Gender Gap In Health Research Articles

Educational attainment, gender and health inequalities among older adults in Catalonia (Spain).

BackgroundHealth expectancies vary worldwide according to socioeconomic status (SES), with health disadvantages being evident among lower SES groups. Using educational attainment as a proxy of SES, we seek to identify trends in SES differentials in health by gender, with a particular focus on individuals with low educational attainment in the adult Catalan population (Spain) aged 55 or older.MethodsUsing cross-sectional data for 1994 and 2010-2014 drawn from the Catalan Health Survey, we examined three health indicators to document social health inequalities: self-perceived health, functional limitations, and restrictions on activities of daily living (ADL). We applied logistic models for each indicator, controlling for sociodemographic characteristics, health coverage and health behaviours.ResultsAmong the less-educated, females presented a greater improvement in their self-perceived health over time than did their male counterparts, there being no significant variations among the medium/high educated. Regardless of education, males showed an increase in the prevalence of functional problems (as did the women, but the increase was not statistically significant). Both genders presented a higher prevalence of limitations when performing ADL in the second time period. The gender health gap was reduced slightly both for the low and the medium/high educated, expect in the case of ADL restrictions. Health and functioning differences by education level persisted, but showed significant signs of reduction.ConclusionsLess-educated females constitute the most disadvantaged group in terms of health and personal autonomy, though there are encouraging signs that the gap is closing both in terms of gender and level of education. Health policymakers need to devote particular attention to the aging population with low SES, especially to women. Public programmes promoting greater protection and equity, while fostering preventive and healthy practices, need to target the most underprivileged.

Gender inequalities in excess adiposity and anaemia combine in a large double burden of malnutrition gap detrimental to women in an urban area in North Africa.

The nutrition transition has exacerbated the gender gap in health in the Middle East and North Africa region as the increase in excess adiposity has been much higher among women than men. This is not exclusive of the persistence of anaemia, generally also more prevalent among women. We assessed the magnitude and sociodemographic factors associated with gender inequality vis-à-vis the double burden of excess adiposity and anaemia. Cross-sectional study, stratified two-stage cluster sample. BMI (=weight/height2) ≥25·0 kg/m2 defined overweight and BMI≥30·0 kg/m2 obesity. Anaemia was defined as Hb <120 g/l for women, <130 g/l for men. Gender inequalities vis-à-vis the within-subject coexistence of excess adiposity and anaemia were assessed by women v. men relative prevalence ratios (RPR). Their variation with sociodemographic characteristics used models including gender × covariate interactions. Greater Tunis area in 2009-2010. Adults aged 20-49 years (women, n 1689; men, n 930). Gender inequalities in excess adiposity were high (e.g. overweight: women 64·9 % v. men 48·4 %; RPR=2·1; 95 % CI 1·6, 2·7) and much higher for anaemia (women 38·0 % v. men 7·2 %; RPR=8·2; 95 % CI 5·5, 12·4). They were striking for overweight and anaemia (women 24·1 % v. men 3·4 %; RPR=16·2; 95 % CI 10·3, 25·4). Gender inequalities in overweight adjusted for covariates increased with age but decreased with professional activity and household wealth score; gender inequality in anaemia or overweight and anaemia was more uniformly distributed. Women were much more at risk than men, from both over- and undernutrition perspectives. Both the underlying gender-related and sex-linked biological determinants of this remarkable double burden of malnutrition inequality must be addressed to promote gender equity in health.

Women Empowerment in the Arab Region: A Comparative Investigation

This study aims at investigating women empowerment in the Arab region through a comparative investigation using the analytical descriptive methodology. Inevitably, woman is a key and an important contributor to development. Therefore, enhancing her empowerment is a vital driver and a key element for a development process that is sustainable and continuous. Measuring the woman empowerment is crucial for pinpointing the fragility in woman empowerment efforts in the Arab region. The overall index consists of four dimensions: economic, educational, political and healthcare. Data used is retrieved from the Global Gender Gap reports (GGG) for the years 2006-2015. By reviewing the GGG reports for fifteen Arab countries during the last ten years, notably the major Arab accomplishment is in bridging the gender gap in health and education, countered by the breadth of the political and economic participation gaps. The inability of Arab countries to bridge both political and economic gaps is attributable to several political, economic, social and religious factors. Based on the analysis in this paper, the authors suggest several actions to improved the economic contribution and political participation of woman.

