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coronary heart disease.

Although most women believe that breast cancer is women’s most pressing health worry, heart disease is a greater risk, causing some 20,000 deaths in the UK every year.  Tests for coronary heart disease (CHD) are designed to be performed on men - yet the symptoms in men and women are different.  This means that female symptoms are less well understood and less well identified.  There is also evidence that women with chest pain are less often referred for full evaluation and diagnostic procedures. The Department of Health National Service Framework (NSF) for coronary heart disease recognises that rates of CHD vary by social circumstance, gender and ethnicity.   A strategic health authority or primary health trust could use national level and local level information on this issue to assess the gender impact of its own policies and procedures on CHD, in prevention and curative care.  A university might reappraise its clinical training to ensure it covers gender differences in symptoms and treatment.  


Not all policies and practices will be equally relevant to gender equality.  It is recommended that public authorities undertake impact assessment as a two-stage process, prioritising through initial ‘screening’ in order to identify the most relevant policies and practices to gender equality.  Where remedial action may be needed, public authorities can take action to eliminate discrimination and harassment or promote equality of opportunity, based on the initial evidence from the screening, or may need to subject the policy to a more detailed assessment.     


The specific duties do not prescribe a particular method of impact assessment – approaches are likely to vary depending upon the nature of the public authority and the degree of relevance to gender equality of each of its functions.  Where the relevance of a function is high, the authority will have to take particular care to be able to demonstrate that it has met the general duty in exercising that function.  Where evidence suggests the relevance is low, public authorities may not need to take further action.


Impact assessment does not necessarily have to be an onerous process, and smaller authorities, such as schools, should be able to set up small-scale and flexible processes.  The key to the effectiveness of the process is good information and staff in relevant posts with the skills to be able to analyse the implications for gender equality.   


The initial screening process could include:

identifying the aims of the policy or practice – for most policies or practices this should be straightforward

considering the evidence – based on existing knowledge and data, will the policy or practice have a differential impact on women and men?  Absence of data should not be a justification for assuming there is no differential impact

deciding whether to take remedial action based on available evidence, or to proceed to a full impact assessment.  


Public authorities may wish to develop criteria for screening and for proceeding to full impact assessment, depending on the scale of their organisation, their remit and the aims of their gender equality scheme.  Core questions could include:

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