Looking twice at the gender equity index for public health impact

Background: It has been shown that gender equity has a positive impact on the everyday activities of people (decision making, income allocation, application and observance of norms/rules) which affect their health. Gender equity is also a crucial determinant of health inequalities at national level; thus, monitoring is important for surveillance of women’s and men’s health as well as for future health policy initiatives. The Gender Equity Index (GEI) was designed to show inequity solely towards women. Given that the value under scrutiny is equity, in this paper a modified version of the GEI is proposed, the MGEI, which highlights the inequities affecting both sexes. Methods: Rather than calculating gender gaps by means of a quotient of proportions, gaps in the MGEI are expressed in absolute terms (differences in proportions). The Spearman’s rank coefficient, calculated from country rankings obtained according to both indexes, was used to evaluate the level of concordance between both classifications. To compare the degree of sensitivity and obtain the inequity by the two methods, the variation coefficient of the GEI and MGEI values was calculated. Results: Country rankings according to GEI and MGEI values showed a high correlation (rank coef. = 0.95). The MGEI presented greater dispersion (43.8%) than the GEI (19.27%). Inequity towards men was identified in the education gap (rank coef. = 0.36) when using the MGEI. According to this method, many countries shared the same absolute value for education but with opposite signs, for example Azerbaijan (−0.022) and Belgium (0.022), reflecting inequity towards women and men, respectively. This also occurred in the empowerment gap with the technical and professional job component (Brunei:-0.120 vs. Australia, Canada Iceland and the U.S.A.: 0.120). Conclusion: The MGEI identifies and highlights the different areas of inequities between gender groups. It thus overcomes the shortcomings of the GEI related to the aim for which this latter was created, namely measuring gender equity, and is therefore of great use to policy makers who wish to understand and monitor the results of specific equity policies and to determine the length of time for which these policies should be maintained in order to correct long-standing structural discrimination against women.

Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study

Background: The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS). Methods: The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or “Basic Stable Input of Care” (BSIC), coded by its principal function or “Main Type of Care” (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal). Results: DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making. Conclusion: DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison.

Cambios en la estructura metropolitana durante la última década. El caso del Área Metropolitana de Valencia

La realidad metropolitana de los países desarrollados está experimentando cambios importantes asociados a la creciente separación entre los espacios de residencia y trabajo. En las áreas metropolitanas se dan los procesos de este tipo más complejos cuyas consecuencias territoriales inmediatas son la potenciación de ciertas centralidades a la vez que crecen centros nuevos o tradicionales en sus áreas de influencia. La estructura territorial (la red urbana y de transportes, fundamentalmente) en el Área Metropolitana de Valencia (AMV) incide claramente en los problemas asociados a la equidad social y a la sostenibilidad ambiental. La comunicación que aquí se presenta se centra en el análisis de dichos cambios en la última década, a partir del comportamiento demográfico de los municipios, las pautas generales de movilidad y los cambios en la ocupación del suelo en el AMV.

Un estudio cualitativo sobre los diferenciales de género en la educación superior: percepciones de las académicas en contextos masculinizados

El contexto universitario refleja, al igual que la sociedad en general, la falta de equidad y equilibrio en la representación de mujeres y hombres. En la academia aún encontramos una alta presencia de hombres, especialmente, en lo que respecta a las cátedras universitarias. En este estudio presentamos y analizamos resultados de un proyecto de investigación desarrollado en la Universidad de Alicante (España). Del análisis realizado en los siete centros o unidades académicas de esta universidad, en el que aún las académicas conviven en contextos masculinizados, emergen las diferencias de oportunidades percibidas por las profesoras universitarias en su desarrollo profesional docente e investigador, aunque muchas de ellas no las relacionan con la discriminación por género. Cuando las académicas se han encontrado en situaciones discriminatorias manifiestan una actitud activa y reivindicativa, excepto en los centros altamente masculinizados donde mantienen una actitud pasiva para que el ambiente de trabajo sea óptimo. Consideramos que es necesario continuar indagando en estos espacios donde la presencia de las académicas sigue siendo minoritaria a pesar de las reformas universitarias en materia de igualdad desarrolladas en la Educación Superior.