The gender health gap in China: A decomposition analysis

Around the world, and in spite of their higher life expectancy, women tend to report worse health than men until old age. Explanations for this gender gap in self-perceived health may be different in China than in other countries due to the traditional phenomenon of son preference. We examine several possible reasons for the gap using the Chinese SAGE data. We first rule out differential reporting by gender as a possible explanation, exploiting information on anchoring vignettes in eight domains of health functioning. Decomposing the gap in general self-assessed health, we find that about 31% can be explained by socio-demographic factors, most of all by discrimination against women in education in the 20th century. A more complete specification including chronic conditions and health functioning fully explains the remainder of the gap (about 69%). Adding chronic conditions and health functioning also explains at least two thirds of the education contribution, suggesting how education may affect health. In particular, women's higher rates of arthritis, angina and eye diseases make the largest contributions to the gender health gap, by limiting mobility, increasing pain and discomfort, and causing sleep problems and a feeling of low energy.

Cross-national differences in the gender gap in subjective health in Europe: Does country-level gender equality matter?

Multiple studies have found that women report being in worse health despite living longer. Gender gaps vary cross-nationally, but relatively little is known about the causes of comparative differences. Existing literature is inconclusive as to whether gender gaps in health are smaller in more gender equal societies. We analyze gender gaps in self-rated health (SRH) and limiting longstanding illness (LLI) with five waves of European Social Survey data for 191,104 respondents from 28 countries. We use means, odds ratios, logistic regressions, and multilevel random slopes logistic regressions. Gender gaps in subjective health vary visibly across Europe. In many countries (especially in Eastern and Southern Europe), women report distinctly worse health, while in others (such as Estonia, Finland, and Great Britain) there are small or no differences. Logistic regressions ran separately for each country revealed that individual-level socioeconomic and demographic variables explain a majority of these gaps in some countries, but contribute little to their understanding in most countries. In yet other countries, men had worse health when these variables were controlled for. Cross-national variation in the gender gaps exists after accounting for individual-level factors. Against expectations, the remaining gaps are not systematically related to societal-level gender inequality in the multilevel analyses. Our findings stress persistent cross-national variability in gender gaps in health and call for further analysis.

Women's higher health risks in the obesogenic environment: a gender nutrition approach to metabolic dimorphism with predictive, preventive, and personalised medicine

Women's evolution for nurturing and fat accumulation, which historically yielded health and longevity advantages against scarcity, may now be counteracted by increasing risks in the obesogenic environment, recently shown by narrowing gender health gap. Women's differential metabolism/disease risks, i.e. in fat accumulation/distribution, exemplified during puberty/adolescence, suggest gender dimorphism with obesity outcomes. Women's higher body fat percentage than men, even with equal body mass index, may be a better risk predictor. Differential metabolic responses to weight-reduction diets, with women's lower abdominal fat loss, better response to high-protein vs. high-carbohydrate diets, higher risks with sedentariness vs. exercise benefits, and tendency toward delayed manifestation of central obesity, metabolic syndrome, diabetes, cardiovascular disease, and certain cancers until menopause—but accelerated thereafter—suggest a need for differing metabolic and chronological perspectives for prevention/intervention. These perspectives, including women's differential responses to lifestyle changes, strongly support further research with a gender nutrition emphasis within predictive, preventive, and personalized medicine.

Women's Empowerment in Agriculture: What Role for Food Security in Bangladesh?

Women’s low status and persistent gender gaps in health and education in South Asia contribute to chronic child malnutrition (Smith et al. 2003) and food insecurity (von Grebmer et al. 2009), even as other determinants of food security, such as per capita incomes, have improved. This is particularly relevant for Bangladesh, where chronic food insecurity continues to be an important issue despite steady advances in food production. To be able to leverage agriculture as an engine of inclusive growth, there is a need to develop indicators for measuring women’s empowerment, examine its relationship to various food-security outcomes, and monitor the impact of interventions to empower women. Using nationally representative survey data from Bangladesh, we examine the relationship between women’s empowerment in agriculture and two measures of household food security: per adult equivalent calorie availability and dietary diversity. We use the Women’s Empowerment in Agriculture Index to assess the extent of women’s empowerment in agriculture and instrumental variables techniques to correct for the potential endogeneity of empowerment. We find that the overall women’s empowerment score, the number of groups in which women actively participate, women’s control of assets, and a narrowing gap in empowerment between men and women within households are positively associated with calorie availability and dietary diversity.

