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Public Health

Partly relevant for Medicine, Care Management and Therapeutic Professions

Course: Public Health
Group of courses: Medicine and Health

Teaching/course objectives:

Teaching gender-sensitive methodical concepts and basic theories on the biological, psychological and social dimensions of health and disease. The objective is to sensitise students to sex differences in health and disease and to gender-specific and other social influences on health and disease. Students should gain knowledge of epidemiological data and the differences in women's and men's social living conditions, as well as a gender-sensitive analysis of the healthcare system. This includes both medical and psychosocial care, along with prevention and health promotion. Students should analyse gender-specific requirements and needs in healthcare, including prevention, and establish the resulting requirements for healthcare.

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 didactic. When applied to 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 on an individual medical level. 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-specific teaching. Here, the focus is on influences arising from gender and other social determinants of health, such as for instance, social class, race and ethnicity and also more complex variables such as education, 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. gendered 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 get knowledge of women's health and men's health studies.

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

  • Women specific care needs and demands, that were highlighted in the 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. Consequently, there are now 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.

Forms of 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 new 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;
  • Modules on specific issues in women's and men's health.

Degree stage:

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

Keywords:

Public Health, Care Management, Nursing, Therapeutic Professions, Medicine, Nursing and Health, Health Communication, Barrierfree Systems, Health Management, Gerontology, Therapies, Special Education Studies and Nursing, Health Care, Health and Social Science