Abstract
The European population is aging and their declining capacity makes older Europeans more dependent on the availability of care. Male and female health needs at older ages are different, yet there are contradictory results on the study of gender inequalities in health among the older European population. The aim of this article is twofold: first, we study whether there is a general gender health gap at older ages across Europe. Secondly, we analyze the existence of an increasing or decreasing universal association between the gender health gap and age among the older European population or whether, by contrast, this depends on the type of welfare state. To achieve these goals, we use data from the Survey on Health, Ageing and Retirement in Europe (SHARE) for respondents aged 50 and over in 2015, and we carry out several multilevel random intercept logistic regressions for European countries. Our results show that when we split European countries into groups according to the type of welfare state, we only find a significant gender health gap in older people in Southern and Social Democratic countries. Some differences have been found in the links between the gender health gap and age among European countries. Old women report worse health than men at all ages in Southern countries while in Social Democratic states it is only true for women aged 80 and over. In Bismarckian states there are barely any gender differences, while the gender health gap has no clearly defined bias. Between the ages of 60 and 79, men from Eastern European countries report poorer health, while after 80 it is women who report poorer health. In general, we found the widest gender inequalities in health for the oldest population group, especially in Southern and Eastern European countries.
Highlights
Health in the latter stages of life is a matter of great interest since older people are a par‐ ticularly vulnerable population group
In accordance with the cumulative disadvantage hypothesis, which proposes an increase in health inequalities over the life cycle, Bambra, Netuveli and Eikemo (2010) found that socioeconomic inequalities in health among the European elderly tended to increase with age, mainly in Southern European countries, where the magnitude of health inequalities was higher than in other welfare regimes
On the other hand, healthrelated behaviors can shape the relation between age and health inequalities, and the con‐ trol for these factors may explain some of the contradictory results in the literature, such as the large health inequalities found in Nordic countries by some studies (Avendano, Jürges and Mackenbach 2009; Thorslund and Lundberg 1994)
Summary
Health in the latter stages of life is a matter of great interest since older people are a par‐ ticularly vulnerable population group They suffer from high rates of dependency and chronic diseases, added to which their income tends to decrease as they get older and leave the job market. Some studies have reported the existence of socioeconomic inequalities in health among older European men and women even for those aged over 80, a decreasing age-pattern has been observed (Beckett 2000; Huisman, Kunst and Mackenbach 2003) This tendency is referred to as the “age-as a leveler” hypothesis, and it has been explained mostly due to the mortality selection, since individuals with a lower socio-economic status experience higher mortality rates, reducing health inequalities among the survivor population. On the other hand, healthrelated behaviors can shape the relation between age and health inequalities, and the con‐ trol for these factors may explain some of the contradictory results in the literature, such as the large health inequalities found in Nordic countries by some studies (Avendano, Jürges and Mackenbach 2009; Thorslund and Lundberg 1994)
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