Gender Inequalities In Health Research Articles

Gender Disparities in Frailty and Its Decomposition Among Chinese Older Adults.

To identify the evidence of gender disparities in frailty and explore the factors contributing to male-female differences. A longitudinal study. A total of 24,429 older adults (60+) were enrolled. Frailty was assessed by frailty index and frailty risk based on Rockwood's cumulative deficit frailty index. OLS and logistic regression models were conducted, with Oaxaca-Blinder and Fairlie decomposition methods to further analyse the factors contributing to gender disparities in frailty. The paper used four waves of the China Health and Retirement Longitudinal Study from 2011 to 2018, a nationwide survey organised by the National Development Institute of Peking University. Women had higher frailty status than men, with more pronounced increases. Among the factors, education has the most significant association with frailty gender disparities. The contribution of individual characteristics, particularly education, to gender disparities in frailty appeared to diminish over time, while the contribution of family and regional factors remained relatively stable, and the contribution of institutions was deemed inadequate. The frailty in Chinese older adults is generally on the rise with continuously expanded gender disparities. It is crucial to consider the contributing factors to frailty in older adults for effective prevention and intervention strategies. Additional gender-specific geriatric care policies are needed in order to address gender inequality in health. The findings of this study highlight the prevalence of increasing gender disparities in frailty and identify that the level of education, per capita annual household income as well as marital status are the most significant factors contributing to the gender gap. Those findings provide policy implications for healthcare nursing service from a gender-specific perspective in order to achieve health equity. This study has adhered to the STROBE guideline. No Patient or Public Contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY: This study provided implications on gender-specific geriatric care nursing services. The study highlighted the importance of focusing on frailty and its gender disparities in geriatric clinical nursing.

Adolescent health-risk behaviours in Uruguay: Patterns from national cross-sectional school surveys conducted in 2006, 2012 and 2019.

There are no trend studies on various health risk behaviours among adolescents in Uruguay. Therefore, this study looked at trends in a number of health-risky behaviours among adolescents in Uruguay from three separate surveys. Data from 9272 adolescents (age range: 11-16 years), who took part in three cross-sectional national in-school surveys in Uruguay in 2006, 2012 and 2019 were analysed. A self-administered survey was used to evaluate 24 health risk behaviours. By using logistic regression analyses to treat the study year as a categorical variable and adjusting food insecurity and age, linear trends were examined. We found a significant increase in the prevalence of being overweight, having obesity, inadequate fruit intake, sedentary behaviour in leisure-time, physical inactivity, bullying victimisation, loneliness, suicidal ideation, and sexual activity. We found a significant decrease in current cigarette use, physical fighting and current alcohol use. Among males, a significant increase of non-condom use, and a decrease in current other tobacco use (other than cigarettes), being physically attacked and the number of sexual partners. Among females, we found an increase in food insecurity, trouble from alcohol use, multiple sexual partners, and sleep problems. Overall, from 2006 to 2019, there was a decrease in seven health risk behaviours among boys and/or girls. Among boys, there was an increase in 10 health risk behaviours and among girls, 15 health risk behaviours increased, highlighting adolescent girls' greater vulnerability, thereby perpetuating further gendered health inequalities. In Uruguay, school health programmes for adolescents are recommended.

Gender Inequalities of Health and Quality of Life in Informal Caregivers in Spain: Protocol for the Longitudinal and Multicenter CUIDAR-SE Study.

The aging population and increased disability prevalence in Spain have heightened the demand for long-term care. Informal caregiving, primarily performed by women, plays a crucial role in this scenario. This protocol outlines the CUIDAR-SE study, focusing on the gender-specific impact of informal caregiving on health and quality of life among caregivers in Andalusia and the Basque Country from 2013 to 2024. This study aims to analyze the gender differences in health and quality of life indicators of informal caregivers residing in 2 Spanish autonomous communities (Granada, Andalusia, and Gipuzkoa; Basque Country) and their evolution over time, in relation to the characteristics of caregivers, the caregiving situation, and support received. The CUIDAR-SE study uses a longitudinal, multicenter design across 3 phases, tracking health and quality of life indicators among informal caregivers. Using a questionnaire adapted to the Spanish context that uses validated scales and multilevel analysis, the research captures changes in caregivers' experiences amid societal crises, notably the 2008 economic crisis and the COVID-19 pandemic. A multistage randomized cluster sampling technique is used to minimize study design effects. Funding for the CUIDAR-SE study was in 3 phases starting in January 2013, 2017, and 2021, spanning a 10-year period. Data collection commenced in 2013 and continued annually, except for 2016 and 2020 due to financial and pandemic-related challenges. As of March 2024, a total of 1294 participants have been enrolled, with data collection ongoing for 2023. Initial data analysis focused on gender disparities in caregiver health, quality of life, burden, perceived needs, and received support, with results from phase I published. Currently, analysis is ongoing for phases II and III, as well as longitudinal analysis across all phases. This protocol aims to provide comprehensive insights into caregiving dynamics and caregivers' experiences over time, as well as understand the role of caregiving on gender inequality in health, considering regional variations. Despite limitations in participant recruitment, focusing on registered caregivers, the study offers a detailed exploration of the health impacts of caregiving in Spain. The incorporation of a gender perspective and the examination of diverse contextual factors enrich the study's depth, contributing significantly to the discourse on caregiving health complexities in Spain. DERR1-10.2196/58440.

