Gender inequality in self-reported health and its evolution in Europe between 2004 and 2016

Abstract

Abstract Background That women generally have worse health than men has long been shown. Yet, the situation in Europe might have changed recently. Gender inequalities have decreased in access to education, employment, and political representation. However, women have increasingly adopted traditionally masculine unhealthy behaviors, such as smoking. Also, the Great Recession may have hurt women harder, due to their greater socioeconomic vulnerability. This study aims to analyze gender inequalities in 30 European countries, and its evolution over the 2004-2016 period. Methods We used data from the Survey on Income and Living Conditions (SILC), from people between 25 and 64 years old (N = 3,109,150). We modeled the probability of bad/very bad self-reported health as function of gender, adjusting for age, country and year, using logistic regressions. We further adjusted for education and employment. Then, we included interactions of gender and year to test changes in inequalities over time. Finally, we stratified the analysis according to countries grouped based on the Gender Development Index (GDI). Results Women were 16.8% more likely to report bad health (OR = 1.17, p < 0.01). Considering education and employment, women were 2.6% less likely to report bad health (OR = 0.97, p < 0.01). Over time, adjusting for age, the gender gap reduced from 81.1% (OR = 1.81, p < 0.01) in 2004 to 16.4% in 2016 (OR = 1.16, p < 0.01), and from 31.5% to 2.5% with socioeconomic adjustment. The reduction was larger in countries with a greater GDI. Conclusions Gender inequality has decreased, but was still present in 2016, in favor of men. This thinning is partly explained by the narrowing of inequalities in education and employment. A greater GDI has favored a larger improvement. Key messages Gender inequalities in self-reported health have narrowed over 2004-2006, following the narrowing of socioeconomic inequalities. A greater GDI has favored a larger improvement in gender inequalities.