Influence of Gender Determinants on Informal Care and Health Service Utilization in Spain: Ten Years after the Approval of the Equality Law

Raquel Sánchez-Recio,Gabriela Topa,Cristina García-Ael

doi:10.3390/admsci11020042

Raquel Sánchez-Recio, Gabriela Topa + Show 1 more

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https://doi.org/10.3390/admsci11020042

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Abstract

The existence of gender inequalities in health, in the use of health services, and in the development of informal care has been demonstrated throughout scientific literature. In Spain, a law was passed in 2007 to promote effective equality between men and women. Despite this, different studies have shown that the previous gender inequalities are still present in Spanish society. For all these reasons, the objective of this paper is to study the differences by sex in informal care and in the use of emergency care, and to identify the existence of gender inequalities in Spain 10 years after the adoption of the aforementioned equality law. In this case, we development a cross-sectional study based on the 2017 Spanish National Health Survey of the Spanish population aged 16 and over. To analyze the influence of gender determinants on informal care and emergency care utilization, logistic regressions were performed, model 1 was adjusted for age, and model 2 was further adjusted too by the variables of the Andersen care demand model. The results showed that informal care and the use of the emergency care continues to be higher in women than in men. Informal care in women was related to a higher level of education. In emergency care, the older the age, the lower the probability of utilization, and living in a rural municipality was related to a higher probability of utilization for both sexes. Finally, we concluded that there is still a need for studies that analyze gender inequalities in different contexts, such as the informal care and the use of health services. This is especially relevant in Spain, where economic changes have led to a change in roles, mainly for women, and new management strategies are needed to achieve equity in care and effective equality between men and women.

Highlights

Inequalities in health are related to the different opportunities and resources that people have, in relation to politics, economics, and access to health (Peter and Evans 2001)
In relation to outcome measurement, we observed that a higher proportion of women than men devoted more time to informal care, and that women spent on average 2.14 h per week to informal care compared to 1.97 h for men (p < 0.001)
Analyzing the variables of interest according to the occupation of the respondent, we find that women engaged in unpaid housework were the most likely to report engaging in informal care alone (14.82%)

Summary

Introduction

Inequalities in health are related to the different opportunities and resources that people have, in relation to politics, economics, and access to health (Peter and Evans 2001). According to the World Health Organization (WHO), gender inequity in health is related to differences in health risks, health needs, and access to health services, coupled with gender differences in health responsibilities and power (Rohlfs et al 2000). Several studies have hypothesized whether the difference in health care between men and women is related to gender roles (Saez et al 2019). This would reduce and/or eliminate certain manifestations of pain, discomfort, or illness itself in men, and in women they would appear to show the role of the sick (Kuhlmann and Annandale 2012; Oksuzyan et al 2019). It has been observed that women between the ages of 18 and 50 years are more likely to attend health services, an age period in which gender roles are more pronounced (Meininger 1986)

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