Intersectionality, gender norms, and young adolescents in context: a review of longitudinal multicountry research programmes to shape future action.

Discriminatory gender norms can intersect and interact with other dimensions of discrimination-such as age, race, ethnicity, disability, education status, and sexual orientation-to shape individuals' experiences and impact their health and wellbeing. This interaction is referred to as intersectionality. Although the theory has been in circulation since the late 1980s, only recently has it gained traction in low-income and middle-income settings, and it has yet to fully penetrate global research on adolescence. The social and structural intersectional drivers of adolescent health and wellbeing, particularly during early adolescence (age 10-14 years), are poorly understood. The evidence base for designing effective interventions for this formative period of life is therefore relatively small. In this Review, we examine how gender intersects with other forms of disadvantage in the early stages of adolescence. Analysing data from hybrid observation-intervention longitudinal studies with young adolescents in 16 countries, our aim is to inform the health and wellbeing of girls and boys from a range of social contexts, including in conflict settings. Adolescents' perceptions about gender norms vary by context, depend on individual opinion, and are shaped by socioecological drivers of gender inequalities in health. Shifting those perceptions is therefore challenging. We argue for the importance of applying an intersectionality lens to improve health and wellbeing outcomes for young adolescents and conclude with five practical recommendations for programme design and research.

Time poverty, health and health-related behaviours in a Southern European city: a gender issue

BackgroundDespite its growing interest, time poverty is a neglected issue in public health analysis and policies. The objectives of this study were: (1) to analyse gender differences in paid, unpaid...

Geographical and gender inequalities in health sciences studies: testing differences in research productivity, impact and visibility

PurposeGender and geographical imbalance in production and impact levels is a pressing issue in global knowledge production. Within Health Sciences, while some studies found stark gender and geographical biases and inequalities, others found little empirical evidence of this marginalization. The purpose of the study is to clear the ambiguity concerning the topic.Design/methodology/approachBased on a comprehensive and systematic analysis of Health Sciences research data downloaded from the Scival (Scopus/Scimago) database from 2017 to 2020 (n = 7,990), this study first compares gender representation in research productivity, as well as differences in terms of citation per document, citations per document view and view per document scores according to geographical location. Additionally, the study clarifies whether there is a geographic bias in productivity and impact measures (i.e. citation per document, citations per document view and view per document) moderated by gender.FindingsResults indicate that gender inequalities in productivity are systematic at the overall disciplinary, as well as the subfield levels. Findings also suggest statistically significant geographical differences in citation per document, citations per document view, and view per document scores, and interaction effect of gender over the relation between geography and (1) the number of citations per view and (2) the number of views per document.Originality/valueThis study contributes to scientometric studies in health sciences by providing insightful findings about the geographical and gender bias in productivity and impact across world regions.

The Gender-Differentiated Impacts of the COVID-19 Pandemic on Health and Social Inequalities in the UK: An Exploration of Gendered Themes within Private and Public Discourse and Policy Implications

Abstract Recent research has evidenced the gender differentiated impacts of the COVID-19 pandemic on health and socio-economic inequalities in the UK. The impact of the COVID-19 pandemic on gender inequalities particularly regarding the increased burden of unpaid care work, health, education, and gender-based violence have been evidenced in a number of recent studies (O’Donnell et al. 2021; Flor et al. 2022; Herten-Crabb and Wenham 2022; Dotsikas et al. 2023). In particular, gendered inequalities are reflected in gendered themes within caregivers’ discourse and reports on patterns among caregivers. This chapter analyses recent empirical evidence relating to the gender-differentiated health, economic and social impacts of the COVID-19 crisis in the UK. The chapter also explores recent research relating to gendered themes within private and public discourse relating to the impact of the COVID-19 pandemic. This is followed by a discussion of the policy implications of private and public discourse relating to the impact of the COVID-19 pandemic on gendered health inequalities in the UK. The main findings of the chapter are that the burden of normative expectations placed on women during the two lockdowns in the UK were overwhelming, with mothers facing extraordinary levels of emotional and psychological stress as they struggled to cope with conflicting demands of domestic work, home schooling, working from home and/or working within health care or social care. Moreover, women and caregivers in general faced extraordinary pressures in attempting to live up to dominant public narratives of caregivers as stoic and heroic.

