(De-)Konstruktion von Geschlecht zur Quantifizierung gesundheitlicher Ungleichheiten

Abstract

Women's socio-economic disadvantage stems from more frequent and substantial unpaid care work such as domestic work, childcare and informal care compared to men. Gender Mainstreaming (GM) measures (Gender Care Gap, Gender Pay Gap, Gender Pension Gap) aim to achieve gender equality and thus pursue a gender-transformative approach. The German Federal Health Monitoring and Reporting (GBE) uses population-based data to analyse the health situation of the population and to identify potential areas for action. In addition to the established stratification by sex/gender, age and socio-economic status, the health relevance of behavioural differences as a result of the internalisation of social gender roles is hardly taken into account in GBE data analyses. This cumulative dissertation examined the extent to which the development of gender-sensitive to gender-transformative GBE can be supported by an analytical approach based on key conceptualisations from feminist perspectives. The first step was to develop a conceptual framework for analysing the data using feminist perspectives of equality, difference and deconstruction. This was followed by a scoping review of the operationalisation of intersectionality and sex/gender in quantitative health research. The conceptual framework was further tested through various classification tree analyses and the development of an 'Intersectional Gender Score'. The results show that 1) social aspects of sex/gender are inadequately operationalised in intersectionality-informed quantitative analyses, 2) gendered lived experiences along mechanism-related sex/gender variables such as family housework, informal care, social support and financial responsibility allow for a more nuanced representation of socially intervenable underlying mechanisms, and 3) the concerns of the GBE are compatible with the gender-transformative orientation of the GM, particularly with regard to Mental Load. This was evident both in the use of different statistical methods and in the use of different population-based data. The conceptual integration of feminist perspectives can contribute to a more gender-sensitive empirical basis for GBE, and at the same time clarify that the realisation of Gender Equality has the potential to promote equal health opportunities in the population.