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Gender-transformative health promotion for women:
a framework for action
ANN PEDERSON*, LORRAINE GREAVES and NANCY POOLE
BC Women’s Hospital & Health Centre, University of British Columbia, Vancouver, BC, Canada
*Corresponding author. E-mail: apederson@cw.bc.ca

SUMMARY
Gender inequity is a pervasive global challenge to health improving the lives of millions of girls and women world-
equity. Health promotion, as a field, has paid only limited wide. Gender-related principles of action are identified that
attention to gender inequity to date, but could be an active extend the core principles of health promotion but reflect the
agent of change if gender equity became an explicit goal of significance of attending to gender in the development and
health promotion research, policy and programmes. As an use of evidence, engagement of stakeholders and selection of
aspect of gendered health systems, health promotion inter- interventions. We illustrate the framework with examples
ventions may maintain, exacerbate or reduce gender-related from a range of women’s health promotion activities, includ-
health inequities, depending upon the degree and quality of ing cardiovascular disease prevention, tobacco control, and
gender-responsiveness within the programme or policy. This alcohol use. The literature suggests that gender-responsiveness
article introduces a framework for gender-transformative will enhance the acceptance, relevance and effectiveness of
health promotion that builds on understanding gender as health promotion interventions. By moving beyond respon-
a determinant of health and outlines a continuum of actions siveness to transformation, gender-transformative health pro-
to address gender and health. Gender-transformative health motion could enhance both health and social outcomes for
promotion interventions could play a significant role in large numbers of women and men, girls and boys.

Key words: framework; determinants of health; women

INTRODUCTION ensure effective use of health resources [(Sen and

Östlin, 2007), p. viii].
Gender inequity is a pervasive global challenge
to health equity (Moss, 2002). As the Women Indeed, Marmot [(Marmot, 2007), p. 1155] has
and Gender Equity Knowledge Network to the also observed that: ‘The differential status of men
WHO Commission on the Determinants of Health and women in almost every society is perhaps the
has argued: most pervasive and entrenched inequity. As such,
the relation between the sexes represents as press-
Gender inequality damages the physical and ing a societal issue for health as the social gradient
mental health of millions of girls and women itself.’
across the globe, and also of boys and men despite Despite comments like these, and others from
the many tangible benefits it gives men through
those working on HIV/AIDS (Colgrove, 2002;
resources, power, authority and control. Because
of the numbers of people involved and the magni- Gupta, 2000; Wingood and DiClemente, 2000),
tude of the problems, taking action to improve gender-based violence (Barker et al., 2007), and
gender equity in health and to address women’s maternal and reproductive health (Boender et al.,
rights to health is one of the most direct and 2004; Feldman-Jacobs et al., 2005; Feldman-Jacobs
potent ways to reduce health inequities and et al., 2011), the health promotion field has largely

140
 Gender-transformative health promotion for women 141
failed to address gender inequity (Östlin et al., et al., 2007, 2012b). Even when it was new, the
2006). In a review of major health promotion fra- Ottawa Charter was challenged for paying inad-
meworks, Gelb et al. (Gelb et al., 2011) identified equate attention to issues of sex and gender:
none that incorporated gender, though the Ottawa
Charter (World Health Organization, 1986) had We believe that inherent in a social approach
noted that ‘People cannot achieve their fullest to health is the goal of reducing inequities in