Education and the Gender Gaps in Health and Mortality

The positive associations between education and health and survival are well established, but whether the strength of these associations depends on gender is not. Is the beneficial influence of education on survival and on self-rated health conditioned by gender in the same way, in opposite ways, or not at all? Because women are otherwise disadvantaged in socioeconomic resources that are inputs to health, their health and survival may depend more on education than will men's. To test this hypothesis, we use data from the National Health Interview Survey-Linked Mortality Files (NHIS-LMF). We find that education's beneficial influence on feeling healthy and on survival are conditional on gender, but in opposite ways. Education has a larger effect on women's self-rated health than on men's, but a larger effect on men's mortality. To further examine the mortality results, we examine specific causes of death. We find that the conditional effect is largest for deaths from lung cancer, respiratory disease, stroke, homicide, suicide, and accidents. Because women report worse health but men's mortality is higher, education closes the gender gap in both health and mortality.

The mental health gender-gap in urban India: Patterns and narratives

Women report significantly higher levels of mental distress than men in community studies around the world. We provide further evidence on the origins of this mental health gender-gap using data from 789 adults, primarily spousal pairs, from 300 families in Delhi, India. These data were collected between 2001 and 2003. We first confirm that, like in other studies, women report higher levels of mental distress and that gender differences in education, household expenditures and age do not explain the mental health gender-gap. In contrast, women report significantly higher levels of distress than men in families with adverse reproductive outcomes, particularly the death of a child. Controlling for adverse reproductive outcomes sharply reduces the mental health gender-gap. Finally, mental health is strongly correlated with physical health for both men and women, but there is little evidence of a differential response by sex. We complement this empirical description with anthropological analysis based on ethnographic interviews with 100 men and 100 women. With the help of these ethnographic interviews we show how adverse life events for women are experienced as the inability to maintain the domestic, which seems to be at stake within their life worlds. We raise issues for further research on the apparent finding that the mental health of women and men are differentially affected by adverse reproductive events in the family in this sample.

The double burden of malnutrition and cardiometabolic risk widens the gender and socio-economic health gap: a study among adults in Burkina Faso (West Africa).

To document the double burden of malnutrition and cardiometabolic risk factors (CMRF) in adults and its occurrence according to different sociodemographic parameters. Population-based cross-sectional observational study. We first randomly selected 330 households stratified by tertile of the income levels proxy as low, middle and high income. Northern district of Ouagadougou, the capital city of Burkina Faso. In each income stratum, 110 individuals aged 25-60 years and who had lived permanently in Ouagadougou for at least 6 months were randomly selected, followed with collection of anthropometric, socio-economic and clinical data, and blood samples. The overall obesity/overweight prevalence was 24.2 % and it was twice as high in women as in men (34.1 % v. 15.5 %, P < 0.001). Hypertension, hyperglycaemia and low HDL cholesterol prevalence was 21.9 %, 22.3 % and 30.0 %, respectively, without gender difference. The prevalence of the metabolic syndrome was 10.3 %. Iron depletion and vitamin A deficiency affected 15.7 % and 25.7 % of participants, respectively, with higher rates in women. Coexistence of at least one nutritional deficiency and one CMRF was observed in 23.5 % of participants, and this 'double burden' was significantly higher in women than in men (30.4 % v. 16.1 %, P = 0.008) and in the low income group. CMRF are becoming a leading nutritional problem in adults of Ouagadougou, while nutritional deficiencies persist. The double nutritional burden exacerbates health inequities and calls for action addressing both malnutrition and nutrition-related chronic diseases.

Are UNDP Indices Appropriate to Capture Gender Inequalities in Europe?

