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Gender inequalities in health: exploring the contribution of living conditions in the intersection of social class.

Malmusi D, Vives A, Benach J, Borrell C - Glob Health Action (2014)

Bottom Line: Gender inequalities in individual income appear to contribute largely to women's poorer health.Individual income may indicate the availability of economic resources, but also the history of access to the labour market and potentially the degree of independence and power within the household.Policies to facilitate women's labour market participation, to close the gender pay gap, or to raise non-contributory pensions may be helpful to improve women's health.

View Article: PubMed Central - PubMed

Affiliation: Centre for Biomedical Network Research on Epidemiology and Public Health (CIBERESP), Spain; Agència de Salut Pública de Barcelona, IIB-Sant Pau, Barcelona, Spain; Unitat Docent de Medicina Preventiva i Salut Pública PSMAR-UPF-ASPB, Barcelona, Spain; dmalmusi@aspb.cat.

ABSTRACT

Background: Women experience poorer health than men despite their longer life expectancy, due to a higher prevalence of non-fatal chronic illnesses. This paper aims to explore whether the unequal gender distribution of roles and resources can account for inequalities in general self-rated health (SRH) by gender, across social classes, in a Southern European population.

Methods: Cross-sectional study of residents in Catalonia aged 25-64, using data from the 2006 population living conditions survey (n=5,817). Poisson regression models were used to calculate the fair/poor SRH prevalence ratio (PR) by gender and to estimate the contribution of variables assessing several dimensions of living conditions as the reduction in the PR after their inclusion in the model. Analyses were stratified by social class (non-manual and manual).

Results: SRH was poorer for women among both non-manual (PR 1.39, 95% CI 1.09-1.76) and manual social classes (PR 1.36, 95% CI 1.20-1.56). Adjustment for individual income alone eliminated the association between sex and SRH, especially among manual classes (PR 1.01, 95% CI 0.85-1.19; among non-manual 1.19, 0.92-1.54). The association was also reduced when adjusting by employment conditions among manual classes, and household material and economic situation, time in household chores and residential environment among non-manual classes.

Discussion: Gender inequalities in individual income appear to contribute largely to women's poorer health. Individual income may indicate the availability of economic resources, but also the history of access to the labour market and potentially the degree of independence and power within the household. Policies to facilitate women's labour market participation, to close the gender pay gap, or to raise non-contributory pensions may be helpful to improve women's health.

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Prevalence ratio (PR) and 95% confidence intervals of fair/poor self-rated health (SRH), women versus men, in different social classes, adding to the model groups of intermediary determinants. Population aged 25–64 residing in Catalonia.
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Figure 0001: Prevalence ratio (PR) and 95% confidence intervals of fair/poor self-rated health (SRH), women versus men, in different social classes, adding to the model groups of intermediary determinants. Population aged 25–64 residing in Catalonia.

Mentions: Then, to estimate the contribution of intermediary factors, we first calculated age-adjusted PRs of fair/poor SRH by gender (within each of the two social class groups). Each intermediary factor was added separately into this baseline model: its individual contribution was estimated as the percentage change in the regression coefficient of gender between the baseline (PRmodel 1) and adjusted model (PRmodel 2), using the formula (PRmodel 1 − PRmodel 2)/(PRmodel 1 − 1). Finally, the preceding analysis was repeated but factors were added sequentially to the model, following a semi-causal sequence (see Fig. 1).


Gender inequalities in health: exploring the contribution of living conditions in the intersection of social class.

Malmusi D, Vives A, Benach J, Borrell C - Glob Health Action (2014)

Prevalence ratio (PR) and 95% confidence intervals of fair/poor self-rated health (SRH), women versus men, in different social classes, adding to the model groups of intermediary determinants. Population aged 25–64 residing in Catalonia.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927744&req=5

Figure 0001: Prevalence ratio (PR) and 95% confidence intervals of fair/poor self-rated health (SRH), women versus men, in different social classes, adding to the model groups of intermediary determinants. Population aged 25–64 residing in Catalonia.
Mentions: Then, to estimate the contribution of intermediary factors, we first calculated age-adjusted PRs of fair/poor SRH by gender (within each of the two social class groups). Each intermediary factor was added separately into this baseline model: its individual contribution was estimated as the percentage change in the regression coefficient of gender between the baseline (PRmodel 1) and adjusted model (PRmodel 2), using the formula (PRmodel 1 − PRmodel 2)/(PRmodel 1 − 1). Finally, the preceding analysis was repeated but factors were added sequentially to the model, following a semi-causal sequence (see Fig. 1).

Bottom Line: Gender inequalities in individual income appear to contribute largely to women's poorer health.Individual income may indicate the availability of economic resources, but also the history of access to the labour market and potentially the degree of independence and power within the household.Policies to facilitate women's labour market participation, to close the gender pay gap, or to raise non-contributory pensions may be helpful to improve women's health.

View Article: PubMed Central - PubMed

Affiliation: Centre for Biomedical Network Research on Epidemiology and Public Health (CIBERESP), Spain; Agència de Salut Pública de Barcelona, IIB-Sant Pau, Barcelona, Spain; Unitat Docent de Medicina Preventiva i Salut Pública PSMAR-UPF-ASPB, Barcelona, Spain; dmalmusi@aspb.cat.

ABSTRACT

Background: Women experience poorer health than men despite their longer life expectancy, due to a higher prevalence of non-fatal chronic illnesses. This paper aims to explore whether the unequal gender distribution of roles and resources can account for inequalities in general self-rated health (SRH) by gender, across social classes, in a Southern European population.

Methods: Cross-sectional study of residents in Catalonia aged 25-64, using data from the 2006 population living conditions survey (n=5,817). Poisson regression models were used to calculate the fair/poor SRH prevalence ratio (PR) by gender and to estimate the contribution of variables assessing several dimensions of living conditions as the reduction in the PR after their inclusion in the model. Analyses were stratified by social class (non-manual and manual).

Results: SRH was poorer for women among both non-manual (PR 1.39, 95% CI 1.09-1.76) and manual social classes (PR 1.36, 95% CI 1.20-1.56). Adjustment for individual income alone eliminated the association between sex and SRH, especially among manual classes (PR 1.01, 95% CI 0.85-1.19; among non-manual 1.19, 0.92-1.54). The association was also reduced when adjusting by employment conditions among manual classes, and household material and economic situation, time in household chores and residential environment among non-manual classes.

Discussion: Gender inequalities in individual income appear to contribute largely to women's poorer health. Individual income may indicate the availability of economic resources, but also the history of access to the labour market and potentially the degree of independence and power within the household. Policies to facilitate women's labour market participation, to close the gender pay gap, or to raise non-contributory pensions may be helpful to improve women's health.

Show MeSH
Related in: MedlinePlus