Sexism against women among primary healthcare workers

Mesquita Filho, Marcos; Marques, Thaline Figueiredo; Rocha, Ana Beatriz Cavalcanti; Oliveira, Suellen Ramos de; Brito, Maíra Barbosa; Pereira, Camila Claudiano Quina

doi:10.1590/1413-812320182311.00132017

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ARTICLE • Ciênc. saúde colet. 23 (11) • Nov 2018 • https://doi.org/10.1590/1413-812320182311.00132017 copy

Sexism against women among primary healthcare workers

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The objective of this study was to research the existence of sexism against women among primary healthcare (PHC) workers and to identify associated factors. This was a cross-sectional study in which 163 PHC professionals of both sexes participated, all of whom were aged over 18 and had completed their primary or secondary education. The Gender Stereotyping and Ambivalent Sexism Inventory questionnaires were used. The average scores were more than 50% of the maximum score: Gender Stereotyping – 53.8%, hostile sexism – 58.2%, benevolent sexism – 64.1%. The average scores stratified by sociodemographic variables were higher. Significant differences in the hostile sexism score were found for sex (men scored higher than women), religion (higher scores for evangelical Christians) and among those who drank alcohol. For benevolent sexism, differences were found for schooling (greater scores for those who had only completed their primary education), religion (higher scores for evangelical Christians and Catholics) and area of work (greater for those working in general services). The stratification of the Gender Stereotyping scores did not point to significant differences. Sexist prejudice was found to exist for hostile sexism, benevolent sexism and gender stereotyping. This finding could have a negative influence on the service-user relationship, leading to greater inequities in health as a result of gender inequality.

Women’s health; Sexism; Health inequality; Healthcare staff; Health services

Variable	n	Percentage (%)
Sex
Female	145	89.0
Male	18	11.0
Age range
18 to 35	67	41.1
Over 35	96	58.9
Schooling
Primary education	35	21.5
Secondary or technical education	128	78.5
Skin color
White	130	79.8
Other	33	20.2
Religion
Catholic	115	70.6
Evangelical Christian	41	25.2
Other	7	4.3
Marital status
Does not have partner	36	22.1
Has partner	127	77.9
Residence
In the neighborhood where you work	75	46.0
Other	88	54.0
Lives with
Parents	34	20.9
Other family members	19	11.7
Spouse	85	52.1
Alone	19	11.7
Other	6	3.7
Type of work
Healthcare	114	69.9
Administrative	28	17.2
General services	21	12.9
Family income (as a multiple of the minimum wage)
Zero to three	75	46.0
Four to five	79	48.5
More than five	9	5.5
Time in position
0 to 5 months	13	8.0
6 to 12 months	34	20.9
13 to 36 months	40	24.5
More than 3 years	76	46.6
Location of work
Urban	159	97.5
Rural	4	2.5
Smoker
Sim	38	23,3
Não	125	76,7
Drinks alcohol
Yes	43	26.4
No	120	73.6
Undergoing treatment for a health condition
Yes	25	15.3
No	138	84.7
Regular use of medication
Yes	55	33.7
No	108	66.3

Tool and Questions	Average Score	% of Total	Median
Gender Stereotyping	15.07	53.8	15.0
1. Most women like to be pushed around by men	1.48	37.1	1.0
2. Most women like to show off their bodies	2.70	67.5	3.0
3. Most men want to go out with women just for sex	2.85	71.3	3.0
4. Most women enjoy romantic affairs with men	2.94	73.5	3.0
5. Most women depend on men to get them out of trouble	2.22	55.5	2.0
6. Sometimes it is right for a man to hit a woman	1.39	34.8	1.0
7. Men and women should have equal responsibility for bringing up children	1.48	63.0	1.0
Ambivalent Sexism Inventory
Hostile sexism	32.03	58.2	32.0
Benevolent sexism	35.23	64.1	36.0
1. No matter how accomplished he is, a man is not truly complete as a person unless he has the love of a woman.	3.36	67.2	4.0
2. Many women are actually seeking special favors, such as hiring policies that favor them over men, under the guise of asking for “equality.”	3.15	63.1	3.0
3. In a disaster, women ought not necessarily to be rescued before men.	2.45	49.1	2.0
4. Most women interpret innocent remarks or acts as being sexist.	2.37	47.5	2.0
5. Women are too easily offended.	3.33	66.5	4.0
6. People are often truly happy in life without being romantically involved with a member of the other sex.	2.60	51.9	2.0
7. Feminists are seeking for women to have more power than men.	2.83	56.6	2.0
8. Many women have a quality of purity that few men possess.	3.37	67.5	4.0
9. Women should be cherished and protected by men.	3.99	79.8	4.0
10. Most women fail to appreciate fully all that men do for them.	2.91	58.3	3.0
11. Women seek to gain power by getting control over men.	2.69	53.9	2.0
12. Every man ought to have a woman whom he adores.	3.57	71.4	4.0
13. Men are complete without women.	3.19	63.8	4.0
14. Women exaggerate problems they have at work.	2.63	52.6	2.0
15. Once a woman gets a man to commit to her, she usually tries to put him on a tight leash.	2.89	57.8	3.0
16. When women lose to men in a fair competition, they typically complain about being discriminated against.	2.78	55.6	2.0
17. A good woman should be set on a pedestal by her man.	2.96	59.3	2.0
18. There are actually very few women who get a kick out of teasing men by seeming sexually available and then refusing male advances.	3.69	73.7	4.0
19. Women, compared to men, tend to have a superior moral sensibility.	3.51	70.2	4.0
20. Men should be willing to sacrifice their own well-being in order to provide financially for the women in their lives.	2.70	54.0	2.0
21. Feminists are making entirely reasonable demands of men.	2.75	55.1	3.0
22. Women, as compared to men, tend to have a more refined sense of culture and good taste.	3.53	70.6	4.0