Social capital as an element of impact on public health: a gender gap analysis for Spain

Abstract The recent COVID-19 pandemic highlighted the importance of health, not only for physical but also mental well-being. The isolation to which the population was subjected in many countries drastically reduced social interaction at that time and emphasized the relevance of social capital. The aim of this article is to study the importance of social capital in health, and its impact in gender inequalities, in order to provide guidance on social policy that contributes to the reduction of the gender health gap. We used the Spanish data from the European Survey on Living Conditions (EU-SILC). Spain is a representative country of Southern Europe, where there are strong gender inequalities in health, especially among the elderly. The selected sample includes the population aged 25 years and over. In total, 25,054 individuals were considered, of whom 47% were men and 53% were women. Self-rated health was used as a general indicator of health status. Different sociodemographic variables and various social capital variables, such as satisfaction with social relationships or meeting with family and friends, were included in the analysis. In order to carry out this analysis, several multivariate logistic estimations were performed. In our results, social capital variables were highly significant and positively associated with perceived health. In the case of women, there is a strong positive association, especially relevant for older women (over 75) and those with lower levels of education (no education or primary education). In both cases, these are the most vulnerable women, who report a poorer health status, with a gender gap in health particularly intense in our estimations for older women. In conclusion, social policies supporting elderly women, promoting participation in group activities and facilitating relationships with others, constitute a strategy of great impact on their perception of health. Key messages • Social capital variables were highly significant and positively associated with perceived health, especially relevant for older women and those with lower levels of education. • Social policies supporting elderly women, promoting participation in group activities and facilitating relationships with others, constitute a strategy of great impact on their perception of health.

Economic costs of gender inequality in health and the labor market: India's untapped potential.

Economic costs of gender inequality in health and the labor market: India's untapped potential.

A machine learning approach to determine the influence of specific health conditions on self-rated health across education groups

BackgroundSelf-rated health, a subjective health outcome that summarizes an individual’s health conditions in one indicator, is widely used in population health studies. However, despite its demonstrated ability as a predictor of mortality, we still do not full understand the relative importance of the specific health conditions that lead respondents to answer the way they do when asked to rate their overall health. Here, education, because of its ability to identify different social strata, can be an important factor in this self-rating process.The aim of this article is to explore possible differences in association pattern between self-rated health and functional health conditions (IADLs, ADLs), chronic diseases, and mental health (depression) among European women and men between the ages of 65 and 79 according to educational attainment (low, medium, and high).MethodsClassification trees (J48 algorithm), an established machine learning technique that has only recently started to be used in social sciences, are used to predict self-rated health outcomes. The data about the aforementioned health conditions among European women and men aged between 65 and 79 comes from the sixth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 27,230).ResultsIt is confirmed the high ability to predict respondents’ self-rated health by their reports related to their chronic diseases, IADLs, ADLs, and depression. However, in the case of women, these patterns are much more heterogeneous when the level of educational attainment is considered, whereas among men the pattern remains largely the same.ConclusionsThe same response to the self-rated health question may, in the case of women, represent different health profiles in terms of the health conditions that define it. As such, gendered health inequalities defined by education appear to be evident even in the process of evaluating one’s own health status.

Perpetuation of gender discrimination in Pakistani society: results from a scoping review and qualitative study conducted in three provinces of Pakistan

BackgroundGender discrimination is any unequal treatment of a person based on their sex. Women and girls are most likely to experience the negative impact of gender discrimination. The aim of this study is to assess the factors that influence gender discrimination in Pakistan, and its impact on women’s life.MethodsA mixed method approach was used in the study in which a systematic review was done in phase one to explore the themes on gender discrimination, and qualitative interviews were conducted in phase two to explore the perception of people regarding gender discrimination. The qualitative interviews (in-depth interviews and focus group discussions) were conducted from married men and women, adolescent boys and girls, Healthcare Professionals (HCPs), Lady Health Visitors (LHVs) and Community Midwives (CMWs). The qualitative interviews were analyzed both manually and electronically through QSR NVivo 10. The triangulation of data from the systematic review and qualitative interviews were done to explore the gender discrimination related issues in Pakistan.ResultsThe six major themes have emerged from the systematic review and qualitative interviews. It includes (1) Status of a woman in the society (2) Gender inequality in health (3) Gender inequality in education (4) Gender inequality in employment (5) Gender biased social norms and cultural practices and (6) Micro and macro level recommendations. In addition, a woman is often viewed as a sexual object and dependent being who lacks self identity unless being married. Furthermore, women are restricted to household and child rearing responsibilities and are often neglected and forced to suppress self-expression. Likewise, men are viewed as dominant figures in lives of women who usually makes all family decisions. They are considered as financial providers and source of protection. Moreover, women face gender discrimination in many aspects of life including education and access to health care.ConclusionGender discrimination is deeply rooted in the Pakistani society. To prevent gender discrimination, the entire society, especially women should be educated and gendered sensitized to improve the status of women in Pakistan.

