On May 19, the Sex & Gender Policies in Medical Research project team of The George Institute and the Australian Human Rights Institute at UNSW Sydney, hosted a targeted virtual event. Almost 50 stakeholders participated in a lively discussion, identifying barriers and facilitators for the development and implementation of policies for the collection, analysis and reporting of sex and gender data in health and medical research in the Australian context. Stakeholders represented a range of critical perspectives across the health and medical research sector including researchers, clinicians, policy makers, advocates and community organisations.

The discussion of barriers and facilitators for developing and implementing these policies highlighted several priority themes, including:

1. The need for institutional and individual leadership and buy-in to drive, monitor and support such policies.

2. The challenges that arise due to a lack of consistent and universally accepted understanding, language and terminology for sex and gender across disciplines, organisations and sectors.

3. Limitations of current research methods for recruitment, data collection and analysis, and the need for a cultural shift, as well as training and support for researchers to adopt new approaches.

These, along with other discussion points, will be incorporated into our future research and strategic priorities.

This event was a follow-up to the 2018 forum – Ensuring the collection, analysis and reporting of sex and gender specific health data in Australia  - hosted by The George Institute for Global Health and Bupa Health Foundation, with international guest Professor Londa Schiebinger. Importantly, since the event in 2018 a call to action was published in the Medical Journal of Australia, and, in collaboration with the Australian Human Rights Institute at UNSW Sydney, The George Institute secured three years of philanthropic funding to continue and expand this work.

The COVID-19 pandemic has exposed the fragmentation of the healthcare delivery systems and highlighted the role of resilient primary healthcare systems for a robust public health response during health emergencies. 

Primary care while being the first point of contact between the citizens and the health systems has received scant attention or targeted investments over the past several decades. 

As the pandemic progressed, several countries in the region introduced or expanded access to telemedicine services to maintain essential medical care as face-to-face visits were deemed unsafe thus making telemedicine critical for care delivery. George Institute India team led a narrative review to outline the potential role of telehealth in augmenting health systems capacity in the WHO South East Asia region.

Role of telemedicine in re-aligning the primary healthcare

Our review highlights that governments, policy makers and implementation agencies have been facing a number of challenges prior to the pandemic, a predominant one being lack of policy support to foster implementation of digital health interventions. Lack of robust primary care systems and non-existing referral pathways result in overburdening of health systems capacity at secondary and tertiary care centres.

While comprehensive evaluation of telemedicine in the SEA region has not been systematically undertaken, the recent experience from use of telemedicine during the pandemic and emerging evidence suggest that telemedicine could hold promise in supporting strong and resilient primary care systems.

The COVID-19 pandemic has highlighted the opportunities that these technologies offer to bridge existing gaps in health services delivery. However, the hope that telemedicine will solve the persistent structural problems, specifically in primary care are likely to be short-lived beyond the pandemic. 

We call for strategic investments into primary healthcare and supportive policy environment to leverage telehealth as a tool to support health systems in WHO South East Asia Region towards achieving universal health coverage.

Download the research paper

Read Full Paper published in BMJ Innovations here

New research shows men, regardless of age, are up to two times more likely to crash, and yet women are more likely to be hospitalised because of an injury sustained in a crash. Men also reported engaging in more risky driving behaviours, such as speeding, compared to women who are generally known to speed less.

Globally, every 24 seconds a person is killed in a road crash, equating to more than 1.3 million people each year, and one in three deaths on the roads in high-income countries is due to speed. Among young people, transport injury is a leading cause of death and disability. Young male drivers are known to be at increased risk of crash compared to young women and older drivers; however, there is limited insight into these differences as men and women get older and gain more driving experience.

Researchers from UNSW School of Population Health and The George Institute for Global Health examined sex differences in the type of crash and crash-related injury in 20,000 young drivers in New South Wales, Australia, for up to 13 years after they first attained their driver licence. According to lead researcher Dr Patricia Cullen from The George Institute and UNSW School of Population Health, the findings show that the established sex differences in risk of crash among young drivers does not diminish with age and experience.

“The differences we found in men’s and women’s risk of crash and crash-related injury, including the need for hospitalisation, signal the need for better understanding of how sex and/or gender may shape crash and injury risk across a person’s life,” she said.

“The sex and/or gendered dimensions of people’s experiences are important, yet our research highlights substantial gaps to date in the understanding of sex and gendered dimensions of road crash and crash-related injury, which are essential to identifying and implementing appropriate interventions to reduce this risk,” said Dr Cullen. 

Sex differences in behavioural tendencies, such as risky driving behaviours, could be a reason for the differences, however the relationship between a person’s sex and/or gender and crash risk is complex. How men’s and women’s driving patterns contribute to these findings need to be considered, for example, differences in distances travelled or types of vehicles used may contribute. The higher rates of hospitalisations among women raises questions about biases in the care system as well as how car design and safety testing accounts for physical differences in bodies in terms of biological sex differences but also age and weight.

Senior author Professor Rebecca Ivers, Head of UNSW School of Population Health, says there is a need for greater diversity and measures of diversity in road safety data, better reporting of sex and gender, and more representation from low- and middle-income countries that bear a disproportionate burden of crash-related death and injury.  

“Because current data is generally limited to binary notions of sex, there is a critical need for more nuanced research that investigates the gendered dimensions of mobility, transport and safety,” she said.

The publication of the research coincides with the 6th UN Global Road Safety Week, calling for 30 km (20 mph) low-speed streets where people work, live and play.  

“The evidence is clear – low-speed streets save lives. We now need governments around the world to act with the policies and infrastructure that can create safe and equitable local environments, with better amenities for thriving cities,” said Professor Ivers.  

The research was published in SMM Population Health and adds to recent research by researchers from UNSW School of Population Health and The George Institute, showing that young drivers from poor areas are up to four times more likely to be in a car crash; and that these social inequalities had a greater impact on women compared to men.