THE
DIFFERENCE DILEMMA THAT IF YOU
ACTUALLY CALL OUT STEREOTYPES,
YOU'RE REINFORCING THEM BUT IF
YOU IGNORE THEM, YOU'RE JUST
LETTING THEM GO ON WITHOUT
CONSCIOUSLY WORKING AGAINST
THEM.
SO, OUR GENDER, THE GENDER
VARIABLES THAT WE HAVE
IDENTIFIED EMERGE FROM THE
CULTURE AND YES THEY WILL HAVE A
CORRELATION TO STEREOTYPES, WE
ARE NOT ADVOCATING THEM BUT WE
ARE BEING AWARE OF THEM AND HOW
THEY WORK WITH HEALTH ISSUES AND
HOPEFULLY THAT WILL HELP PEOPLE
OVERCOME THE STEREOTYPES.
LL OF MY WORK IS AIMED AT
OVERCOMING STEREOTYPES MIGHT BE
MAKING PEOPLE CONSCIOUS OF THEM
AND YOU CAN ACCEPT OR REJECT OR
REVISE.
>>THIS IS A RELATED QUESTION WE
RECEIVED AND THIS IS DIRECTED
TOWARDS DR. PILOTE, HOW DO
GENDER NORMS AND TRAITS IN
RELATION CHANGE AS PEOPLE WITH
DIFFERENT BIOLOGIES START TO
IESHES DENTIFY WITH GENDER
LABELS AND I SHOULD SAY THAT WE
RECENTLY GOT DATA FROM
CALIFORNIA WHERE FROM
ADOLESCENTS WHERE
ADOLESCENTS A THIRD OF THE
POPULATION EYE SCHOOL STUDENTS
DID NOT IDENTIFY WITH THE
TRADITIONAL MALE/FEMALE BINARY.
>>YEAH, MY 17 YEAR-OLD DAUGHTER
ONCE TOLD ME JUST, YOU KNOW DO
AWAY WITH GENDER AND JUST
MEASURE WHO PEOPLE ARE AND I
THOUGHT IT WAS QUITE INSIGHTFUL
BECAUSE, YOU KNOW DEPENDING ON
YOUR GENDER IDENTITY, YOU KNOW
NOT DEPENDING PUBLISHED ALMOST
LIKE REGARDLESS OF IT, YOU KNOW,
RATHER, PEOPLE WOULD HAVE ROLES
AND THEY WOULD HAVE EXPECTATIONS
OF THEIR ENVIRONMENT AND THEY
WILL HAVE, YOU KNOW RELATIONS
WITH THEIR PEERS AND ALL THAT
AND THEN, YOU KNOW WE WANT TO
KNOW WHETHER THESE FACTORS
INFLUENCE HOW THEY ACCESS HEALTH
AND HOW THEY RESPOND TO
TREATMENT, YOU KNOW AND ALL
THAT, SO, IN A WAY, YOU KNOW
IT'S THE SAME THING WITH SEXUAL
ORIENTATION, PEOPLE TELL US,
DOES THAT--DOES GENDER ISHT ACT
WITH SEXAL ORIENTATION?
WELL IT'S THE SAME THING, YOU
HAVE TO YOU KNOW TO MEASURE SOME
OF THE GENDER RELATED ATTRIBUTES
THAT YOU KNOW BOTH LONDA AND OUR
TEAM HAVE IDENTIFIED THAT AS YOU
KNOW POTENTIALLY BEING, YOU KNOW
GENDER RELATED AND IT AFFECTING
HEALTH EMPLOY SO IN A WAY I
DON'T THINK IT CHANGES.
IT'S JUST A MATTER OF REALLY
MEASURING YOU KNOW THOSE
POTENTIALLY IMPACTFUL FACTORS.
>>AND THEN FOR DR. NEILSEN, THE
IDENTIFY FACTORS APPEAR TO
DIRECTLY TO HEALTH, SO WHY WOULD
YOU ALIGN THOSE FACTORS WITH
GENDER LABELS?
>>YEAH, SO, I THINK THE
IMPORTANT THING HERE IS TO SORT
OF OPEN UP FOR A BROADER
THINKING ABOUT WHAT A GENDER
ACTUALLY IS AND THE DIFFERENT
DIMENSIONS OF THAT AND HEREBY
PROVIDING A DIFFERENT VARIABLES
TO CAPTURE THIS.
THIS IS ALSO FOR A BETTER
UNDERSTANDING OF HOW GENDER
RELATED FACTORS MAY MATTER IN
RELATION TO A SPECIFIC DISEASE
FOR INSTANCE.
