Skip to main content
Top
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Research article

Can the health effects of widely-held societal norms be evaluated? An analysis of the United Nations convention on the elimination of all forms of discrimination against women (UN-CEDAW)

Authors: Christopher A. Tait, Ifrah Abdillahi, Wendy Wong, Heather Smith-Cannoy, Arjumand Siddiqi

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

Female life expectancy and mortality rates have been improving over the course of many decades. Many global changes offer potential explanations. In this paper, we examined whether the United Nations Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) has, in part, been responsible for the observed improvements in these key population metrics of women’s health.

Methods

Data were obtained from the United Nations Treaty Series Database, the World Bank World Development Indicators database and, the Polity IV database. Because CEDAW is nearly universally ratified, it was not feasible to compare ratifying countries to non-ratifying countries. We therefore applied interrupted times series analyses, which creates a comparator (counterfactual) scenario by using the trend in the health outcome before the policy exposure to mathematically determine what the trend in the health outcome would have been after the policy exposure, had the policy exposure not occurred. Analyses were stratified by country-level income and democratization.

Results

Among low-income countries, CEDAW improved outcomes in democratic, but not non-democratic countries. In middle-income countries, CEDAW largely had no effect and, among high-income countries, had largely positive effects.

Conclusions

While population indicators of women’s health have improved since CEDAW ratification, the impact of CEDAW ratification itself on these improvements varies across countries with differing levels of income and democratization.
Appendix
Available only for authorised users
Literature
1.
go back to reference Marmot M, Friel S, Bell R, Houweling TA, Taylor S. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372(9650):1661–9.CrossRef Marmot M, Friel S, Bell R, Houweling TA, Taylor S. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372(9650):1661–9.CrossRef
2.
go back to reference Marmot M. Social determinants of health inequalities. Lancet. 2005;365(9464):1099–104.CrossRef Marmot M. Social determinants of health inequalities. Lancet. 2005;365(9464):1099–104.CrossRef
3.
go back to reference Basu S, Rehkopf DH, Siddiqi A, Glymour MM, Kawachi I. Health behaviors, mental health, and health care utilization among single mothers after welfare reforms in the 1990s. Am J Epidemiol. 2016;183(6):531–8.CrossRef Basu S, Rehkopf DH, Siddiqi A, Glymour MM, Kawachi I. Health behaviors, mental health, and health care utilization among single mothers after welfare reforms in the 1990s. Am J Epidemiol. 2016;183(6):531–8.CrossRef
4.
go back to reference Stuckler D, Basu S, Suhrcke M, Coutts A, McKee M. The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis. Lancet. 2009;374(9686):315–23.CrossRef Stuckler D, Basu S, Suhrcke M, Coutts A, McKee M. The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis. Lancet. 2009;374(9686):315–23.CrossRef
5.
go back to reference Stuckler D, Basu S. The International Monetary Fund’s effects on global health: before and after the 2008 financial crisis. Int J Health Serv. 2009;39(4):771–81.CrossRef Stuckler D, Basu S. The International Monetary Fund’s effects on global health: before and after the 2008 financial crisis. Int J Health Serv. 2009;39(4):771–81.CrossRef
6.
go back to reference Basu S, Meghani A, Siddiqi A. Evaluating the health impact of large-scale public policy changes: classical and novel approaches. Annu Rev Public Health. 2017;38:351–70.CrossRef Basu S, Meghani A, Siddiqi A. Evaluating the health impact of large-scale public policy changes: classical and novel approaches. Annu Rev Public Health. 2017;38:351–70.CrossRef
8.
go back to reference Moss NE. Gender equity and socioeconomic inequality: a framework for the patterning of women’s health. Soc Sci Med. 2002;54(5):649–61.CrossRef Moss NE. Gender equity and socioeconomic inequality: a framework for the patterning of women’s health. Soc Sci Med. 2002;54(5):649–61.CrossRef
10.
go back to reference McEwen BS, Stellar E. Stress and the individual: mechanisms leading to disease. Arch Intern Med. 1993;153(18):2093–101.CrossRef McEwen BS, Stellar E. Stress and the individual: mechanisms leading to disease. Arch Intern Med. 1993;153(18):2093–101.CrossRef
11.
go back to reference Gruskin S, Bogecho D, Ferguson L. ‘Rights-based approaches’ to health policies and programs: articulations, ambiguities, and assessment. J Public Health Pol. 2010;31(2):129–45.CrossRef Gruskin S, Bogecho D, Ferguson L. ‘Rights-based approaches’ to health policies and programs: articulations, ambiguities, and assessment. J Public Health Pol. 2010;31(2):129–45.CrossRef
12.
go back to reference Hoffman SJ, Røttingen J-A. Assessing the expected impact of global health treaties: evidence from 90 quantitative evaluations. Am J Public Health. 2014;105(1):26–40.CrossRef Hoffman SJ, Røttingen J-A. Assessing the expected impact of global health treaties: evidence from 90 quantitative evaluations. Am J Public Health. 2014;105(1):26–40.CrossRef
13.
go back to reference Palmer A, Tomkinson J, Phung C, Ford N, Joffres M, Fernandes KA, et al. Does ratification of human-rights treaties have effects on population health? Lancet. 2009;373(9679):1987–92.CrossRef Palmer A, Tomkinson J, Phung C, Ford N, Joffres M, Fernandes KA, et al. Does ratification of human-rights treaties have effects on population health? Lancet. 2009;373(9679):1987–92.CrossRef
14.
go back to reference Mariani G, Kasznia-Brown J, Paez D, Mikhail MN, Salama D H, Bhatla N, et al. Improving women’s health in low-income and middle-income countries. Part I: challenges and priorities. Nucl Med Commun. 2017;38(12):1019–23.CrossRef Mariani G, Kasznia-Brown J, Paez D, Mikhail MN, Salama D H, Bhatla N, et al. Improving women’s health in low-income and middle-income countries. Part I: challenges and priorities. Nucl Med Commun. 2017;38(12):1019–23.CrossRef
15.
go back to reference Temmerman M, Khosla R, Laski L, Mathews Z, Say L. Women’s health priorities and interventions. BMJ. 2015;351:h4147.CrossRef Temmerman M, Khosla R, Laski L, Mathews Z, Say L. Women’s health priorities and interventions. BMJ. 2015;351:h4147.CrossRef
17.
go back to reference Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D, et al. Financial crisis, austerity, and health in Europe. Lancet. 2013;381(9874):1323–31.CrossRef Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D, et al. Financial crisis, austerity, and health in Europe. Lancet. 2013;381(9874):1323–31.CrossRef
18.
go back to reference Stuckler D, Basu S. The body economic: why austerity kills: Harper Collins; 2013. Stuckler D, Basu S. The body economic: why austerity kills: Harper Collins; 2013.
19.
go back to reference Finnemore M, Sikkink K. International norm dynamics and political change. Int Organ. 1998;52(4):887–917.CrossRef Finnemore M, Sikkink K. International norm dynamics and political change. Int Organ. 1998;52(4):887–917.CrossRef
Metadata
Title
Can the health effects of widely-held societal norms be evaluated? An analysis of the United Nations convention on the elimination of all forms of discrimination against women (UN-CEDAW)
Authors
Christopher A. Tait
Ifrah Abdillahi
Wendy Wong
Heather Smith-Cannoy
Arjumand Siddiqi
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-6607-6

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue