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Public Health

Partly relevant for Medicine, Care Management and Therapeutic Professions

Course: Public Health
Group of courses: Medicine and Health

Content:

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Course objectives:

In public health, the focus is on teaching gender-sensitive methodical concepts and basic theories on the biological, psychological and social dimensions of health and disease. It is intended to sensitise students to sex differences in health and disease and to gender-related influences on health and disease as well as on health-related behaviour. Students should be enabled to assess the relevance of such differences in correlation with other variables of social differentiation and gain knowledge of epidemiological data and the differences in women's and men's (social) living conditions as well as of a gender-sensitive analysis of the healthcare system. This includes the entire intervention chain of both medical and psychosocial care (prevention, health promotion, therapy, rehabilitation and care). Students should be enabled to analyse gender-specific requirements and needs in healthcare, including prevention, and to establish the resulting requirements for healthcare as well as to assess the influence of gender on ecological and economic determinants of health.

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Teaching content/subject-specific gender studies content:

Public health is a multidisciplinary field, combining different theoretical and methodological perspectives of health and disease and the organisation of healthcare. Various aspects of gender are relevant in core areas of public health such as epidemiology, medicine, psychology, health economics, social sciences and didactics. When applied to gender-related teaching this multi-disciplinary nature of public health creates challenges but also embodies opportunities for taking into account the various different dimensions of gender studies and feminist approaches. In public health, gender studies embody the biological and social dimensions of the category of gender. This includes:

  1. interactions of the biological and social influences on health and disease,
  2. the analysis of gender bias in the healthcare system and
  3. the development of gender-sensitive healthcare concepts, including specific services for women and men.

In public health, gender studies therefore often overlap with medical, psychological and social science issues in gender studies:

  • Public health draws on findings from gender studies in medicine and the natural sciences, but applies this knowledge to public health and population-related issues rather than to individual health issues. Examples of this include findings on sex differences in coronary heart disease as well as human papiloma virus (HPV) vaccination and tobacco and alcohol control.
  • Social epidemiology also offers further material for gender-related teaching. Here, the focus is on influences arising from gender and other social determinants of health and also from more complex variables such as education, a possible immigrant background, labour market integration, religion, and sexual orientation.
  • Social sciences are also relevant beyond social epidemiology. Examples of this include gender-sensitive analyses of the organisation of healthcare and the management of medical performance, (e.g. gender-specific distributions of drugs without medical reasons, as reported for psychotropic drugs). Research into the professionalisation of new emergent health occupations with overall high proportions of women provides further examples.
  • Across the different disciplines and their specific empirical findings and methodology, students should learn about feminist theories and the concept of gender mainstreaming and also acquire knowledge of women's health and men's health studies.

A wide range of gender-related issues are relevant for public health, for example:

  • Women-specific care needs and demands that are highlighted in debates of the women's health movement, e.g. menopause, birth and pregnancy, reproductive health; healthcare services for women who experienced violence.
  • Men-specific healthcare needs and demands, e.g. prevention and psychosocial care programmes in areas where men are under-researched and under-supplied (e.g. depression).
  • Gender-sensitive analyses of diseases that affect both men and women, while the healthcare services are biased towards men's healthcare needs; one such example is coronary heart disease and myocardial infarction, where a male bias has led to poor quality of women's healthcare. By contrast, studies into depression provide examples for under-supply of men.

More complex empirical studies and gender-specific concepts are especially available in the area of disease prevention; here, epidemiological data and health reports are increasingly sex-disaggregated, thus providing the evidence for gender-sensitive healthcare planning and intervention. In recent years, health reports for both sexes have been conducted providing differentiated data on health, disease and health-related behaviour. With the prevention report coming into effect in 2016, a gender-sensitive design of SHI activities has gained particular importance, and a connection between quality development and gender discussions can be observed. Yet, the development of a concept is still pending. With regard to empirical data, there are various different sources available that can support gender-specific teaching in Germany. Also, there are some methodological concepts available that can help uncovering gender bias and implementing gender mainstreaming policies in public health research and practice. Compared to this, material on gender-sensitive organisation and delivery of healthcare is overall poorly developed in Germany; so lecturers should refer to Anglo-American research.

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Integration of gender studies content into the curriculum:

In line with the concept of gender mainstreaming, gender should be integrated into all areas and issues of public health. This integration is essential, because health and disease are closely connected to gender issues; various different sources of data clearly document differences between women and men in health and illness. Additionally, specific gender modules are recommended in some areas. Examples of gender modules could be:

  • Modules on methodological issues of gender studies; for example, development of gender-sensitive indicators to assess the quality of models of healthcare, such as the disease management programmes in the ambulant sector and the DRGs in the hospital sector;
  • modules on the implementation of gender mainstreaming in healthcare;
  • modules on the development of gender-sensitive healthcare programmes, e.g. in prevention and health promotion, including the integration of the gender category as a quality criterion in SHI activities;
  • modules on specific issues in women's and men's health.

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Degree Stage:

The above content should be integrated into Bachelor's and Master's curricula as of the first semester; specific gender modules can be offered in the second year of study, depending on the curriculum.

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