Integrating Sex/Gender into Environmental Health Research: Development of a Conceptual Framework

Bolte, Gabriele; Jacke, Katharina; Groth, Katrin; Kraus, Ute; Dandolo, L; Fiedel, Lotta; Dębiak, Małgorzata; Kolossa-Gehring, Marike; Schneider, Alexandra; Palm, Kerstin

doi:10.3390/ijerph182212118

Cited by 24 publications

(56 citation statements)

References 55 publications

(162 reference statements)

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“…The project aimed to develop innovative methods for data collection and analyses in population-based studies on environmental health, to be able to assess the impacts of sex/gender more comprehensively. Within INGER, we developed a multidimensional sex/gender concept with a focus on intersectionality [ 9 ] and created new sex/gender questionnaire modules to improve sex/gender data collection in population-based studies. We used this newly developed INGER questionnaire within the Cooperative Health Research in the Region of Augsburg (KORA) study to investigate the aforementioned research questions.…”

Section: Methodsmentioning

confidence: 99%

“…For our main decision tree analyses we chose a total of 40 sex/gender covariates based on our INGER multidimensional sex/gender concept [ 9 ]. This concept describes an individual sex/gender self-concept that is embedded in an environment and society that is defined by structural sex/gender relations.…”

Section: Methodsmentioning

confidence: 99%

“…As some variables included in the KORA FIT survey can add some additional information that can be interpreted with respect to our INGER multidimensional sex/gender concept [ 9 ], we decided to run additional decision tree analyses for all INGER participants who had also taken part in the KORA FIT study with a total of 53 covariates, i.e., the original 40 covariates plus 13 additional ones. Of the 13 new covariates, six correspond to intersectionality-related social categories , three portray health related behaviors and four covariates are psychosocial factors .…”

Section: Methodsmentioning

confidence: 99%

“…To comprehensively assess the impact of gender relations as well as sex-linked biology, there has been a call to integrate sex/gender with its complexity and entanglement of biological and social dimensions into health research beyond a simple binary approach [ 5 , 6 , 7 , 8 ]. We use the term “sex/gender” to express this entanglement of sex and gender [ 9 , 10 ]. Moreover, an intersectionality perspective strengthens the consideration of structural causes of health inequities such as systems of power and discrimination processes [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…To meet the challenge of a comprehensive integration of sex/gender into environmental health research, various data to depict multidimensionality, variety, embodiment and intersectionality in the study of sex/gender impacts [ 9 ] have to be used in multivariate statistical analyses. In quantitative health research, standard methods to examine relationships between covariates and outcomes are regression models.…”

Section: Introductionmentioning

confidence: 99%

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Decision Tree Analyses to Explore the Relevance of Multiple Sex/Gender Dimensions for the Exposure to Green Spaces: Results from the KORA INGER Study

Dandolo

Hartig

Telkmann

et al. 2022

IJERPH

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Recently, attention has been drawn to the need to integrate sex/gender more comprehensively into environmental health research. Considering theoretical approaches, we define sex/gender as a multidimensional concept based on intersectionality. However, operationalizing sex/gender through multiple covariates requires the usage of statistical methods that are suitable for handling such complex data. We therefore applied two different decision tree approaches: classification and regression trees (CART) and conditional inference trees (CIT). We explored the relevance of multiple sex/gender covariates for the exposure to green spaces, measured both subjectively and objectively. Data from 3742 participants from the Cooperative Health Research in the Region of Augsburg (KORA) study were analyzed within the INGER (Integrating gender into environmental health research) project. We observed that the participants’ financial situation and discrimination experience was relevant for their access to high quality public green spaces, while the urban/rural context was most relevant for the general greenness in the residential environment. None of the covariates operationalizing the individual sex/gender self-concept were relevant for differences in exposure to green spaces. Results were largely consistent for both CART and CIT. Most importantly we showed that decision tree analyses are useful for exploring the relevance of multiple sex/gender dimensions and their interactions for environmental exposures. Further investigations in larger urban areas with less access to public green spaces and with a study population more heterogeneous with respect to age and social disparities may add more information about the relevance of multiple sex/gender dimensions for the exposure to green spaces.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Decision Tree Analyses to Explore the Relevance of Multiple Sex/Gender Dimensions for the Exposure to Green Spaces: Results from the KORA INGER Study

