It has become increasingly clear among health researchers in various disciplines that being vulnerable to certain diseases or being protected against a disease involves a complex set of relationships that go beyond the disease model of host and agent relationships. More and more research suggests that in the epidemiological triangle, the environment (in its broad notions) plays a far more critical role in disease transmission than formerly envisaged. Between exposure and infection lies a lot of social, psychological and physical interrelationships which have very little to do with how infectious an agent is or how weak a host is. In trying to unravel one social dimension of disease, which is gender, a review of studies exposes a complex array of issues, a few of which are raised here: How men and women socially, sexually and spatially/physically relate to each other at different ages, in different families, in different cultures and at various levels of development, influence the ways in which individuals respond to disease? How do males and females relate with the medical facilities, at a structural, macro and micro levels? How do male and female medical and health personnel relate to their females and male clients? How does the degree of trust that men and women have in the health facilities and in their governments increase or decrease vulnerability to disease? Does how women and men engage with power at individual, cultural, local and international levels also protect them from disease or increase their vulnerability to disease? Does how poor one is, how educated you are, what resources you have, the colour of your skin, your ethnicity, your sexual orientation and your disability status also influence how vulnerable you are to disease?. There is heterogeneity in gender.
These few factors studies suggest a number of critical issues. There is no one simple direct explanation why some people succumb to disease while others do not. In some contexts, in Africa, being female creates vulnerability to disease. In some contexts, being poor increased one’s vulnerability to disease; in others, living in an area with very poor health facilities increases vulnerability to disease; in others being disabled increase vulnerability to diseases; in some being from a minority ethnic group, or being of a certain race or being of a certain sexual orientation or being a member of a certain cultural group, or being displaced all create different levels of vulnerability. But what is clear in all these cases is this: In any situation where all these disadvantages collate/intersect in one individual or in a group of people, vulnerability to disease is intensely multiplied. It is therefore critical that in all our work on gender in this Institute, we highlight intersectionality.