Populations Practice

Remember that a population can be defined in a variety of ways: by geography and political boundaries, such as countries or provinces; by specific characteristics, such as sex, age, education, ethnicity, etc.; by common practices and shared interests, such as an organization of parents of autistic children or an association of nurse practitioners.

TIP: Don’t overthink this exercise. Just quickly list the main points of what you know or believe about the population(s). Don’t worry about getting it ‘right’ at this stage.

Can you clearly state why you are interested in, concerned about or working with a specific population? For instance, are you responding to research evidence, to media coverage, to political decisions, to government priorities, to instructions from your manager or to some other factor?

Does knowing why you are focusing on a population affect your understanding of the population or what you’ve been asked to do with or for them? For example, are you working with young people because there is a higher incidence of obesity in this age group, because media coverage is pointing to an “epidemic” of obesity in children, or because you’ve have been asked to develop policies around physical education in the schools?

Tip: If you need a quick refresher on how the core concepts are defined, go here:

Characterize a population using the core concepts of sex, gender, diversity and equity.

Have you thought about the sex of the population you are describing?

Hint: Remember that sex is biological and is expressed along a continuum.

Does the population you are interested in consist of one, two or more sexes? Is this population defined by characteristics other than sex, such as age, ethnicity, and education? For example, if you are interested in understanding men’s experiences of overweight and obesity, your population would include only males. By comparison, if you are interested in understanding the impact of income on rates of overweight and obesity, your population might include both males and females as well as those who identify as neither or both. It is important to be clear about the sex of the population you are interested in or working with.

If you don’t have appropriate data for the population you are interested in or working with, can you get it? If not, why not?

Hint: Gaps in the evidence may make it impossible to address the entire continuum of sex. But data may be available for males and females, if not for those who identify as neither or both. Sometimes researchers try to ensure a balance of female and male participants in their studies, but then do not report their findings by sex. Sex-disaggregated data may be available if you ask for it.

Does your description of the population include an understanding of how gender roles and norms might affect those you are interested in or working with?

Hint: Remember that gender is social and is expressed along a continuum.

Think about the social norms and expectations in the population. Are they different for women, men, transgendered people, etc.? For example, in societies where female beauty is associated with thinness, women are more likely than men to fall within a healthy weight range or to be underweight. But women in these societies are also more likely than men to suffer stigma and discrimination if they are overweight or obese.

Consider whether your population includes people who are visibly different – age, race, etc. – as well as people who may be different in ways that are not visible or obvious – sexual orientation, economic status, place of residence, etc.

How does thinking about diversity affect your understanding of the population? For example, women are more likely than men to be obese, but among women, lesbians experience much higher rates of overweight and obesity than heterosexual women.

Tip: Trying using one of these lists of the social determinants of health as a quick guide for thinking about types of diversity and their significance.

List of social determinants of health.

Ask yourself the following questions: 1. Does the description of the population include all those who are at risk, in need and/or affected? If not, why not? 2. Does the population you are describing or working with experience conditions that are different from those of other populations? 3. Are differences and/or gaps in knowledge and experience unfair – caused by inequity or leading to inequity?

The answers to these questions will help you to think about equity and population.

For example, we have limited information about obesity amongst people living with disabilities, despite the fact that they represent a significant proportion of the population and many are at heightened risk of obesity as a result of mobility and exercise challenges. Gaps in our knowledge of the needs and experiences of this population may lead to inequity because responses to the problem of obesity typically do not include those living with disabilities.

Tip: Need a reminder about the definitions of equity and equality?

Distinguish between equity and equality.

If you are already using sex-disaggregated data or data that address other social determinants of health, your description of the population may not change a great deal. But even if you are dealing with a single-sex population, you will still need to consider the influence of gender and diversity on that population as well as where there are inequities. For example, pregnant women who are overweight or obese represent a distinct population, since only females can become pregnant. But they are as likely to suffer stigma and discrimination as other females and males who are overweight or obese.

If you are new to SGBA, thinking about sex, gender, diversity and equity may significantly alter your understanding of a population. For example, if you had thought that poor people did not experience obesity because they could not afford to ‘indulge’ in unhealthy foods, you might now consider how many women and men living on low income are struggling with healthy weights because they have limited control over their food choices.

Keep in mind that you may not be able to address all of the core concepts if there is no separate evidence for males, females and transgender people, or if there is inadequate information about diverse populations and sub-groups.

If your information is incomplete or limited in some other way, you may still be able to define and work on an issue, but you will need to be clear and precise about what you know and what you don’t know. For example, without specific information about the weight experiences of different ethnic groups or people living in rural versus urban environments, we are limited in our discussion of the impact of diversity – place and culture in this case.

This is an excellent opportunity for reflection. Take a moment to examine your own assumptions or beliefs about the population you are describing as well as those of your colleagues, managers and partners. Did you already have a firm opinion about the population when you began your work?

Pop Up: Need a quick reminder about types of bias?

Identify Types and Sources of Bias.

At this point, you want to be as thorough and specific as you can in your description of the population.

Ask yourself if there might be other evidence or opinions that suggest the need for a different description of the population.

It’s time to practice iteration. Need a reminder about the meaning of iteration?

Explain and Practice Iteration.

“Iteration” is the practice of reflecting on our knowledge of a particular issue and adjusting our thinking and processes to address gaps, inconsistencies and oversights as well as to accommodate new knowledge or insights. In other words, iteration involves asking what the issue is, who framed it, who is at risk or in need, what evidence is available to shed light on the topic, and what we are doing about the issue.

Tip: Click here for an overview of the SGBA process.