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      Gender differences in the health workforce in China: an analysis of national data

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          Abstract

          Gender differences in the health workforce matter for women's health and healthcare, and is also crucial for both health and economic development. Drawing on limited national gender data from China over the last 10 years, during which the country was undergoing a healthcare reform, this study dissects gender-related issues to identify existing problems, monitor progress, and develop strategies to promote change. Although women constituted the majority of health workers, they are predominantly engaged in service-oriented occupations. The gender distribution substantially differed between urban and rural primary health institutions. Moreover, significant differences in gender distribution among professional public health institutions were observed. The gender distribution of administrators varied in different types of health institutions. Women had lighter workloads because of the imbalanced distribution of specialties. Academicians comprised very few female scientists. To promote a more balanced gender distribution, policies should be developed to encourage a more reasonable division of family responsibilities. Further, equal higher education opportunities should be ensured for girls, especially in rural areas. Solutions to free more women from work–marriage–childcare conflicts and to decrease turnover rates deserve further discussion. Gender data should be highlighted and optimized to further advance gender differences among the health workforce and for women's health in China.

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          Role congruity theory of prejudice toward female leaders.

          A role congruity theory of prejudice toward female leaders proposes that perceived incongruity between the female gender role and leadership roles leads to 2 forms of prejudice: (a) perceiving women less favorably than men as potential occupants of leadership roles and (b) evaluating behavior that fulfills the prescriptions of a leader role less favorably when it is enacted by a woman. One consequence is that attitudes are less positive toward female than male leaders and potential leaders. Other consequences are that it is more difficult for women to become leaders and to achieve success in leadership roles. Evidence from varied research paradigms substantiates that these consequences occur, especially in situations that heighten perceptions of incongruity between the female gender role and leadership roles.
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            Race, gender, and partnership in the patient-physician relationship.

            Many studies have documented race and gender differences in health care received by patients. However, few studies have related differences in the quality of interpersonal care to patient and physician race and gender. To describe how the race/ethnicity and gender of patients and physicians are associated with physicians' participatory decision-making (PDM) styles. Telephone survey conducted between November 1996 and June 1998 of 1816 adults aged 18 to 65 years (mean age, 41 years) who had recently attended 1 of 32 primary care practices associated with a large mixed-model managed care organization in an urban setting. Sixty-six percent of patients surveyed were female, 43% were white, and 45% were African American. The physician sample (n = 64) was 63% male, with 56% white, and 25% African American. Patients' ratings of their physicians' PDM style on a 100-point scale. African American patients rated their visits as significantly less participatory than whites in models adjusting for patient age, gender, education, marital status, health status, and length of the patient-physician relationship (mean [SE] PDM score, 58.0 [1.2] vs 60.6 [3.3]; P = .03). Ratings of minority and white physicians did not differ with respect to PDM style (adjusted mean [SE] PDM score for African Americans, 59.2 [1.7] vs whites, 61.7 [3.1]; P = .13). Patients in race-concordant relationships with their physicians rated their visits as significantly more participatory than patients in race-discordant relationships (difference [SE], 2.6 [1.1]; P = .02). Patients of female physicians had more participatory visits (adjusted mean [SE] PDM score for female, 62.4 [1.3] vs male, 59.5 [3.1]; P = .03), but gender concordance between physicians and patients was not significantly related to PDM score (unadjusted mean [SE] PDM score, 76.0 [1.0] for concordant vs 74.5 [0.9] for discordant; P = .12). Patient satisfaction was highly associated with PDM score within all race/ethnicity groups. Our data suggest that African American patients rate their visits with physicians as less participatory than whites. However, patients seeing physicians of their own race rate their physicians' decision-making styles as more participatory. Improving cross-cultural communication between primary care physicians and patients and providing patients with access to a diverse group of physicians may lead to more patient involvement in care, higher levels of patient satisfaction, and better health outcomes.
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              Gender equality in science, medicine, and global health: where are we at and why does it matter?

              The purpose of this Review is to provide evidence for why gender equality in science, medicine, and global health matters for health and health-related outcomes. We present a high-level synthesis of global gender data, summarise progress towards gender equality in science, medicine, and global health, review the evidence for why gender equality in these fields matters in terms of health and social outcomes, and reflect on strategies to promote change. Notwithstanding the evolving landscape of global gender data, the overall pattern of gender equality for women in science, medicine, and global health is one of mixed gains and persistent challenges. Gender equality in science, medicine, and global health has the potential to lead to substantial health, social, and economic gains. Positioned within an evolving landscape of gender activism and evidence, our Review highlights missed and future opportunities, as well as the need to draw upon contemporary social movements to advance the field.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                J Mol Cell Biol
                J Mol Cell Biol
                jmcb
                Journal of Molecular Cell Biology
                Oxford University Press
                1674-2788
                1759-4685
                September 2024
                09 October 2024
                09 October 2024
                : 16
                : 9
                : mjae040
                Affiliations
                School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai 200025, China
                Department of Respiratory Disease, The 903rd Hospital of the People's Liberation Army , Hangzhou 310000, China
                Affiliated Xihu Hospital, Hangzhou Medical College , Hangzhou 310000, China
                School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai 200025, China
                Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200030, China
                School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai 200025, China
                Department of Military Health Management, College of Health Service, Second Military Medical University , Shanghai 200433, China
                School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai 200025, China
                School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai 200025, China
                Author notes
                Correspondence to: Yang Ge, E-mail: geyang19861026@ 123456icloud.com
                Correspondence to: Wei Mu, E-mail: weimu@ 123456shsmu.edu.cn

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0003-2828-8096
                Article
                mjae040
                10.1093/jmcb/mjae040
                11949620
                39384565
                0e8d8256-b5c5-4422-9b0b-08c3a186e974
                © The Author(s) (2024). Published by Oxford University Press on behalf of Journal of Molecular Cell Biology, CEMCS, CAS.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@ 123456oup.com

                History
                : 13 October 2022
                : 05 September 2023
                : 08 October 2024
                : 27 March 2025
                Page count
                Pages: 8
                Funding
                Funded by: National Natural Science Foundation of China, DOI 10.13039/501100001809;
                Award ID: 72104140
                Award ID: 82101870
                Award ID: 81902939
                Award ID: 72274209
                Funded by: Shanghai Pujiang Program;
                Award ID: 21PJC083
                Funded by: Soft Science Project of Shanghai Science and Technology Innovation Action Plan;
                Award ID: 23692115000
                Award ID: 23692113200
                Funded by: Zhejiang Provincial Natural Science Foundation, DOI 10.13039/501100004731;
                Award ID: LQ21H100001
                Funded by: Hangzhou Health Science and Technology Program;
                Award ID: B20220431
                Funded by: Innovative Research Team of High-level Local Universities in Shanghai, DOI 10.13039/100020732;
                Award ID: SHSMU-ZLCX20211602
                Categories
                Review
                AcademicSubjects/SCI01180

                gender,equity,health workforce,human resources,china
                gender, equity, health workforce, human resources, china

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