Improving the Response of Health Systems to Female Genital Schistosomiasis in Endemic Countries through a Gender-Sensitive Human Rights-Based Framework.

The right to health was enshrined in the constitution of the World Health Organization in 1946 and in the Universal Declaration of Human Rights in 1948, which also guaranteed women's fundamental freedoms and dignity. The Declaration of Human Rights was signed by almost every country in the world. Nonetheless, gender inequalities in health and health systems continue to persist, especially in lower and middle income countries that are disproportionately affected by a litany of neglected diseases. In this paper, we focus on one of the most neglected human rights, development, and reproductive health issues globally, female genital schistosomiasis (FGS), which imposes enormous unacknowledged suffering on an estimated 56 million women and girls in Sub-Saharan Africa. Despite increasing calls for attention to FGS, no country has fully incorporated it into its health system. An appropriate response will require a comprehensive approach, guided by human rights mandates and the redress of FGS-related gender inequalities. In this paper, we propose the application of existing human rights and its clients, women, and girls affected by FGS as rights holders. Within the different components or building blocks of the health system, we propose elements of an appropriate health system response using the four components identified within the FGS Accelerated Scale Together (FAST) Package-awareness raising, prevention of infection, training of health personnel, and diagnosis and treatment. The framework is aspirational, its recommended elements and actions are not exhaustive, and countries will need to adapt it to their own situations and resource availability. However, it can be a useful guide to help health systems define how to begin to incorporate FGS into their programming in a way that responds to their human rights obligations in a gender- and culturally sensitive manner.

Gender and the COVID-19 pandemic: Multinational research indicate that we must support and compensate LMIC women's leadership in crises.

Gender and the COVID-19 pandemic: Multinational research indicate that we must support and compensate LMIC women's leadership in crises.

Do Different Patterns of Employment Quality Contribute to Gender Health Inequities in the U.S.? A Cross-Sectional Mediation Analysis.

Compared to recent generations, workers today generally experience poorer quality employment across both contractual (e.g., wages, hours) and relational (e.g., participation in decision-making, power dynamics) dimensions within the worker–employer relationship. Recent research shows that women are more likely to experience poor-quality employment and that these conditions are associated with adverse health effects, suggesting employment relations may contribute to gender inequities in health. We analyzed data from the General Social Survey (2002–2018) to explore whether the multidimensional construct of employment quality (EQ) mediates the relationship between gender and health among a representative, cross-sectional sample of U.S. wage earners. Using a counterfactually-based causal mediation framework, we found that EQ plays a meaningful role in a gender–health relationship, and that if the distribution of EQ among women was equal to that observed in men, the probability of reporting poor self-reported health and frequent mental distress among women would be lower by 1.5% (95% Confidence Interval: 0.5–2.8%) and 2.6% (95% CI: 0.6–4.6%), respectively. Our use of a multidimensional, typological measure of EQ allowed our analysis to better account for substantial heterogeneity in the configuration of contemporary employment arrangements. Additionally, this study is one of the first mediation analyses with a nominal mediator within the epidemiologic literature. Our results highlight EQ as a potential target for intervention to reduce gender inequities in health.

Maternal self-conception and mental wellbeing during the first wave of the COVID-19 pandemic. A qualitative interview study through the lens of "intensive mothering" and "ideal worker" ideology.

Mothers tended to be responsible for most of the (additional) caregiving and domestic tasks during the COVID-19 pandemic while simultaneously having to pursue their work duties. Increased role conflicts, parenting stress, and exhaustion predict adverse mental health. We aimed to examine how women referred to and made sense of dominant gender norms in their arrangements of pandemic daily life and how these beliefs impacted their maternal self-conception. Qualitative interviews with 17 women were analyzed through the lens of “intensive mothering” ideology and “ideal workers” norms, emphasizing notions of maternal guilt rising from a perceived mismatch between the ideal and actual maternal self-conception. We found that mothers' notions of guilt and their decreases in health link to dominant discourses on motherhood and intersect with “ideal worker” norms. As such, these norms amplify the burden of gendered health inequalities.