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health potential unless they are able to take control health which arise from all forms of social stratifi-
of those things which determine their health. This cation, such as class, race and gender. Too often,
must apply equally to women and men’ (p. 1). however, the health consequences of sex-gender
inequalities remain invisible. The priorities and
Most health promotion programmes and policies
content of traditional health promotion pro-
adopt gender-blind or gender-neutral language grammes have often placed a further burden on
(Kabeer and Subrahmanian, 1996) and strategies women’s lives by prescribing health behaviours
(World Health Organization, 2010a) and some which are unrealistic and in some instances not
problems, such as violence against women—an designed to improve women’s health but instead
extreme and widespread manifestation of gender focus on the health of the family [(Ruzek and
inequality that affects the health of millions of Hill, 1986), pp. 301 – 302].
women and girls globally (World Health
Organization, 2009b, 2013)—are not yet consid- Despite such critiques (Daykin and Naidoo, 1995;
ered core health promotion issues at all (World Thurston and O’Connor, 1996; Keleher, 2004;
Health Organization, 2002). Given how addres- Östlin et al., 2006), health promotion interventions
sing gender inequity could improve the health directed to women have, at times, relied upon
of women and girls (and men and boys), health inappropriate evidence (e.g. research cardiovascu-
promotion policy, research and practice need lar disease in men (Abramson, 2009), gendered
to develop evidence on the impact of gender norms (e.g. assuming that all women are carers and
inequity on health, establish policies that support therefore responsible for the health of the family
gender equity and offer interventions that explicit- (Heller, 1986) and/or stereotypes (e.g. that all
ly address gender inequities (e.g. End Violence women value attractiveness (Rothblum, 1994).
Against Women Coalition, 2011). Gender- These assumptions are then reflected in interven-
transformative health promotion interventions— tions including awareness-raising campaigns, educa-
ones that address both improving health and tional bulletins or community development. For
changing negative gender norms at the same example, a 1972 poster by the American Cancer
time—could play a significant role in improving Society (see http://collections.vam.ac.uk/item/O76
the lives of millions worldwide (Hankins, 2008). 205/smoking-is-very-glamorous-poster-american-
This article introduces a framework for gender- cancer-society/) used the phrase ‘smoking is very
transformative health promotion that builds on glamorous’ overlaid on the face of an ageing, un-
recent analyses of gender as a determinant of attractive woman who is smoking to not only
health and core principles to guide interventions. challenge tobacco companies’ use of glamour to
The potential value of the framework is illustrated encourage women’s smoking but also to remind
with examples drawn from women’s health pro- women that smoking is associated with prema-
motion activities in cardiovascular disease pre- ture ageing. This practice continues today: in rec-
vention, efforts to address women and alcohol ognition of World No Tobacco Day on 31 May
use and tobacco control. 2014, the government of Queensland, Australia
initiated a campaign with the tagline, ‘If you
smoke, your future’s not pretty’ featuring Miss
THE NEED FOR A NEW APPROACH Universe 2009 in a photo spread with the Minister
of Health (http://www.health.qld.gov.au/news/sto
Women’s health researchers and advocates have ries/140529-youth-smoking.asp). Research sug-
long questioned the link between women’s health gests, however, that while such appeals to attract-
and their social position (McDonough and iveness remain a theme in health promotion
Walters, 2001), how women are represented in aimed at reducing tobacco use (Grogan et al.,
health education and health promotion (Frank, 2009), young women (and men) are actually less
1995) and whether health promotion interventions concerned about skin ageing than about look-
are appropriately designed with respect to women ing mature, ‘cool,’ and managing their weight—
(Doyal, 1995; Ward-Griffin and Ploeg, 1997; Reid attributes they associate with tobacco use.
142 A. Pederson et al.
Health promotion efforts during pregnancy— history of changing gender norms with respect to
a time when many women are interested in smoking (Greaves, 1996, 2014; Amos and Haglund,
optimizing their health—sometimes exacerbate 2000; Tinkler, 2006). Some health promotion
women’s stress by adopting messages that are efforts use shame to stigmatize pregnant women
shaming and blaming rather than messages sup- who smoke such as a depiction of a pregnant
portive of both women’s and foetal health woman smoking with her hands covered in blood

