Gender inequality and population-level health outcomes: Panel data analysis of OECD countries

Abstract

Abstract Background Gender plays a well-recognized role in many health inequalities. However, the population-level health consequences of gender inequalities have not been measured comprehensively. The goal of this study, therefore, was to evaluate associations between gender inequality 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 inequality 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. Two way fixed-effects linear models were developed to assess the relationship between gender inequality and health outcomes. Models included potential mediating and confounding factors such as health spending, political model, and economic inequities. Results Greater gender inequality was associated with lower LE (-0·49%; CI95 -0·63%- -0·31%; p-value <0·0001) and HALE (-0·47%; CI95 -0·63%- -0·31%; p-value <0·0001) as well as less-favorable figures for YLL (6·82%; CI95 3·63%-10·75%; p-value <0·0001), DALYs (1·50%; CI95 0·48%-2·46%; p-value=0·0028), and YLD (2·59%; CI95 0·67%-4·77%; p-value=0·0063). The sensitivity analysis indicated that the results were robust to the various specifications of the causal models. Conclusions Our results suggest that gender inequality has a negative impact on the health of the population. Promoting gender equality as part of policy-making is vital for optimizing health on a population scale Key messages Reduce gender inequality can advance health outcomes on a population scale, resulting in increased LE and HALE and decreasing YLL, YLD, and DALY, in the general population, and in men as well as women. This information supports the need to develop gender-sensitive public policies, for the benefit of society as a whole.