For a structured response to the psychosocial consequences of the restrictive measures imposed by the global COVID-19 health pandemic: the MAVIPAN longitudinal prospective cohort study protocol

IntroductionThe COVID-19 pandemic and associated restrictive measures have caused important disruptions in economies and labour markets, changed the way we work and socialise, forced schools to close and healthcare and...

Trends in gender and socioeconomic inequalities in adolescent health over 16 years (2002-2018): findings from the Canadian Health Behaviour in School-aged Children study.

Monitoring health inequalities in adolescents informs policy approaches to reducing these inequalities early in the life course. The purpose of this study was to investigate trends in gender and socioeconomic inequalities in six health domains. Data were from five quadrennial survey cycles of the Health Behaviour in School-aged Children (HBSC) study in Canada (pooled n = 94 887 participants). Differences in health between socioeconomic groups (based on material deprivation) and between genders were assessed using slope and relative indices of inequality in six health domains: daily physical activity, excess body weight, frequent physical symptoms, frequent psychological symptoms, low life satisfaction, and fair or poor self-rated health. Over a 16-year period, adolescents in Canada reported progressively worse health in four health domains, with those at the lowest socioeconomic position showing the steepest declines. Socioeconomic differences increased in excess body weight, physical symptoms, low life satisfaction, and fair or poor health. Gender differences also increased. Females showed poorer health than males in all domains except excess body weight, and gender differences increased over time in physical symptoms, psychological symptoms and low life satisfaction. Socioeconomic and gender inequalities in health are persistent and widening among adolescents in Canada. Policies that address material and social factors that contribute to health disparities in adolescence are warranted.

Global Capitalism, Racism, and Social Triage during COVID-19

The theory of global capitalism offers useful tools for understanding the socio-structural determinations that result in enduring global health inequities. The theory’s conceptual framework highlights the role of transnational corporations, financialization, consumerism, transnational social classes, and the transnational state in affecting the production and distribution of economic resources, spread of cultural ideologies, and exercise of political power. To understand the health consequences and economic disruptions caused by the COVID-19 pandemic, the theory of global capitalism offers a holistic approach for understanding the current geopolitical order as well as its inherently contested nature. However, the approach often elides questions of race and gender while privileging class analysis. To understand the intersectionality in the reproduction of capitalist globalization, the concept of social triage offers an organizational level of analysis to interrogate how bureaucratic decision-making leads to racial and gender health inequalities at the global and national levels. The examples of essential workers, immigration detention, and disparate access to medical technologies reveal the necropolitical reality of an anti-Black pandemic, contributing to current debates about racial capitalism.

Biomedical Science’s Embodiments in Contemporary Laos. Informal Caregivers and Children Living with HIV

Who provides informal care? What help informal caregivers do provide it and at what costs? This contribution examines the Biomedical Science’s Embodiments in Contemporary Laos in looking at the materiality of its technologies in the everyday and the ordinary. We aim to tackle this issue in approaching the daily lives of children living with HIV from the point of view of the people who are taking care of them, the so-called informal caregivers. The paper highlights the constraints created by caregiving responsibilities, and the emerging issues related to HIV disclosure, stigma and discrimination and conflicting feelings. The informal caregivers’ narratives underline how families, institutions and local, national and transnational institutions are assigning care work. Informal care offers a lens to explore the social and gender health inequalities, both interrelated with, and too often disregard by the biomedical science.

Solving gender gaps in health, what else is missing?

In recent years, a great deal of attention has been paid to gender inequities in health. However, while we have a good body of evidence on the impact of gender on the health and vulnerability of women and men, we have not yet been able to generate sufficient evidence on effective interventions that can transform this situation or can influence public health policy making. Only a limited number of educational interventions on gender-sensitivity, gender bias in clinical practice and policies to tackle gender inequalities in health have been formulated, implemented and evaluated. Even in the current pandemic situation caused by SARS-CoV2, we have seen the lack of gender mainstreaming reflected in the global response. This happens even when we have tools that facilitate the formulation and implementation of actions to reduce gender inequities in health. We consider that the current initiatives organized to carry out advocacy activities on gender inequity in health to be very positive. In the same line of these initiatives, we propose that while academic and institutional research on gender and health remains essential, we need to shift the focus towards action. In order to move forward, we need public health researchers questioning what public health practice need to do to address gender inequities and shake structural and social power inequities in order to increase the gender equity in health.