SO, YOU CAN THINK ABOUT THIS
ALSO AS A PROCESS WHERE STUDIES
MAY START LOOKING INTO THIS MORE
BROADLY AND IN THE LONG RUN
UNDERSTAND WHICH OF THESE
FACTORS MAY BE THE CRITICAL 1S
TO TAKE INTO ACCOUNT.
AND AS WE POINT TO IN OUR PAPER,
OF COURSE THIS IS AN ONGOING
PROCESS, IT'S IMPORTANT TO POINT
OUT THAT MANY OF THE EXISTING
MEASURES HERE ARE PRETTY OLD
ACTUALLY AND THERE'S STILL A LOT
OF WORK TO BE DONE AS YOU POINT
TO YOURSELF ALSO WITH THE
EXAMPLES FROM CALIFORNIA NOW,
THAT THERE MAY BE NEW WAYS OF
THINKING ABOUT GENDER AND NEW
WAYS OF UNDERSTANDING WHY GENDER
IS ESPECIALLY AT THE TRAIT OR
THE IDENTITY LEVEL THAT WE NEED
TO CAPTURE BETTER AND
QUALITATIVE RESEARCH WILL BE
VERY IMPORTANT AS PART OF THAT
AS WELL.
>>YEAH, THANK YOU SO MUCH.
SO I WAS GOING TO ASK THE
QUESTION TO DR. FELDMAN AND
[INDISCERNIBLE] NEXT AND THEN WE
WILL HANDOFF TO THE AUDIENCE,
BUT I THOUGHT I HEARD SOMEBODY?
>>I WAS GOING TO SAY IN TERMS
OF MEASURING GENDER, SOME OF THE
STUFF THAT I HAVE DONE WITH THE
CHICAGO HEALTH AND LIFE
PRESENCES OF WOMEN STUDY WHICH
IS A STUDY PI BY DR. HUGHS AND
THE GENDER MEASURES THAT ARE
INCLUDED IN THERE, ARE MORE
GENERAL IN TERMS THAT THEY DON'T
REALLY--THEY'RE NOT REALLY TIED
TO KIND OF A SPECIFIC STEREO
TYPICAL IDENTITY OR BEHAVIOR.
THEY'RE MORE LIKE HOW DO YOU HAD
OF-HOW MASCULINE OR FEMININE DO
YOU PERCEIVE YOURSELF?
HOW MASCULINE OR FEMININE DO
OTHERS PERCEIVE YOU?
SO YOU HAVE INTERNAL AND
EXTERNAL EVALUATION AND WHAT WE
HAVE FOUND IS IT'S NOT JUST THE
MEASURE OF GENDER BUT THERE'S A
SOCIAL AND CULTURAL MEANING
ATTACHED TO DIFFERENT FORMS OF
MASKUE LYNNITY AND
FEMININITYENTIOUS SPECIALLY
WITHIN THE QUEER COMMUNITY AND
WE FOUND THAT SELF-PERCEIVED AND
THE WAY THAT OTHERS PERCEIVED
GENDER, VALUATION HAD DIFFERENT
IMPLICATIONS FOR EXPERIENCES OF
STIGMA BASED ON UPON THE QUEER
WOMEN'S RACE.
SO FOR BLACK WOMEN AND WHITE
WOMEN THE HISTORICAL ATTACHMENT
FORS GENDER NANOG CONFORMITY FOR
WOMEN WERE VERY POWERFUL FOR THE
SECOND WAVE FEMINIST MOVEMENT
BUT FOR BLACK WOMEN WHO WERE
OFTEN EXCLUDED FROM THIS
MOVEMENT THEY DID NOT, THEY
DON'T HAVE THE SAME SORT OF
HISTORICAL ATTACHMENT TO
REJECTING TRADITIONAL FEMININE
NORMS THAT YOU SAW IN A LOT OF
MOVEMENTS.
THERE'S REALLY, REALLY GREAT
HISTORICAL WORK ON THIS BUT WE
FOUND THAT THERE'S STILL
PLANNING OUT SOME OF THOSE STUDY
TO GENERATION BY RACE AMONG
QUEER WOMEN.
>>I AM GOING IN THIS DIRECTION,
I THINK THE QUESTION FOR YOU IS
THAT [INDISCERNIBLE] CROSS ROADS
WHERE THERE ARE JUST KIND OF
DIFFERENT GENERATIONAL
RESPONSES.
WE SEE IT AROUND THE
[INDISCERNIBLE] IN TERMS OF THE
LANGUAGE OF INCLUSIVITY,
RELATIVE TO THE DESIRE TO HEAR
THE WORD WOMAN AFFECTED.
