Gender differences in health in Havana versus in Mexico City and in the US Hispanic population

Mine Kühn,Domantas Jasilionis,Carlos Díaz-Venegas,Anna Oksuzyan

doi:10.1007/s10433-020-00563-w

Abstract

Health progress in the 1960s and 1970s placed Cuba at the vanguard of longevity in Latin America and the Caribbean. This success has often been attributed to equity of access to the health care system and its cost-effectiveness in the country. Cuba also has a small gender gap in life expectancy. In this study, we examined how this pattern is reflected in the gender differences in health among the population aged 60+ in Havana. We compared gender differences in health in samples drawn from Havana, Mexico City, and the US Hispanic population: three geographic settings with very different political, health care, and social systems. The data come from the Survey on Health, Well-Being, and Aging in Latin America and the Caribbean and the 2000 Health and Retirement Study. Age-adjusted prevalence and logistic regressions were estimated for poor self-rated health, limitations on activities of daily living, depression, and mobility limitations. While an absolute female disadvantage in health was apparent in all three populations, the relative gender differences were inconsistent across all four health domains. Gender differences were most pronounced in Havana, even after adjusting for age, socio-economic status, family characteristics, and smoking behaviour. Despite having higher overall life expectancy and more equitable and universal access to primary care and preventive medicine, women in Havana appear to have a larger burden of ill health than women in less equitable societies. The study provides indirect evidence that Cuba faces challenges in combating the health threats posed by chronic diseases and other diseases and conditions common among the population aged 60+.

Highlights

Empirical analyses have consistently shown that women live longer than men in almost all nations, the magnitude of the gender gap varies across countries (Clark and Peck 2012)
The absolute gender differences in poor self-rated health (SRH) were similar in Havana (5.9% confidence intervals (CI) 3.03; 8.7) and Mexico City (5.9% CI 1.5; 10.23) and larger than among foreign-born US Hispanics (2.1%, CI 0.37; 3.81)
Our findings indicate that both the absolute and, in particular, the relative gender gaps in four major health domains were consistently more pronounced in the Havana sample than in the samples for Mexico City and foreign-born Hispanics in the USA

Summary

Introduction

Empirical analyses have consistently shown that women live longer than men in almost all nations, the magnitude of the gender gap varies across countries (Clark and Peck 2012). There is evidence that women tend to show worse health. 2013), rates of depression (Salk et al 2017), and comorbidities (Case and Paxson 2005; Crimmins et al 2011). A variety of studies have reported generally higher prevalences of poor self-perceived health (Crimmins et al 2011) and functional limitations among women than among their male counterparts from very young to old ages (Palacios-Ceña et al 2012)

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Discussion

Conclusion