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(Greaves and Poole, 2005). A recent variation of with the caption ‘When you are pregnant smoking
such messaging depicts a pregnant woman is a crime’, implying that by smoking a woman is
without clothes and with her pregnant belly pro- murdering her foetus (at http://www.choosehelp.
truding through one of the letters of the message com/news/tobacco/smoking-during-pregnancy-
‘For the love of children don’t drink while preg- linked-to-birth-defects-like-missing-limbs-and-
nant’ (see www.fasdworld.com). More sinister cleft-pallet) (see Berridge, 2013). Practices such as
are punitive legal interventions against women these help to perpetuate gender and health inequi-
who drink alcohol when pregnant, such as the ties. Fundamentally, ‘the lack of translation of
current legal test case in the UK attempting to gender inequities in health into health promotion
criminalize women whose children have alcohol- interventions leads to misallocated resources and
related brain damage (Herst, 2013). Nathoo et al. weakened potential for success’ [(Östlin et al.,
(Nathoo et al., 2013) suggest that campaigns and 2006), p. 26]. It is time for a new approach.
interventions that chastise women for substance Figure 1 illustrates a continuum of potential
use during pregnancy rather than support them gender-responsive interventions derived from
through strategies for managing stress, accessing discussions within the HIV/AIDS epidemic (Gupta,
good nutrition and increasing social support may 2000) and emerging evidence of the ways that
increase the likelihood that women avoid health health interventions relate to gender (Sambo, 2010;
care for fear of how they will be treated, rather World Health Organization, 2010a). This con-
than seek the support that non-judgemental, tinuum, based on the World Health Organization’s
gender-informed health care providers might offer. (World Health Organization, 2011) Gender
Some educational efforts actively engage in Responsive Assessment Scale, illustrates that
gender-based fearmongering to raise awareness health interventions can exploit, accommodate,
of a health issue. An extreme example is a recent or transform gender norms, systems and relations
Canadian television campaign to raise awareness in the way that they frame an issue, use imagery
about cardiovascular disease in women that por- and language and/or engage with gender inequity
trayed heart disease as a stalker of women with a (World Health Organization, 2010a). Gender-
voice-over announcing that ‘Death Loves the transformative approaches ‘actively strive to
Ladies’ (see http://www.youtube.com/watch?v= examine, question, and change rigid gender
GpMIKOUyZ5g). Such approaches cannot be norms and imbalance of power as a means of
justified: they exploit women’s fears of gender- reaching health as well as gender equity objec-
based violence to draw attention to another tives’ [(Rottach et al., 2009) p. 8]; World Health
problem—in this case heart disease—while liken- Organization, 2011). Applied to health promotion,
ing heart disease (in this case) to a predatory, this implies developing approaches that avoid
potential rapist. While cardiovascular disease is a reproducing harmful gender norms or stereotypes
significant health problem for women, it is not and instead empower women and men to reach
equivalent to sexual assault. Exploiting women’s their health potential.
fears in drawing such an analogy weakens the
credibility of health education campaigns.
Gender has rarely been incorporated into FRAMEWORK FOR
tobacco control activities in a meaningful way GENDER-TRANSFORMATIVE
(Amos et al., 2012). Indeed, there are numerous HEALTH PROMOTION
examples of exploiting or accommodating gender
in harmful or stereotyped ways, such as the Over a period of 6 years, we developed a
overemphasis on women’s reproductive role and its Framework for Gender-transformative Health
interaction with smoking (Greaves, 1996; Jacobson, Promotion through an iterative process of literature
1986). Meanwhile, the tobacco industry has gener- reviews, consultation and case studies (Pederson
ated many gender-informed approaches to market- et al., 2010). Consultations included an online
ing and product development, and has a stellar survey, in-person and online focus groups, and
 Gender-transformative health promotion for women 143

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Fig. 1: A continuum of approaches to action on gender and health. Inspired by remarks by Geeta Rao Gupta,
Ph.D, Director, International Center for Research on Women (ICRW) during her plenary address at the XIIIth
International Aids Conference, Durban, South Africa, 12 July 2000: ‘To effectively address the intersection
between HIV/AIDS and gender and sexuality requires that interactions should, at the very least, not reinforce
damaging gender and sexual stereotypes’ (and see also World Health Organization, 2011).

key informant interviews with international fostering change, it is vital to recognize that gender
experts in women’s health, gender and health is not an immutable personal characteristic but
promotion. The Framework depicts a pathway rather a complex, multi-faceted social phenomenon.
through which health promotion could transform
gender and health inequities. Its purpose is to Like other social relations, gender relations as ex-
guide researchers, policy makers and programme perienced in daily life, and in the everyday business
developers to reflect upon how gender inequity of feeling well or ill, are based on core structures
influences health and social outcomes and how that govern how power is embedded in social hier-
archy. The structures that govern gender systems
gender-transformative interventions could con-
have basic commonalities and similarities across
tribute to reducing gender inequity and improv- different societies, although how they manifest
ing health. through beliefs, norms, organisations, behaviours and
The figure is to be read from the left where practices can vary [(Sen and Östlin, 2007), p. xii].
there is a representation of gendered social, cul-
tural, political and economic ‘determinants’ inter- Gender is not a simple, binary categorical vari-
acting with biological and environmental ones to able that can be adequately captured by sex-
produce gendered social structures and systems. disaggregated data (see Kabeer and Subrahmanian,
Regardless of the particular society, gender forms 1996). For the purposes of this paper, however, we
a metaphorical ‘fault line’ (Papanek and Schwede, wish to stress the social and relational nature of
1988), such that structures and systems are defined gender (Connell, 2012) and, most significantly, that
by values, norms and practices that produce and it is not a static phenomenon: as a social construct,
are maintained by differential gendered power gender is subject to historical, cultural, generational
dynamics, which, in turn, influence differential and local expressions and manifestations and
exposures to health risks and different vulnera- hence, can and does change.
bilities (Sen and Östlin, 2010). Gendered roles, ‘Health is a social as well as biological phe-
economic opportunities and opportunities for nomenon, involving societal systems as well as
leadership generate and sustain these gendered individual behaviours (sic) and lifestyles’ [(Travis
social structures, which advantage some and disad- and Compton, 2001), p. 319]. Accordingly, both
vantage others in a temporal, culture-bound sex and gender are fundamental determinants of
context (Johnson et al., 2007, 2009). ‘Gender hier- health (Benoit and Shumka, 2009) that intersect
archy governs how people live and what they in significant and meaningful ways with other
believe and claim to know about what it means to aspects of social identity and social positioning
be a girl or a boy, a woman or a man’ [(Sen and (Hankivsky and Christoffersen, 2008) such as
Östlin, 2007), p. xiii]. But from the perspective of race/ethnicity, class, age, disability and culture
144 A. Pederson et al.
(Reid et al., 2012a). While biological sex deter- they should produce health and social outcomes
mines or affects some health conditions, gender that contribute to gender equity and change
socialization and power relations generate many gender norms (Kabeer and Subrahmanian, 1996).
health challenges for both women and men as If not, health promotion interventions likely re-
manifest in multiple ‘gender paradoxes in health’ inforce existing gendered social structures, as
that change with time, giving further support to signalled through a feedback loop—however un-