WE HEAR IT, YOU KNOW YOU'RE
LOOKING AT THIS HETERONORMATIVE
PATRIARCHY PIECE WHICH REALLY
BRIDGES THE IDEA OF GENDER WITH
IDENTITY, WITH SEXUAL
ORIENTATION OR AFFINITY.
I'M CURIOUS TO YOU AS YOU'RE
TAKING THIS WORK OUT WHICH DOES
PRESENT WITH A CERTAIN LENS
THAT'S MORE REFLECTIVE OF WHAT
IS BEING SEEN IN YOUNGER
GENERATIONS, DO YOU FIND A
GENERATIONAL DIVIDE IN TERMS OF
RESPONSIVENESS TO THAT?
ANOTHER EXAMPLE IS JUST BEING
FULL FORWARD.
WE'RE GOING TO ELECTRIC AT
PERCENT OF REPUBLICAN, THESE ARE
BOLD VIEWS.
SO I'M CURIOUS WHAT ARE THE
RESPONSE FROM THE FIELD ON
THESE?
>>MY IMPRESSION IS POSITIVE
WHICH I THINK IS GOOD, BUT IT'S
FOR ME TOO, I'M ALWAYS, ALWAYS
LEARNING AND STRIVING TO
INCORPORATE NEW IDEAS AND
CONCEPTS.
I MEAN 1 OF THE THINGS I
CONTINUE TO WRESTLE WITH IN
TERMS OF THINKING ABOUT THE
STRUCTURAL HETEROPATRIARCHY
MEASURE BEING FOCUSED ON LGBT
POLICIES, FAMILY PLANNING AND
STRUCTURAL RACISM, HOW DOES
STRUCTURAL RACISM FIT IN HERE
AND THERE'S A PIECE THAT CAME
OUT A COUPLE WEEKS AGO ABOUT
INCLUDING ANTIABORTION POLICIES
INTO STRUCTURAL RACISM MEASURES
AND I SOMETIMES I START TO
WONDER IF HOW MANY POLICIES WE
CAN PACK INTO A SCALE TO GET
LIKE BAD STATE SCALE OR GOOD
STATE SCALE AND IF YOU'RE JUST
HIGHLIGHTING EVERYTHING ARE YOU
THEN SAYING NOTHING?
AND HOW TO BE FLEXIBLE BUT ALSO
TARGETED AND SO THAT IS
SOMETHING THAT I AM SORT OF
WRESTLING WITH AND I KNOW IT IS
SOMETHING THAT YOU KNOW OTHER
SCHOLARS YOU KNOW EVEN YOUNGER
THAN ME, WHO MAY BE CRITICAL OF
THAT, I AM OPENING TO LISTENING
AND LEARNING AND WE ALL HAVE TO
TRIEF TO DO AS WE GET MORE AND
MORE SILOED WITHIN OUR FIELDS.
>>DR. FELDMAN DID YOU WANT TO
ADD ANYTHING?
>>YEAH, I THINK THE 1 THINK
THIS WE'RE INTERESTED, WE DID
GET A COLLEGE STUDENT WHO WAS
TRYING TO HIT A PIECE ABOUT IT
AND WHO WE JUST IGNORED AND
WROTE IT ANYWAY, BUT 1 THING AS
WE THINK ABOUT THE PUSH BACK IS
THE IRONY IS OBVIOUSLY
HETEROPATRIARCHY AFFECTS
EVERYBODY SO THE PUSH BACK WE
GOT WAS A MORE CONSERVATIVE
BASED ON THE PHOTO WE SAW OF
HIM, YOU KNOW WHITE PRESENTING
CIS MALE.
>>AND IT WAS A CONSERVATIVE
NEWS PAPER.
>>THESE FACTORS CONSTRAIN HIM
AS WELL, RIGHT?
SO WE TEND TO OBVIOUSLY THINK
ABOUT THE IMPACT OF THESE
POLICIES ON POPULATIONS THAT ARE
MOST MARGINALIZED AND EVEN WITH
STRUCTURAL SEXISM IN THE WORK
THAT DR. HOMAN HAS DONE AND IT
AFFECTS CIS MEN AS WELL AND I
THINK WE NEED TO THINK BROADLY
ABOUT HOW TO COMMUNICATE WHO
THIS WORK IMPACTS AND WHY.