This study critically investigates the suitability of United Nations’ composite indices and other related measures—among which the Gender Inequality Index just released in 2010—to capture gender inequalities in the context of “highly developed” countries, focusing on the case of Europe. Our results indicate that many of the gender gaps in health and education variables have either vanished or even reversed, thus questioning their appropriateness to capture women’s disadvantage in Europe and inviting to construct region-specific measures. Alternatively, parliamentary representation and labor force participation are variables with large gender gaps that highlight important dimensions where women disadvantage prevails. Different cross-section and cross-time associations between economic growth and gender equality are generally not statistically significant—or at most weakly correlated—at European level. This is basically due to the fact that the gender gaps included in UNDP gender-related indices reached their normatively desirable values long ago, therefore leaving no room for further improvement.

Research on Ageing, Health and Gender: A Long and Winding Road

This contribution is a reply to Dr. Månsdotter’s comments on our discussion paper ‘Health and well-being in old age: the pertinence of a gender mainstreaming approach in research’ published in Gerontology [Gerontology 2010 (in press)]. Even though the comments are interesting and comprehensible, they cannot be left unanswered, this primarily because they are based on weak empirical evidence. (1) It is broadly uncontested that gender is not static. However, the conclusion that the more egalitarian division of parental duties can be viewed as an indicator for reduction of the gender gap in longevity and health is highly speculative. There is not enough empirical evidence to substantiate this position. (2) The ‘caring hypothesis’ proposed by Månsdotter, which holds that caring fathers develop less risky lifestyles and increased worries, is a possible, but not a sufficient explanation for gender convergence of physical and psychological health in future generations. Such a convergence seems to be heavily co-determined by the changing lifestyles of women. (3) From a lifespan developmental perspective, androgyny does not mean gender equality, but a necessary openness of an individual for the positive traits of the opposing gender role, an essential trait for successful ageing. (4) Månsdotter’s doubts concerning the implementation of gender mainstreaming in gerontological research and practice because of society’s limited resources are not comprehensible. Exactly because economical resources are limited, and exactly because men and women have different resources and disadvantages due to their specific bio-psycho-social realities, the most efficient way of dealing with the gender gaps in health is with a differentialapproach. (5) The concluding recommendation of Månsdotter for more openness as a scientific position regarding the impact of gender roles on human health and well-being stands in contrast to her claim for normative standpoints and prioritization of either women or men in health promotion. We certainly need openness as a scientific position, but what we urgently need are good theoretical frameworks and more interdisciplinary and longitudinal approaches, which help to overcome the thin empirical base we have. This is a challenge and a chance for future research.

Gender Differences in Trajectories of Health Limitations and Subsequent Mortality. A Study Based on the German Socioeconomic Panel 1995-2001 With a Mortality Follow-up 2002-2005

Although research on health limitations has investigated gender differences in health and mortality, gender differentials in individual-level trajectories have been studied less frequently. Moreover, there are no studies on the relationship between course types and subsequent mortality. We investigate course types, explore confounding by socioeconomic and demographic correlates, and pose the question of whether the gender gap in morbidity results from differences in the onset of, and/or survival with, health limitations. Using the German Socioeconomic Panel, we identify individual trajectories of health limitations and use multinomial logistic regressions to explore confounding and the relationship with mortality. The frequency of stable trajectories without limitations is lower among women because they tend to experience courses that involve extended periods of limitations and deteriorating health. Women also experience more frequently improvement after deterioration. The female mortality advantage is particularly large after health deterioration. Health limitations do not make men and women more equal in the face of death. Our results are consistent with earlier studies showing that mortality selection and differences in chronic conditions may explain the gender gap in health and mortality. We extend previous research showing that the female health disadvantage is largely the result of their mortality advantage.

Sex Differences in Human Biological Aging

This study aims to clarify sex differences in human biological aging and to explore the gender gaps in health and longevity. Eighty-six men and 93 women who received a 2-day routine health checkup for 6-7 years beginning in 1992 at the Kyoto Red Cross Hospital were selected. Five candidate biomarkers of aging (forced expiratory volume in 1.0 second per square of height [FEV(1)/Ht(2)], systolic blood pressure [SBP], red blood cells [RBC], albumin [ALBU], and blood urea nitrogen [BUN]) were selected from 29 physiological variables. Individual biological ages (BAS) were estimated from these five biomarkers by a principal component model. From the investigation of the longitudinal changes of individual BAS, it was suggested that (i) beyond 65 years, the rate of aging showed a rapid increase, and (ii) women had relatively lower functional capabilities compared with men, but the rate of aging was slower than that of men, suggesting that these differences might present both disadvantages and advantages for women with regard to health and longevity.

