We need to talk about gender equity

Gender Equity

June 16, 2022

Even as someone who used to work in women’s health, I have sometimes lost sight of how critical women’s rights are to our work. But now is the time to resurface the conversation. We cannot address access to care if we do not talk about gender equity. We cannot improve food security if we do not talk about gender equity. We cannot increase health equity if we do not talk about gender equity. The United States is failing women, birthing people and gender minorities and we need to talk about it as a public health imperative. 

When I worked at the U.S. Department of Health and Human Services Office on Women’s Health, I attended an international development event on gender integration and asked why we often discuss gender equity as a “them” problem and not an “us” problem (hint: the answer is white supremacy and colonialism). The speaker, an American woman, suggested that we just don’t have as big of a gender equity problem in the U.S. 

But if you look at the soaring maternal mortality rates, economic inequality and  Supreme Court Justice Samuel Alito's recently leaked draft opinion reversing Roe v. Wade, you’ll notice that we do indeed have a gender equity problem. It is a problem that is blatantly reinforced through both discriminatory lawmaking and political inaction. Neglecting gender equity in our policies, and passing laws that are actively hostile toward women, will only further exacerbate health disparities. 

For example, pregnancy-related deaths increased by nearly 20% from 2019 to 2020, with Black women dying at three times the rate of white women. Additionally, 7 million reproductive-aged women in the U.S. live somewhere with no or limited access to maternity care. 

Beyond inadequate access to care, many women in this country face economic hardship, which the pandemic has only worsened. The dual reality of economic insecurity and lack of access to reproductive care is a bleak one. Areas classified as maternity care deserts tend to have lower average household incomes and higher poverty rates than counties with access to maternity care (and are more likely to ban abortion). And women who have been denied an abortion experience greater economic hardship for years following their denial of care compared to those who do obtain one. Removing abortion access can only push women deeper into poverty.

Furthermore, predictions indicate that women’s economic and food insecurity will only continue to grow with future disasters. These challenges are already worse for Black and Hispanic households. Given that food insecurity is higher in single-parent households, and 85.5% of individuals who received an abortion in 2019 were unmarried, the absence of abortion care will likely increase food access disparities. According to a United Nations statement released in 2021:

“Pregnancy under conditions of malnutrition or undernutrition can have life-threatening consequences. Deficiencies in antenatal micronutrients contribute significantly to the risk of haemorrhage, the leading cause of maternal mortality.” 
Despite all these facts, a simple Google search for “gender equity and food security” or “gender equity and access to care” shows it is difficult to find U.S. resources and programs that consider gender as a key factor. Because we don’t think gender equity is still a problem, we tend to avoid treating it as an explicit goal in public health programming and other social justice programs, including food justice programs. This is especially unfortunate given that both the reproductive justice and the food justice movements were born out of the Black community, while policies that limit access to reproductive health care and food continue to harm Black people the most.

If we are going to be prepared for the inevitable increase in food insecure households following abortion restrictions, then an intersectional approach is needed to fully understand and address the ways in which birthing individuals, and Black women in particular, are disproportionately impacted. 

So, what can we do to start drawing this connection? Here are a few questions to consider:

  • When I think about racial justice am I considering how experiences differ between people of different gender identities?
  • Have we integrated gender into our organization’s procedures or community’s policymaking process?
  • How might this policy or system change impact women, gender minorities and men differently?
  • What is our program doing to support access to culturally appropriate and non-discriminatory maternity care?
  • How might restrictions to abortion access impact food security in my community?
  • How are women’s unique barriers and voices being integrated into our approaches to addressing food access?
  • How do women’s rights fit into our definition of food sovereignty?

To increase access to care for all people, regardless of gender, we need to stop taking a gender-blind approach to our program planning, implementation and evaluation. If we aren’t thinking about how gender norms affect access to care and food access, then we aren’t getting to the root of the problem. And most importantly, we need to fight back against policies that disproportionately harm women and other birthing people of color.