Variable	Gender Stereotyping		Hostile sexism		Benevolent sexism

	Average	%	Average	%	Average	%
Sex
Female	15.02	53.6	31.41	57.1	35.41	64.4
Male	15.44	55.1	37.06	67.4	33.78	61.4
Age range
18 to 35	15.1	53.9	32.67	59.4	35.82	65.1
Over 35	15.04	53.7	31.58	57.4	34.82	63.3
Schooling
Primary education	14.71	52.5	31.63	57.5	37.03	67.3
Secondary or technical education	15.16	54.1	32.14	58.4	34.74	63.2
Skin color
White	14.98	53.5	31.97	58.1	35.22	64.0
Other	15.39	55.0	32.27	58.7	35.27	64.1
Religion
Catholic	14.97	53.5	31.86	57.9	34.96	63.6
Evangelical Christian	15.39	55.0	33.32	60.6	36.76	66.8
Other	14.86	53.1	27.29	49.6	30.86	56.1
Marital status
Does not have partner	14.51	51.8	32.5	59.1	34.97	63.6
Has partner	15.2	54.3	31.9	58.0	35.31	64.2
Residence
In the neighborhood where you work	15.44	55.1	33.12	60.2	35.88	65.2
Other	14.75	52.7	31.1	56.5	34.68	63.1
Lives with
With spouse	15.02	53.6	31.78	57.8	35.27	64.1
Alone or with others	15.12	54.0	32.31	58.7	35.19	64.0
Type of work
Healthcare	15.11	54.0	31.94	58.1	35.06	63.7
Administrative	15.32	54.7	33.25	60.5	35.57	64.7
General services	14.52	51.9	30.9	56.2	35.71	64.9
Family income (as a multiple of the minimum wage
Zero to three	15.23	54.4	32.25	58.6	36	65.5
Four to five	14.9	53.2	31.71	57.7	34.72	63.1
More than five	15.22	54.4	33	60.0	33.33	60.6
Time in position
0 to 5 months	15.23	54.4	33.62	61.1	34.31	62.4
6 to 12 months	14.94	53.4	31.21	56.7	33.65	61.2
13 to 36 months	15.48	55.3	31.27	56.9	35.77	65.0
More than 3 years	14.88	53.1	32.53	59.1	35.82	65.1
Location of work
Urban	15.04	53.7	31.99	58.2	35.26	64.1
Rural	16.25	58.0	33.75	61.4	34	61.8
Smoker
Yes	15.37	54.9	32.61	59.3	35.45	64.5
No	14.98	53.5	31.86	57.9	35.17	63.9
Drinks alcohol
Yes	15.37	54.9	33.84	61.5	35.79	65.1
No	14.96	53.4	31.38	57.1	35.03	63.7
Undergoing treatment for a health condition
Yes	14.4	51.4	31.76	57.7	36.16	65.7
No	15.19	54.3	32.08	58.3	35.07	63.8
Regular use of medication
Yes	14.93	53.3	31.75	57.7	35.55	64.6
No	15.14	54.1	32.18	58.5	35.07	63.8
Total	15,07	53.8	32.03	58.2	35.23	64.1

