Activity: Reviewing recommendations using sex, gender, diversity and equity
Read through the following recommendations for health planning, policy and research. Do these recommendations address the core concepts? How do you know?
1. In 1997, Health Canada issued drug research guidelines “to encourage the inclusion of women, especially those of child-bearing potential at the earliest stages of drug development, in order (i) to ensure that potential sex-related differences are being identified and taken into consideration when planning [further research] and (ii) to generate appropriate data to inform both physicians and potential users concerning sex-related characteristics of a new drug”. 
This guideline represents an important step forward because historically women have been excluded from research with the result that scientists and health care providers have had little or no information about how women and men might respond differently to medications and other treatments. The recommendation clearly addresses the role of sex (biology) in health and may also address equity in health outcomes as it is designed to increase knowledge about and improve care for both women and men. But the recommendation does not address diversity in that it does not recommend including different groups of women and men. Moreover, these recommendations are framed as guidelines rather than requirements, which makes them less influential and therefore perhaps not the best approach for translating knowledge into action or ensuring equitable outcomes.
2. In 2008, the Manitoba government announced plans to revitalize public housing, including improvements to structures and neighbourhood security. Specifically, the province decided that it would reduce crime in public housing by evicting anyone convicted of committing “even one criminal offence that poses an immediate risk to tenants, or for drug dealing or use, possession or storage of unlawful firearms, prostitution or sexual abuse and child”. 
While this might seem like a sensible solution for crime in public housing neighbourhoods, it is a rather blunt strategy that ignores potential differences between and among women and men. For example, this approach to crime reduction would mean that women engaging in sex trade work for survival would be evicted and forced into deeper poverty as well as environments that are less safe. Similarly, women often have limited control over the activities of other members of their households, but might be evicted along with those committing crimes.
3. In 2007, the Federal Government introduced the Children’s Fitness Tax Credit to promote healthy active lifestyles among children and youth. The tax credit covers up to $500 of enrolment fees for eligible physical activities and recreational programs. An additional credit of $500 is also available for children and youth with disabilities. To qualify, programs must have a significant physical-activity component where improved fitness can be expected over time, including cardio-endurance, muscular strength, flexibility, and balance.
Much controversy has surrounded the children’s fitness tax credit since it was first introduced. Many argue that it primarily benefits children from higher income families who are already involved in organized team sports, such as hockey, baseball, and soccer. Little benefit is experienced by lower income households, who first have to have the money to pay for programs upfront and have sufficient taxable income to receive the tax credit. For example, parents who receive social assistance do not have taxable income and are ineligible for the benefit. In addition, while the children’s fitness tax credit takes into account disabilities, other diverse socio-demographic characteristics are not considered. For example, the tax credit may be of little to no value for families living in rural or remote areas of the country who have limited or no access to eligible types of programs. In addition, gender differences in participation in physical activities between girls and boys have not been addressed – with males being more physically active during and outside of school hours than females. As a result, the fitness tax credit disproportionately supports boys’ physical activities.
4. A common recommendation for increasing physical activity and combating childhood and adult obesity is using more active modes of transportation, such as riding bicycles, instead of cars. In 2011, the Public Health Agency in Belfast, UK circulated health promotion material promoting cycling as a form of healthy physical activity. Their slogan was “Getting regular exercise is as simple as riding a bike.” 
Getting regular exercise may not be “as simple as riding a bike” for many people, especially those who are obese. There are often personal and environmental challenges that make certain strategies for promoting healthy weight difficult for some people to partake in. For example, riding a bike could prove challenging for people who live in colder and/or wet climates. People living with disabilities would also find it challenging in many cases to ride a bicycle for exercise. Furthermore, many cities and towns in Canada do not have bicycle lanes. Bicyclists often have to share the road with other vehicles in busy urban areas. For those growing up in rural areas, there may not even be a place to ride a bike. In addition, many homes do not have driveways or suitable sidewalks for children and young people to ride bicycles safely away from traffic. There are also many people who cannot afford to outfit their families with bicycles.