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the understanding that gender and its effects can wittingly. Gender-transformative health promo-
also change (Greaves, 2014; Marmot, 2007; tion for women strives to improve the health and
Stuart and Soulsby, 2011a,b,c; World Health status of women by addressing gender inequities
Organization, 2010b). Differences in exposures and helping women to increase control over the
(both biological and social) and vulnerability determinants of their health.
(the ability to avoid, cope or recover from an
exposure) (Sen and Östlin, 2007) account for
some of the observed differences in health condi- PRINCIPLES TO GUIDE
tions among women and men in relation to GENDER-TRANSFORMATIVE HEALTH
osteoporosis, depression, HIV, tuberculosis, lung PROMOTION
cancer, chronic obstructive pulmonary disease
and blindness (Sen and Östlin, 2007). Other To support implementation of gender-transformative
sources of injury, morbidity and mortality with health promotion, we envisage a planning process
identified sex- and gender-related roots include that engages multi-sectoral stakeholders; involves
violence against women (Barker et al., 2007), the analysis of diverse forms of evidence; critically
motor vehicle crashes (Pearlman and Viano, examines current health promotion practice; iden-
1996), workplace injury (Messing and Östlin, tifies interventions to improve women’s health
2006) and suicide (Schrijvers et al., 2012). When and change harmful gender norms, roles and rela-
such patterns are examined, it becomes evident tions; and implements interventions that improve
that women and girls suffer the most from the women’s health and foster equitable roles for
persistence of gender norms, relations and struc- women and access to resources. This approach
tures in relation to their health (Sen and Östlin, recognizes that gender, gender relations and
2007), which calls for action on gender itself as a gendered structures are relevant throughout all
determinant of health. aspects of health promotion planning. A gender-
This complex set of gendered social structures transformative approach to health promotion
and systems includes the formal health care planning also asks how interventions can be
system and the associated structures of health women-centred, embrace harm reduction princi-
policy and research, which generate knowledge ples, build on women’s strengths and be explicit-
about and regulate people’s bodies and everyday ly equity-oriented.
lives, as well as individual social and biological Through our literature reviews, case studies
determinants and the lay world of health ideas, and consultations, we identified several princi-
discourses and practice (Sen and Östlin, 2010). ples to guide gender-transformative health pro-
Health promotion, understood to be the process motion planning. Most of these are familiar to
of empowering individuals and communities to those in the health promotion field, such as fos-
address the determinants of health (World Health tering empowerment, pursuing equity and redu-
Organization, 1986), is ideally positioned within cing health disparities, being evidence-based, and
the health field as a mechanism for challenging being culturally-responsive and safe (Victorian
gender as a determinant of health. Health promo- Government Department of Human Services,
tion interventions—a diverse set of communica- 2008). Some, however, reflect a paradigm shift in
tion, organizational, community and political regard to the centrality of gender and by the way
practices that operate at multiple levels (Keleher they attend to the positioning of women in rela-
et al., 2007)—are depicted in Figure 2 as a con- tion to health issues.
tinuum cutting across the context of health policy, Interventions that are explicitly women-centred,
research and services. Depending on the specific trauma-informed and which embrace harm reduc-
approach taken, health promotion interventions tion approaches are promising ways of engaging dir-
can exploit, accommodate or transform existing ectly with how gender shapes women’s health (and
gender norms, structures and relations. If health health inequities). Women-centred approaches
promotion activities are gender-transformative, acknowledge women’s rights to control their own
 Gender-transformative health promotion for women 145