Variable	Hostile sexism				Benevolent sexism

	Average	Standard deviation	Median	p	Average	Standard deviation	Median	p
Sex				< 0.001*^{, ES}				0.239*
Female	31.41	5.83	31.00		35.41	5.52	36.00
Male	37.06	6.68	37.00		33.78	5.68	35.50
Age range				0.269*				0.260*
18 to 35	32.67	6.23	32.00		35.82	5.45	37.00
Over 35	31.58	6.11	31.00		34.82	5.60	35.00
Schooling				0.612*				0.013^*SS
Primary education	31.63	4.89	31.00		37.03	4.36	37.00
Secondary or technical education	32.14	6.48	32.00		34.74	5.75	35.00
Skin color				0.801*				0.964*
White	31.97	6.15	31.50		35.22	5.39	36.00
Other	32.27	6.33	32.00		35.27	6.22	38.00
Religion				0.048^{**. SS}				0.020^**SS
Catholic	31.86	5.76	32.00		34.96	5.53	35.00
Evangelical Christian	33.32	7.12	32.00		36.76	4.93	37.00
Other	27.29	4.11	27.00		30.86	6.91	33.00
Marital status				0.606*				0.750*
Does not have partner	32.50	6.39	33.00		34.97	6.26	35.50
Has partner	31.90	6.12	31.00		35.31	5.35	36.00
Lives with				0.584*				0.929*
With spouse	31.78	5.93	31.00		35.27	5.30	36.00
Alone or with others	32.31	6.44	32.00		35.19	5.83	35.50
Type of work				0.405**				0.024**^SS
Healthcare	31.94	6.13	36.00		35.06	5.60	36.00
Administrative	33.25	7.25	36.00		35.57	5.90	36.00
General services	30.90	4.58	36.00		35.71	4.97	36.00
Family income (as a multiple of the minimum wage)				0.767**				0.207**
Zero to three	32.25	6.53	32.00		36.00	5.29	37.00
Four to five	31.71	5.77	31.00		34.72	5.67	35.00
More than five	33.00	6.93	32.00		33.33	6.23	36.00
Time in position				0.468**				0.226**
0 to 5 months	33.62	7.02	33.00		34.31	4.96	33.00
6 to 12 months	31.21	6.06	30.00		33.65	6.28	34.50
13 to 36 months	31.27	5.29	31.50		35.77	4.41	36.00
More than 3 years	32.53	6.50	32.00		35.82	5.76	36.00
Location of work				0.574*				0.654**
Urban	31.99	6.17	32.00		35.26	5.57	36.00
Rural	33.75	6.65	32.00		34.00	4.76	32.00
Smoker				0.513*				0.787**
Yes	32.61	7.14	31.00		35.45	5.70	36.00
No	31.86	5.86	32.00		35.17	5.52	36.00
Drinks alcohol				0.025^{*. SS}				0.444**
Yes	33.84	6.52	34.00		35.79	5.43	36.00
No	31.38	5.93	30.50		35.03	5.60	36.00
Total	32.03	6.17	32.00		35.23	5.55	36.00

Variable	Average	Standard deviation	Median	p
Sex				0.699*
Female	15.02	2.51	15.00
Male	15.44	2.71	15.00
Age range				0.841*
18 to 35	15.10	2.00	15.00
Over 35	15.04	2.85	15.00
Schooling				0.102*
Primary education	14.71	3.21	15.00
Secondary or technical education	15.16	2.32	15.00
Skin color				0153*
White	14.98	2.52	15.00
Other	15.39	2.59	15.00
Religion				0.772**
Catholic	14.97	2.57	15.00
Evangelical Christian	15.39	2.45	15.00
Other	14.86	2.48	16.00
Marital status				0.699*
Does not have partner	14.51	2.99	15.00
Has partner	15.20	2.38	15.00
Residence				0.074*
In the neighborhood where you work	15.44	2.26	15.00
Other	14.75	2.71	15.00
Lives with				0.172*
Spouse	15.02	2.32	15.00
Others	15.12	2.75	15.00
Type of work				0.992**
Healthcare	15.11	2.13	15.00
Administrative	15.32	3.23	14.50
General services	14.52	3.40	16.00
Family income (as a multiple of the minimum wage)				0.477**
Zero to three	15.23	2.76	15.00
Four to five	14.90	2.36	15.00
More than five	15.22	1.99	15.00
Time in position				0.656**
0 to 5 months	15.23	2.28	15.00
6 to 12 months	14.94	2.19	15.00
13 to 36 months	15.48	2.46	15.00
More than 3 years	14.88	2.76	15.00
Location of work				0.204*
Urban	15.04	2.55	15.00
Rural	16.25	1.26	16.00
Smoker				0.545*
Yes	15.37	2.66	15.00
No	14.98	2.49	15.00
Drinks alcohol				0.521*
Yes	15.37	2.74	15.00
No	14.96	2.45	15.00
Undergoing treatment for a health condition				0.132*
Yes	14.40	2.58	14.00
No	15.19	2.51	15.00
Regular use of medication				0.774*
Yes	14.93	2.43	15.00
No	15.14	2.59	15.00
Total	15.07	2.53	15.00

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[1] Collaborations

M Mesquita Filho worked on the study conception and design, analysis and interpretation of data, article write-up, critical revision and approval of the final version for publication. ABC Rocha, MB Brito, SR Oliveira and TF Marques worked on the study conception and design, and on the collection, analysis and interpretation of the data. CCQ Pereira was involved in writing the article, its critical revision and approval of the final version for publication.