Explaining gender differences in ill-health in South Korea: The roles of socio-structural, psychosocial, and behavioral factors

This study examines and explains the gender disparity in health despite rapid modernization in South Korea where the social structure is still based on traditional gender relations. A nationally representative sample of 2897 men and 3286 women aged 25–64 from the 2001 Korean National Health and Nutrition Examination Survey was analyzed. Health indicators included self rated health and chronic disease. Age-adjusted prevalence was computed according to a gender and odds ratios (OR) derived from logistic regression. Percentage changes in OR by inclusion of determinant variables (socio-structural, psychosocial, and behavioral) into the base logistic regression model were used to estimate the contributions to the gender gap in two morbidity measures. Results showed a substantial female excess in ill-health in both measures, revealing an increasing disparity in the older age group. Group-specific age-adjusted prevalence of ill-health showed an inverse relationship to socioeconomic position. When adjusting for each determinant, employment status, education, and depression contributed the greatest to the gender gap. After adjusting for all suggested determinants, 78% for self rated health and 86% for chronic disease in excess OR could be explained. After stratifying for age, the full model provided a complete explanation for the female excess in chronic illness, but for self rated health a female excess was still evident for the younger age group. Socio-structural factors played a crucial role in accounting for female excess in ill-health. This result calls for greater attention to gender-based health inequality stemming from socio-structural determinants in South Korea. Cross-cultural validation studies are suggested for further discussion of the link between changing gender relations and the gender health gap in morbidity in diverse settings.

Determinants of Gender Differences in Health among the Elderly in Latin America

This paper identifies the main gender differences in health and socio-economic characteristics of the elderly in four Latin American cities. Using locally weighted regressions as well as a flexible model specification that treats age non-parametrically, we investigate whether these unadjusted gender gaps in health are due to gender differences in the distribution of age and other explanatory variables. Interestingly, for all cities, the analyses show a gender gap in health in favour of males at each age. The gaps are larger when one uses functional impairment in mobility and personal self-care as indicators of an individual's health instead of self-reported health. Furthermore, controlling for demographic characteristics, baseline health and the availability of family support do little to change the disadvantage for women in measured health outcomes. Controlling for socio-economic variables does, however, reduce most of the gender differences in health.

Gender differences in the consumption of meat, fruit and vegetables are similar in Finland and the Baltic countries

Women's diets are healthier than men's. Finnish women eat more fruits and vegetables but less meat than men. Gender differences may be larger in the Baltic countries, which represent Eastern European transition societies than in Finland, a society characterized by the Scandinavian welfare ideology and a high degree of gender equality. The data are based on questionnaires to random samples of adults in Finland, Estonia, Latvia and Lithuania. The data provide a way of addressing gender differences at the turn of the century in the economically and culturally different countries. The purpose is to explore whether the consumption of foods classified as masculine or feminine-meat, fruits and vegetables-follow a similar gender pattern in Finland and the Baltic countries. Men ate meat more often while women ate fruits and vegetables. A high educational level was associated with frequent consumption of fruits and vegetables. Educational differences in the consumption of meat were few and inconsistent. The consumption of fruits and vegetables was more common in urban areas except in Finland. Gender differences were similar in all countries throughout age and educational groups and in rural and urban areas. The consistent association of gender and food and the similarity of gender patterning in population subgroups point to the stability of masculine versus feminine food habits. The similarity suggests that food habits contribute equally to the gender gap in health in the Baltic countries as they do in Finland.

Working until You Drop: The Elderly of Rural China

In developing countries aging is in many ways more difficult than in developed countries. In order simply to maintain the same standard of living as they age people must rely on pensions their savings and/or their children or other relatives. However few developing nations offer formal pension plans for rural residents. Nor can they live off of their savings; in developing countries they are generally poor and are not able to accumulate sufficient assets or saving during their lifetimes. Therefore villagers in developing countries typically rely on their extended family to support them in their old age. Life in rural China traditionally has been like rural life in many other developing countries as families have played an important role in maintaining the elderlys livelihood. As in time past this still primarily means reliance on the support of sons. In a typical situation the elderly in rural China live with or next door to one of their sons in an extended family arrangement. (excerpt)