Abstract
Theoretical approaches suggest that gender inequity increases men’s health risks. Previous findings from the United States support this contention, however only a small number of health outcomes have been explored. This study extends the range of health outcomes examined by using a cross-sectional, multilevel analysis to investigate whether measures of state-level gender inequity are predictors of men’s self-rated health. Data were derived primarily from the Behavioral Risk Factor Surveillance System and the full-case data set included 116,594 individuals nested within 50 states. Gender inequity was measured with nine variables: higher education, women’s reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status and employment status. Covariates at the state level were income inequality and gross domestic product per capita. In fully adjusted models for all-age men the reproductive rights (OR 1.06 95% CI 1.01–1.11), abortion provider access (OR 1.11 95% CI 1.05–1.16) and earnings (OR 1.06 95% CI 1.02–1.12) measures all predicted an increased risk of men reporting poorer self-rated health for each 1 standard deviation increase in the gender inequity z-score. The most consistent effect was seen for the 65+ age group where the reproductive rights (OR 1.09 95% CI 1.03–1.16), abortion provider access (OR 1.15 95% CI 1.09–1.21), elected office (OR 1.06 95% CI 1.01–1.11) and earnings (OR 1.10 95% CI 1.04–1.16) measures all showed a significant effect. These findings provide evidence that some aspects of gender inequity increase the risk of poorer self-rated health in men. The study contributes to a growing body of literature implicating gender inequity in men’s health patterns.
Highlights
For many important measures men have poorer health than women [1,2]
The strongest correlation was between the reproductive rights composite measure and the abortion provider measure (r = 0.73)
This was expected, as the abortion provider measure is a component of the reproductive rights composite measure
Summary
For many important measures men have poorer health than women [1,2]. Men for example have higher mortality in almost all countries [3]. This pattern is borne out in the United States. Gender inequity and men’s self-rated health in the US (US) where men have a 4.8-year lower life expectancy than women [4]. Biological differences between men and women are likely to contribute to these health differences [7]. The variability of men’s health relative to women across different social contexts suggests that social processes are of primary importance [2,8]. Gaining an understanding of these social processes is likely to make an important contribution to the public health literature
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