Abstract
BackgroundIndividual and area socio-economic status (SES) are significant predictors of morbidity and mortality in developed and developing countries. However, the span in health from poorest to richest, that is, the socio-economic gradient, appears steeper for men than women.ObjectiveOur aim is to understand women's apparent immunity to the health harms of the SES gradient.DesignFindings from a non-systematic search of Medline for population-based, SES gradient studies reporting results for both men and women and with health outcomes of morbidity, mortality or self-rated health (SRH) were reflectively analyzed.ResultsThe 36 papers reviewed generally showed women to be relatively immune to the SES gradient for all but cardiovascular health outcomes. However, addressing the interconnected nature of socio-economic circumstances, exploring whether some measures of SES had ambiguous meanings for either women or men, including modifiers of SES such as household circumstances, social capital or area gender equity, or using indicators of area SES that were contextual rather than aggregates of individual, compositional measures increased the SES gradient for women. Outcome measures that combined mental and physical health, accounted for gender differences in SRH and adjusted for sex-specific differences in causes of mortality also explained some of the observed amelioration of the SES gradient among women.ConclusionsSocio-economic circumstances have a real and sustained impact on individual health. The SES gradient appears stronger for men than for women for all health outcomes other than heart disease. However, some of the observed variability between men and women may be an artifact of biased methodology. Considering webs of causation rather than individual markers of SES along with other sources of gender bias can explain much of women's blunted socio-economic gradient and deepen understanding of the pathways from SES to morbidity and mortality overall.
Highlights
Individual and area socio-economic status (SES) are significant predictors of morbidity and mortality in developed and developing countries
Gender differences in the SES gradient In general, regardless of SES indicator or health outcome but with the important exception of heart disease, SES gradients were attenuated among women relative to men
Indicators of SES varied from study to study and included combinations of individual or area education (10, 14Á16, 18Á20, 22, 23, 25, 26, 28, 30Á32, 34, 36, 37, 41, 43, 44), individual or area income (14, 15, 23, 26, 29Á31, 34, 37, 43, 44), occupational class and working conditions of self and/or spouse (11, 13, 15, 18, 20, 21, 23, 26, 28, 35Á37, 39Á44), housing quality [18, 20], subjective social position of women [19], household social position [35], access to economic resources [9], and neighborhood deprivation/inequality [12, 17, 18, 24, 33, 34, 38, 39, 41]
Summary
Individual and area socio-economic status (SES) are significant predictors of morbidity and mortality in developed and developing countries. Design: Findings from a non-systematic search of Medline for population-based, SES gradient studies reporting results for both men and women and with health outcomes of morbidity, mortality or self-rated health (SRH) were reflectively analyzed. Results: The 36 papers reviewed generally showed women to be relatively immune to the SES gradient for all but cardiovascular health outcomes. Outcome measures that combined mental and physical health, accounted for gender differences in SRH and adjusted for sex-specific differences in causes of mortality explained some of the observed amelioration of the SES gradient among women. Considering webs of causation rather than individual markers of SES along with other sources of gender bias can explain much of women’s blunted socio-economic gradient and deepen understanding of the pathways from SES to morbidity and mortality overall
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
