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This chapter focuses on gender, culture and power. Our attention is directed to how gender and culture influence the ways in which people approach and receive health care and on how we as health practitioners

Assignment Task


This chapter focuses on gender, culture and power. Our attention is directed to how gender and culture influence the ways in which people approach and receive health care and on how we as health practitioners can work to ensure equity and inclusion for all people. The first part of the chapter focuses on gender and the second on culture. Attention to gender issues is important for several reasons. Gender is a pivotal social determinant of health (SDH) and instrumental to socio-economic position (SEP). A person’s gender can determine the extent to which they have opportunities to achieve health and wellbeing. People are also assigned relatively different positions in society depending on their gender, particularly in being granted differential education, work opportunities or social support. Gender influences can be cumulative along the life course. As individuals develop along the critical pathways from birth to older age, gender, like other SDH, shapes not only biology, but experiences and opportunities that become reinforced over time. Because men and women occupy different social positions in the household, the workplace and in the community, they are exposed to different risks and potential. Along the pathways of women’s and men’s life course, gender differences are apparent at every stage, and this is the case in different countries and contexts. These gender differences interact with other life circumstances to create complex webs of factors affecting health and wellbeing.

Key Points

Culture provides a different marker for inclusiveness with the most compelling indicator of an inclusive society the respect conferred on its Indigenous people. Yet, in many countries of the world Indigenous people are treated as outsiders, the ‘other’ in relation to the dominant culture. This lack of cultural inclusiveness has an enormous impact on their health and wellbeing, and, in some cases, determines whether an Indigenous person is able to live a long life in harmony with the natural and spiritual environment, or suffer premature mortality. In many places, cultural exclusiveness divides citizens by race, ethnicity or affiliation, igniting oppressive actions.

Evidence to support primary Health Care

that, at worst, include violent exchanges and civil wars. In other places, cultural exclusion is more subtle and expressed in racist attitudes, thinly veiled arrogance, and dominant forms of exclusive language. Over time, those who are disadvantaged by ethnicity, race or affiliation, lose not only opportunities to live vibrant, healthy lives, but their sense of place in the world, and in the community. As time goes by, dispossession and hopelessness pervade all aspects of life, and create a self-fulfilling prophecy of vulnerability to ill health and incapacity to change. The community is an ideal place to address inequities that arise from social and cultural exclusion, particularly in the process of unravelling constraints and facilitating factors involved in developing capacity. Gender and cultural equity, and differential access to childhood education, health literacy, prevention, care and economic opportunities are pivotal to community development, community competence and building social capital. Support for equity must therefore begin in the community; otherwise, in this rapidly changing global world, civilisations will grow stagnant. To flourish, societies need to address the way power and social inclusion interact with the social determinants of health, and to seek ways of creating more harmonious, socially just communities.


Discuss the importance of social inclusion and its relevance to primary health care.Describe the role of equity in the health of individuals, communities and societies.Explain the influence of culture on health and social justice.Define cultural safety as a concept and explain its relevance and importance in the provision of health care.Prioritise a set of goals for primary health care practice when working with diverse communities.


How inclusive is my community’?What factors assist/prevent you and your friends and family as feeling ‘part’ of that community?In terms of health services in your community, to what extent is Indigenous health catered for? Are the services visible to the public – or did you have to Google to find out? Are they inclusive?

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