Social Determinants of Self-Reported Health in Women and Men: Understanding the Role of Gender in Population Health

Abstract

BackgroundWomen and men share similar health challenges yet women report poorer health. The study investigates the social determinants of self-reported health in women and men, and male-female differences in health.MethodsData on 103154 men and 125728 women were analysed from 57 countries in the World Health Survey 2002–2004. Item Response Theory was used to construct a composite measure of health. Associations between health and determinants were assessed using multivariate linear regression. Blinder-Oaxaca decomposition partitioned the inequality in health between women and men into an “explained" component that arises because men and women differ in social and economic characteristics, and an “unexplained" component due to the differential effects of these characteristics. Decomposition was repeated for 18 countries in the World Health Organization (WHO) African region and 19 countries in the WHO European region.ResultsWomen's health was significantly lower than men's. Health was associated with education, household economic status, employment, and marital status after controlling for age. In the pooled analysis decomposition showed that 30% of the inequality was “explained", of which almost 75% came from employment, education, marital status. The differential effects of being in paid employment increased the inequality. When countries in Africa and Europe were compared, the “explained" component (31% and 39% respectively) was largely attributed to the social determinants in the African countries and to women's longevity in the European countries. Being in paid employment had a greater positive effect on the health of males in both regions.ConclusionsWays in which age and the social determinants contribute to the poorer health status of women compared with men varies between groups of countries. This study highlights the need for action to address social structures, institutional discrimination and harmful gender norms and roles that differently influence health with ageing.

Men and Gender Equality

“…However, this is a complex equality issue as, though there are some areas of variance that are based on biological factors, there are also big differences in health (for both men and women) based on socio-economic inequalities and power differentials between men who are living under different circumstances. (Hosseinpoor et al 2012;Schütte et al 2013) Therefore many of the health and wellbeing problems men face are not specific examples of sex-inequality. This was a key finding from the State of Men's Health Report, which noted that: "This variability [in men's health] demonstrates clearly that men's health disadvantage is an issue of inequity and not biological inevitability and highlights the impact of the social environment in which men find themselves."…”

Public health in China: An environmental and socio-economic perspective

“…It has been proposed that life expectancy is influenced by multiple factors, with environmental and socio-economic factors considered to be two of the most important (Christensen and Vaupel, 1996;Cournil and Kirkwood, 2001;Gonos, 2000;Hosseinpoor et al, 2012;Huang et al, 2009;Kawata, 2009;Sun et al, 2014;Wang et al, 2015b). People in more developed areas tend to have higher average life expectancy (United Nations Development Programme (Ghana), 2011) and Wang et al (2015a) have demonstrated that life expectancy is affected by both contemporaneous and historical GDP per capita significantly.…”

The Correlation between Gender Inequalities and Their Health Related Factors in World Countries: A Global Cross-Sectional Study

“…But some studies have investigated that, after controlling for health outcomes, women have higher utilization rates of medical services than men [15][16][17]. Numerous studies in the literature have reported that determinants of gender differences include welfare indicators (e.g., education and income) and behavioural (e.g., smoking and drinking) and social factors (e.g., social support and socioeconomic status) [18][19][20].…”