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Fig. 2: A Framework for gender-transformative health promotion for women.

health, avoid unnecessary medicalization and con- prevention of child apprehension thus become
sider women’s everyday lives (Hills and Mullett, aspects of harm-reducing, health-promoting
2002); they account for women’s roles as caregivers, approaches to supporting women with sub-
partners and mothers and women’s patterns and stance use problems (Boyd and Marcellus,
preferences in obtaining health care and support 2007; Mehrabadi et al., 2008; Shannon et al.,
(Ballem and Women’s Health Planning Project 2008; Poole et al., 2010; Nathoo et al., 2013).
Steering Committee, January 2000; Greaves et al., In many settings, experiences of current
2002; Cory, 2007). Women-centred approaches are partner violence and symptoms of past trauma
inherently empowering and position women as are overlooked, a gender-blind approach with
agents of change in their own lives. very serious implications through this omission
Health promotion interventions taking a and through re-traumatizing interactions (Cory
harm-reducing stance provide pragmatic support and Dechief, 2007). A key element of trauma-
to people by helping with immediate goals; informed health promotion is active tailoring of
providing a variety of options and supports for environments and approaches to take into account
improving health; and focusing not only on the likelihood that women will have experienced
narrow goals related to change in a specific violence and trauma: this means understanding
health behaviour, but also on facilitating change that substance use may be an adaptation or a
in the full range of influences and harms asso- coping mechanism (Jean Tweed Centre, March
ciated with a behaviour (Government of British 2013). Substance use is often the focus of health
Columbia, 2005). As a principle for gender- promotion efforts, while the issues underlying
transformative health promotion, harm reduction the behaviour are typically ignored (Greaves
is closely aligned with women-centredness in its at- et al., 2011). Applying trauma-informed principles
tention to empowerment and self-determination, involves enacting health promotion through rep-
and recognition of social context and specific, gen- arative, trustworthy relationships rather than
dered influences and harms. Facilitating women through directive, power-over interventions direc-
finding safe housing, safety from violence, food se- ted toward specific behaviour change (Elliott
curity, income security, fair policing practices and et al., 2005). Such a collaborative and relational
146 A. Pederson et al.
approach takes place on all levels of individual economic position is central to addressing
and group interactions in service delivery, includ- gender-based inequities across the globe.
ing policy, leadership and organization (Harris Second, gender-transformative health promo-
and Fallot, 2001; Poole and Greaves, 2012). tion entails looking beyond single health issues to
At their core gender-transformative health pro- how multiple factors and experiences intersect
motion interventions employ strengths-based ap- with gender in women’s lives to generate condi-

