Association between Gender Inequity and Population-Level Health Outcomes: Panel Data Analysis of OECD Countries

Abstract

Background: Gender plays a well-recognized role in shaping health inequities. However, the population-level health consequences of gender inequalities have not been measured precisely. The goal of this study was to evaluate the association between gender inequity and health indicators in OECD countries. Methods: Ecological study based on 1990–2017 panel data for Organisation for Economic Co-operation and Development (OECD) member countries. Gender inequity was measured using the Gender Inequality Index (GII). The population health parameters evaluated were life expectancy (LE), healthy life expectancy (HALE), years of life lost (YLL), years lived with disability (YLD), disability-adjusted life years (DALYs), and specific-cause mortality. Fixed-effects linear models were used to assess the relationship between gender inequity and health outcomes. Models included potential mediating and confounding factors such as health spending, political model, and income inequalities. Findings: Greater gender inequity was associated with lower LE (-0·49%; CI 95 -0·63%– -0·31%; p-value <0·0001), HALE (-0·47%; CI 95 -0·63%– -0·31%; p-value <0·0001) and with increased premature mortality (YLL 6·82%; CI 95 3·63%–10·75%; p-value <0·0001). and morbidity measured in DALYs (1·50%; CI 95 0·48%–2·46%; p-value=0·0028) and YLD (2·59%; CI 95 0·67%–4·77%; p-value=0·0063) for each 0·1 increments on the GII. The sensitivity analysis indicated that the results were robust to the various specifications of the causal models. Interpretation: Our results suggest that gender inequity pose a sizable impact on population health outcomes. Promoting gender equality as part of public policies is vital for optimizing health on a population scale. Funding Statement: Agencia Nacional de Investigacion y Desarrollo (ANID)/Programa Becas/Magister Becas Chile/2017- 22170332 Declaration of Interests: The authors have declared that no competing interests exist.