Self-rated health inequalities in the intersection of gender, social class and regional development in Spain: exploring contributions of material and psychosocial factors

Núria Pedrós Barnils,Per E Gustafsson,Eva Eurenius

doi:10.1186/s12939-020-01202-7

Núria Pedrós Barnils, Per E Gustafsson + Show 1 more

Open Access

https://doi.org/10.1186/s12939-020-01202-7

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Abstract

BackgroundInequalities in health across social class, gender and regional context in Spain are well-known; however, there is a lack of research examining how these dimensions of inequality interact. This study explores self-rated health (SRH) inequalities across intersectional positions of gender, social class and region, and the contribution of material and psychosocial factors to these inequalities.MethodsParticipants were drawn from the cross-sectional 2015 National Living Conditions Survey of Spanish residents aged 19–88 years (N = 27,215; 77% response rate). Eight intersectional positions were formed by combining dichotomous variables of gender, social class and regional development. Poisson regression was used to estimate intersectional inequalities in SRH as prevalence ratios, and the contributions of material and psychosocial factors.ResultsResults showed both cumulative and heterogeneous inequalities within and across intersectional positions. Inequalities in the intersection of social class and regional development were best explained by the joint contributions of material and psychosocial factors, while gender inequalities within non-manual social class were better explained by material factors alone.ConclusionsThe results illustrate the complexity of interacting inequalities in health and their underpinnings in Spain. Local and national policies taking this complexity into account are needed to broadly improve equity in health in Spain.

Highlights

Inequalities in health across social class, gender and regional context in Spain are well-known; there is a lack of research examining how these dimensions of inequality interact
Gender inequalities are found in phenomena such as women having longer life expectancy than men, but poorer health when it comes to chronic illnesses, mental health or self-rated health (SRH) [3, 4]
Gender was homogenously distributed by region, but when it comes to social class men tended to belong to manual class more often that women did (68% v 61%)

Summary

Introduction

Inequalities in health across social class, gender and regional context in Spain are well-known; there is a lack of research examining how these dimensions of inequality interact. This study explores selfrated health (SRH) inequalities across intersectional positions of gender, social class and region, and the contribution of material and psychosocial factors to these inequalities. It is widely recognised that there are unacceptable social inequalities in health among different population groups, which potentially could be reduced through equity promoting policies and inclusive interventions [1]. These notions are embraced by The Commission to Reduce Social Inequalities in Health in Spain [2]. Individuals’ health status can differ depending on geographical contexts, as illustrated by regional inequalities within countries [7, 8]

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