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proaches focused on restoring and building health tions of risk, vulnerability or protection. Gender-
rather than identifying and focusing on women’s transformative approaches are more likely to
deficits. Accordingly, gender-transformative health involve working cross-sectorally, recognizing the
promotion includes secondary prevention and harm limits of fostering change one issue at a time, com-
reduction and actively considers what is working peting for scarce resources and the limits of indi-
well for girls and women, and what of their qualities vidual control over the determinants of many
and resources can be supported, enhanced or built health issues. For example, a multi-sectoral col-
upon. It challenges stereotypes of women as weak, laborative of researchers, mental health clinicians,
sick and fragile by positioning women as people shelter providers, police, community housing co-
who can grow, thrive and recognize their own alition advocates and government policy analysts
strengths (Norman, 2000; Watkins, 2002; Gottlieb, have been voluntarily meeting for 2 years in com-
2013). Taken together, these principles of action munities of practice to learn about and design
suggest that gender-transformative health promo- gendered health promotion and system change
tion is both an outcome and a process. approaches to improve the response to women’s
homelessness and mental health issues in the
three northern territorial capital cities in Canada
(Bopp et al., August 7, 2012).
TOWARD GENDER-TRANSFORMATIVE Understanding the common risk conditions and
HEALTH PROMOTION experiences that generate girls’ and women’s health
challenges calls for combining efforts to link issues.
Applying the gender-transformative framework This is why trauma-informed approaches are inher-
entails creativity, critical analysis and new ways of ently egalitarian and potentially transformative: by
thinking. Gender-transformative tobacco control, creating circumstances of safety for all program
for example, would reinvent standard thinking on participants, everyone can tolerate, stay and benefit
prevention, cessation and policy by clearly in- from services they need. Trauma-informed sub-
corporating the improvement of gender relations stance use programmes assume widespread experi-
and gender norms in its remit (Greaves, 2014). ences of trauma and adjust treatment goals and
We suggest that tobacco control advocates and protocols accordingly by not employing punitive or
programmers would examine interventions for authoritarian approaches (Bloomenfeld and
their effectiveness in preventing tobacco use or Rasmussen, 2012; Urquhart and Jasiura, 2012).
reducing its harms, and, in the case of women, in Gender-transformative health promotion must
enhancing women’s autonomy as reflected, for tackle gender as an element of social systems and
example, in their capacity to control their expos- structures, not merely an individual attribute.
ure to secondhand smoke or their understanding This may mean addressing the gender wage gap;
of the workings of the tobacco industry (World the participation of women in leadership; or the
Health Organization, 2010b; Dworkin et al., investment in research funding on women-
2013; Greaves, 2014). specific health concerns. These actions expand
Another implication of gender-transformative the definition of what constitutes health promo-
health promotion is that the outcomes of interest tion, moving it from a set of interventions direc-
expand to include social and economic outcomes. ted at individual behaviour change to a set of
In the field of HIV/AIDS, for example, this trans- initiatives, policies and programmes that work to
lates into a concern with addressing gender norms strategically enhance women’s lives and health
related to male risk-taking, health services usage (Moser, 1989; Keleher, 2007; Mackenzie, 2007).
and gender-based violence (Sambo, 2010) and Most of the activities that are identified as
acting to address women’s poverty, education and health promotion for women continue to be
legal protections within a broad framework for focused on a narrow range of ‘healthy living’
HIV/AIDS initiatives (World Health Organization, efforts focused on achieving healthier weights
2009a). Indeed, improving women’s social and through physical activity and healthful eating,
 Gender-transformative health promotion for women 147
and preventing or reducing tobacco and alcohol address and change those interventions that
use (e.g. PEI Healthy Eating Alliance, 2007). In ignore or accommodate gender norms, relations
contrast, gender-transformative chronic disease and structures and perpetuate harm by fostering
prevention efforts would attend to emerging risk-taking, silencing debate or depriving people
evidence on women’s challenges in achieving of decision-making power. Health promotion
‘healthy living’ (Pederson et al., 2013), including can foster gender-related empowerment, sustain

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how socio-economic status shapes the opportun- gender-related legal and ethical standards and
ities for purchasing and preparing healthful sanctions and redress gendered biases that limit
meals, how gender relations contribute to human agency. The challenge is clear: by acting
women’s use of smoking to control their appetite deliberately on gender inequity in health promo-
and manage weight and/or how women’s experi- tion research, policy and practice, the field may
ences of physical activity often reflect the norms finally move gender from the margins to the
of a male-centred sport and recreation culture centre of health promotion praxis.
(Liwander et al., 2013). Working with women to
identify the opportunities for change and adopt-
ing culturally-appropriate forms of learning, ACKNOWLEDGEMENTS
sharing and change may mean disrupting norms
of professional practice, where expertise resides, The authors would like to thank the rest of the
how change happens, and what is important to members of the Promoting Health in Women
women (Ziabakhsh et al., 2013). Transformative project team for their contributions to this frame-
heart health promotion campaigns would then work and the many individuals around the world
tackle issues of weight bias and stigma as part of who provided feedback on earlier versions of the
how to encourage healthy weights without per- framework (www.promotinghealthinwomen.ca).
petuating gender stereotypes (Puhl and Brownell,
2003), support healthful eating through ensuring
adequate financial resources for nutritious food FUNDING
(Power, 2005) and/or encourage governments to
engage with gender and culture in the design This manuscript was prepared with support from
and operation of physical activity interventions the Canadian Institutes of Health Research
(Frisby, 2013). through funding support to the CIHR Team in
Through attending to gender as a facet of Sex, Gender and Health Promotion (Grant No.
social life that generates opportunities as well as GTA91806).
constraints, health promotion interventions are a
potentially valuable resource for gender equity.
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