Introduction
Sex and gender have a significant relationship to health and health outcomes for both women and men (World Health Organization [WHO], 2016a). Sex relates to biological attributes whether born female or male, while gender is sociocultural identity that is learned over time (Canadian Institutes of Health Research [CIHR], 2016; WHO, 2016b). The differences in morbidity and mortality between women and men have been well recognised (Australian Institute of Health and Welfare [AIHW], 2016; WHO, 2016b). Biological characteristics expose both women and men to different health risks and heath conditions. Gender also exposes women and men to different health risks and gender inequity impacts on their potential to achieve health and well-being. This chapter focuses on both biological and sociocultural factors that impact on women and men's health and how health professionals, and in particular community nurses, can mitigate health disparities and inequities.
Sex and gender
Health is a biological as well as a social phenomenon (Pederson, Greaves & Poole, 2014) by which individuals’ characteristics, lifestyles and their social context impact on health and health outcomes. Biological characteristics related to sex are often categorised as being either female or male, but variation exists in both biological attributes and the concept of sex (CIHR, 2016). For example, intersex people are born with sex characteristics that do not fit within the binary notions of female or male bodies, which may be visible at birth or not apparent until puberty (United Nations, 2016). Gender relates to socially constructed roles, behaviours, expressions and identities of women, men, girls and boys and includes how people perceive themselves and others, how they relate and act toward one another, and how power is distributed in society (CIHR, 2016). Gender expectations vary between cultures and across cultures and can change over time (WHO, 2015a). The impact of gender, like other social health determinants, can be cumulative across the life course (McMurray & Clendon, 2015). It has been argued that ‘the gendered distribution of power and resources produces persistent differences between men and women’ (Springer, Hankivsky & Bates, 2012, p.1661). Women and men occupy different social positions in the household, at work and in the workplace and the community, with different experiences and access to education, income and resources which expose them to different risks and potential (McMurray & Clendon, 2015, p. 363).