The more women in govern­ment, the health­ier a pop­u­la­tion

Sherbrooke Record - - EDITORIAL - By Ed­win Ng As­sis­tant Pro­fes­sor, School of So­cial Work, Univer­sity of Water­loo and Car­les Mun­taner Pro­fes­sor, Fac­ulty of Nurs­ing, Univer­sity of Toronto

In Novem­ber 2015, Prime Min­is­ter Justin Trudeau formed the first gen­der-bal­anced cab­i­net in Cana­dian his­tory. In an­nounc­ing his cab­i­net, he en­sured that half of his clos­est ad­vis­ers (15 out of a to­tal of 30) were women.

Canada’s gen­der-equal cab­i­net vaulted the coun­try from 20th to fifth place in the world in terms of per­cent­age of women in min­is­te­rial po­si­tions.

When re­porters asked Trudeau about why gen­der par­ity was im­por­tant to him, he re­torted: “Be­cause it’s 2015.” His sim­ple yet mo­men­tous re­sponse res­onated with those com­mit­ted to eq­uity, di­ver­sity and in­clu­sion.

As pub­lic health re­searchers, this got us think­ing — if in­creas­ing the num­ber of women in po­si­tions of power pro­motes gen­der eq­uity, could it also pro­mote pop­u­la­tion health and well-be­ing?

Our find­ings, pub­lished re­cently in the jour­nal SSM - Pop­u­la­tion Health, sup­port the ar­gu­ment that yes, women in govern­ment do in fact ad­vance pop­u­la­tion health.

More women in power, fewer deaths

We first dug into the re­search lit­er­a­ture to see how male and fe­male politi­cians might dif­fer from each other. Com­pared to their male coun­ter­parts, fe­male politi­cians are more likely to hold left-wing at­ti­tudes (with re­gard to is­sues such as civil rights, so­cial equal­ity and egal­i­tar­i­an­ism) and sub­stan­tively ad­vance women’s rights in ar­eas such as pay eq­uity, vi­o­lence against women, health care and fam­ily pol­icy.

Deb Haa­land is one of two Na­tive Amer­i­can women who marked his­toric con­gres­sional vic­to­ries in Novem­ber 2018 as a record num­ber of women were elected to the U.S. House of Rep­re­sen­ta­tives. (AP Photo/juan Labreche)

Also, re­search has shown that women in govern­ment tend to work in more col­lab­o­ra­tive and bi­par­ti­san ways and em­ploy a more demo­cratic lead­er­ship style com­pared to men’s more au­to­cratic style. Women are also more ef­fec­tive at build­ing coali­tions and reach­ing con­sen­sus.

Next, we ex­am­ined whether there’s a his­tor­i­cal as­so­ci­a­tion be­tween women in govern­ment and pop­u­la­tion health among Canada’s 10 prov­inces. Be­tween 1976 and 2009, the per­cent­age of women in pro­vin­cial govern­ment in­creased six-fold from 4.2 per cent to 25.9 per cent, while mor­tal­ity from all causes de­clined by 37.5 per cent (from 8.85 to 5.53 deaths per 1000 peo­ple).

Us­ing data from pro­vin­cial elec­tion of­fices and Sta­tis­tics Canada, we found that as the av­er­age per­cent­age of women in govern­ment has his­tor­i­cally risen, to­tal mor­tal­ity rates have de­clined.

Women spend more on health and ed­u­ca­tion

This link does not of course mean that the in­crease of women in govern­ment has di­rectly caused the de­cline in mor­tal­ity.

To as­sess this, we re­gressed mor­tal­ity rates on women in govern­ment while con­trol­ling for sev­eral po­ten­tial con­founders. Our find­ings sup­port the hy­poth­e­sis that women in govern­ment do in fact ad­vance pop­u­la­tion health.

New Zealand’s Prime Min­is­ter Jacinda Ardern ad­dresses Par­lia­ment in Wellington, N.Z., in May 2018 while preg­nant with her first child. Many hope the 37year-old will be­come a role model for com­bin­ing moth­er­hood with po­lit­i­cal lead­er­ship. (AP Photo/nick Perry, File)

In­ter­est­ingly, women in govern­ment in Canada have had a big­ger ef­fect on male mor­tal­ity rates than on fe­male rates (1.00 vs 0.44 deaths per 1,000 peo­ple). We also found a path­way that con­nects women in govern­ment, pop­u­la­tion health and the po­ten­tial role of par­ti­san pol­i­tics. In an ear­lier study, we found that four types of pro­vin­cial govern­ment spend­ing are pre­dic­tive of lower mor­tal­ity rates: med­i­cal care, pre­ven­tive care, other so­cial ser­vices and post-sec­ondary ed­u­ca­tion.

When we tested govern­ment spend­ing as a me­di­at­ing fac­tor, we found that women in govern­ment in Canada have re­duced mor­tal­ity rates by trig­ger­ing these spe­cific types of health-pro­mot­ing ex­pen­di­tures.

Women work in more col­lab­o­ra­tive ways

We also found that there was no re­la­tion­ship be­tween the po­lit­i­cal lean­ings of women in govern­ment — whether they be­longed to left-wing, cen­trist or right-wing par­ties — and mor­tal­ity rates.

Ide­o­log­i­cal dif­fer­ences among so­cial demo­cratic (e.g., NDP), cen­trist (e.g., Lib­eral), and fis­cal con­ser­va­tive (e.g., Con­ser­va­tive) po­lit­i­cal par­ties seem to be less im­por­tant to mor­tal­ity rates than in­creas­ing the ac­tual num­ber of women elected to govern­ment.

This find­ing sup­ports the idea that women in govern­ment tend to work in more col­lab­o­ra­tive and bi­par­ti­san ways than their male coun­ter­parts.

It’s now 2019 and lead­ing pub­lic health schol­ars still tend to down­play the po­ten­tial ef­fects of po­lit­i­cal de­ter­mi­nants such as gen­der pol­i­tics on pop­u­la­tion health. In­stead, they opt to fo­cus al­most ex­clu­sively on in­di­vid­ual and so­cial de­ter­mi­nants of health.

We be­lieve gen­der pol­i­tics mat­ters in pub­lic health be­cause it helps to de­ter­mine “who gets what, when and how.”

We be­lieve that elect­ing more women in govern­ment not only pro­motes gen­der equal­ity and strength­ens demo­cratic in­sti­tu­tions but also makes real and sub­stan­tive con­tri­bu­tions to govern­ment spend­ing and pop­u­la­tion health.

Given that women in govern­ment can bring about de­sir­able changes in pop­u­la­tion health, let’s fig­ure out how we can gen­uinely level the po­lit­i­cal play­ing field for women.

The au­thors do not work for, con­sult, own shares in or re­ceive fund­ing from any com­pany or or­gan­i­sa­tion that would ben­e­fit from this ar­ti­cle, and have dis­closed no rel­e­vant af­fil­i­a­tions be­yond their aca­demic ap­point­ment.

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