I THINK 1 OF THE CHALLENGES THAT
BETHANY ALLUDED TO IS THE
BALANCE OF TRYING TO CAPTURE
EVERYTHING THAT IS GOING ON AND
KIND OF FIGURE OUT THE SO WHAT
IN SO THERE'S THIS SORT OF
CONCEPTUAL INTELLECTUAL CONCEPT
ABOUT WHAT MATTERS AND AT THE
END OF THE DAY, WE HAVE TO GET
IT THROUGH REVIEW PANELS AND WE
GET THE COMMENT OF WHAT POLICY
DO WE CHANGE.
AND IT'S LIKE WE LIVE IN A WORLD
WITH HUNDREDS AND HUNDREDS OF
POLICIES, NO 1 POLICY IS GOING
TO FIX EVERYTHING.
SO I THINK IT IS THE CHALLENGE
OF TRYING TO THINK ABOUT
THEORETICALLY WHAT WE KNOW,
LOGISTICALLY WHAT WE CAN STUDY
BASED ON EXISTING DAILY BASIS
THEA SETS AND VARIABLES AND THEN
WHAT WE CAN GET FUNDED TO DO AND
IT'S HARD TO FIND THAT DIAGRAM
OF WHAT'S IN THE MIDDLE.
>>AND I'M GOING TO WE HAVE 2
MINUTES SO HERE'S WHAT I'M GOING
TO ASK PEOPLE TO DO.
I KNOW THAT NIH WANTS TO HEAR
FROM ALL OF US.
THE PANELISTS AS WELL AS
PARTICIPANTS.
WHAT DO YOU WANT?
START TACKLING THESE ISSUES?
RESEARCH PRIORITIES ARE NEEDED?
I WILL ASK EVERYBODY TO THROW UP
TELL ME IN THE CHAT OR Q&A THAT
WOULD BE BEST FOR A PIECE OF
FEEDBACK?
>>Q&A.
>>OKAY BEING IF EVERYONE WOULD
WRITE SOMETHING IN THE Q&A, THIS
IS OUR TIME, OUR VOICE TO GET
THIS OUT THERE.
JUST EVERYBODY WRITE AS FAST AS
CAN YOU.
I'M GOING TO STAY AND KEEP THIS
OPEN AND PLEASE JUST WRITE AND
WE WILL GO FOR ANOTHER 3 MINUTES
KNOW THAT I'M PRESSING INTO
THEIR TIME, PLEASE GO AHEAD.
>>CAN I ASK BETHANY AND MORGAN
A QUESTION?
, IF IT'S VERY QUICK BECAUSE WE
HAVE TO GET BACK TO THE 4:00.
>>I WAS WONDERING WHY YOU
DIDN'T INCLUDE TRANSGENDER IN
YOUR STUDIES.
I CAN IMAGINE BUT I WAS
WONDERING WHAT YOU'RE REASONS
ARE.
>>IT WASN'T AVAILABLE TO US IN
THE POLICY SO THE WAY IT WORKS
IS AT THE TIME OF INTERVIEW,
THEY WILL TAKE THE LOCATION BUT
THEN IT'S HIDDEN THROUGH
RESEARCHERS AND YOU HAVE TO GO
THROUGH A BIG PROCESS OF
APPLYING TO GET CONTEXTURAL
MEASURES MERGED IN AND I BELIEVE
SO, SO, WINDY MANNING THE PI ON
ADDING THE LGBI POLICY MEASURES
AND I THINK THEY WANTED TO HAVE
TRANSGENDER POLICIES AREYALATED
BECAUSE OF DEDUCTIVE DISCLOSURE
REASONS THEY WERE TAKEN OUT.
SO WE'RE HOPING THAT IN THE
FUTURE WE CAN GET SEXUAL
ORIENTATION MEASURES ON MORE ARE
PRODUCTIVE SURVEYS THAT WOULD
ALLOW US TO DO MORE AVAILABLE
POLICIES.
>>THAT'S USUALLY THE ANSWER
WITH POLICY RESEARCH IS WE WANT
TO DO BUT THE DATA SET WON'T
ALLOW IT.
>>ISN'T THAT EVERYTHING?
>>OH DATA.
>>SO WE DO HAVE TO CLOSE THIS 1
AND GO BACK TO THE MAIN SESSION,
BUT I DID PUT THE LINK IN THE
CHAT FOR OUR FEEDBACK FORM.
YOU WILL SEE IT BACK IN THE MAIN
SESSION TO ANSWER DR. RAJ'S
QUERY.
AND THANK YOU ALL.
THIS HAS BEEN SUCH A PHENOMENAL
SESSION AND I WILL SEE YOU IN
THE OTHER ROOM IN 30-SECONDS.
THANK YOU, THANKS FOR ALLOWING
ME TO HOST.
IT WAS A GREAT