Dandolo

Hartig

Telkmann

et al. 2022

IJERPH

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Association of Prenatal and Postnatal Exposures to Warm or Cold Air Temperatures With Lung Function in Young Infants

et al. 2023

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ImportanceLittle is known about long-term associations of early-life exposure to extreme temperatures with child health and lung function.ObjectivesTo investigate the association of prenatal and postnatal heat or cold exposure with newborn lung function and identify windows of susceptibility.Design, Setting, and ParticipantsThis population-based cohort study (SEPAGES) recruited pregnant women in France between July 8, 2014, and July 24, 2017. Data on temperature exposure, lung function, and covariates were available from 343 mother-child dyads. Data analysis was performed from January 1, 2021, to December 31, 2021.ExposuresMean, SD, minimum, and maximum temperatures at the mother-child’s residence, estimated using a state-of-the-art spatiotemporally resolved model.Main Outcomes and MeasuresOutcome measures were tidal breathing analysis and nitrogen multiple-breath washout test measured at 2 months of age. Adjusted associations between both long-term (35 gestational weeks and first 4 weeks after delivery) and short-term (7 days before lung function test) exposure to ambient temperature and newborn lung function were analyzed using distributed lag nonlinear models.ResultsA total of 343 mother-child pairs were included in the analyses (median [IQR] maternal age at conception, 32 [30.0-35.2] years; 183 [53%] male newborns). A total of 246 mothers and/or fathers (72%) held at least a master’s degree. Among the 160 female newborns (47%), long-term heat exposure (95th vs 50th percentile of mean temperature) was associated with decreased functional residual capacity (−39.7 mL; 95% CI, −68.6 to −10.7 mL for 24 °C vs 12 °C at gestational weeks 20-35 and weeks 0-4 after delivery) and increased respiratory rate (28.0/min; 95% CI, 4.2-51.9/min for 24 °C vs 12 °C at gestational weeks 14-35 and weeks 0-1 after delivery). Long-term cold exposure (5th vs 50th percentile of mean temperature) was associated with lower functional residual capacity (−21.9 mL; 95% CI, −42.4 to −1.3 mL for 1 °C vs 12 °C at gestational weeks 15-29), lower tidal volume (−23.8 mL; 95% CI, −43.1 to −4.4 mL for 1 °C vs 12 °C at gestational weeks 14-35 and weeks 0-4 after delivery), and increased respiratory rate (45.5/min; 95% CI, 10.1-81.0/min for 1 °C vs 12 °C at gestational weeks 6-35 and weeks 0-1 after delivery) in female newborns as well. No consistent association was observed for male newborns or short-term exposure to cold or heat.Conclusions and RelevanceIn this cohort study, long-term heat and cold exposure from the second trimester until 4 weeks after birth was associated with newborn lung volumes, especially among female newborns.

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Regitz-Zagrosek

2023

Gendermedizin in Der Klinischen Praxis

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Integrating Sex/Gender into Environmental Health Research: Development of a Conceptual Framework

Cited by 24 publications

References 55 publications

Decision Tree Analyses to Explore the Relevance of Multiple Sex/Gender Dimensions for the Exposure to Green Spaces: Results from the KORA INGER Study

Decision Tree Analyses to Explore the Relevance of Multiple Sex/Gender Dimensions for the Exposure to Green Spaces: Results from the KORA INGER Study

Association of Prenatal and Postnatal Exposures to Warm or Cold Air Temperatures With Lung Function in Young Infants

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