Do restrictive gender attitudes and norms influence physical and mental health during very young Adolescence? Evidence from Bangladesh and Ethiopia

Sarah Baird; Zulfiqar A Bhutta; Bassam Abu Hamad; Joan Hamory Hicks; Nicola Jones; Jennifer Muz

doi:10.1016/j.ssmph.2019.100480

Do restrictive gender attitudes and norms influence physical and mental health during very young Adolescence? Evidence from Bangladesh and Ethiopia

SSM Popul Health. 2019 Nov 20:9:100480. doi: 10.1016/j.ssmph.2019.100480. eCollection 2019 Dec.

Authors

Sarah Baird¹, Zulfiqar A Bhutta^{2

3}, Bassam Abu Hamad⁴, Joan Hamory Hicks⁵, Nicola Jones⁶, Jennifer Muz¹

Affiliations

¹ Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, D.C, 20052, USA.
² Centre for Global Child Health, The Hospital for Sick Children, 525 University Avenue, Suite 702, Toronto, Canada.
³ Canada and Centre of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.
⁴ School of Public Health, Al Quds University, Abu Dees, POB 89, Jerusalem, Palestinian Authority.
⁵ Department of Economics, University of Oklahoma, 308 Cate Center Drive, Norman, OK, 73072, USA.
⁶ Overseas Development Institute, 203 Blackfriars Rd, London, UK.

Abstract

Adolescence is seen as a window of opportunity for intervention but also as a time during which restrictive gender attitudes and norms become more salient. This increasingly gendered world has the potential to profoundly influence adolescents' capabilities, including their physical and mental health. Using quantitative data on 6,500 young adolescents (10-12) from the Gender and Adolescence: Global Evidence (GAGE) program, this paper analyses the association between restrictive gender attitudes (RGAs) at the individual level and restrictive gender norms (RGNs) at the community level and physical and mental health in Bangladesh and Ethiopia. We find significant associations between RGAs and RGNs and height-for-age z-scores, body mass index z-scores, self-reported health, adolescent hunger, psychological well-being, and self-esteem. We find no relationship between RGAs or RGNs and illness. We also find heterogeneity across country and urbanicity. We find surprisingly limited variation by gender, and the differences we do see point to important vulnerabilities for both boys and girls. Our results point to the powerful role that distal factors such as culture and beliefs, as manifested through RGAs and RGNs, can play in shaping health outcomes for both boys and girls and suggest important next steps for future research and policy.

Keywords: Adolescent health; Gender norms; LMICs; Mental health.