TY - JOUR
T1 - Social determinants of self-reported health in women and men
T2 - Understanding the role of gender in population health
AU - Hosseinpoor, Ahmad Reza
AU - Stewart Williams, Jennifer
AU - Amin, Avni
AU - Araujo de Carvalho, Islene
AU - Beard, John
AU - Boerma, Ties
AU - Kowal, Paul
AU - Naidoo, Nirmala
AU - Chatterji, Somnath
PY - 2012/4/13
Y1 - 2012/4/13
N2 - Background: Women and men share similar health challenges yet women report poorer health. The study investigates the social determinants of self-reported health in women and men, and male-female differences in health. Methods: Data on 103154 men and 125728 women were analysed from 57 countries in the World Health Survey 2002-2004. Item Response Theory was used to construct a composite measure of health. Associations between health and determinants were assessed using multivariate linear regression. Blinder-Oaxaca decomposition partitioned the inequality in health between women and men into an "explained" component that arises because men and women differ in social and economic characteristics, and an "unexplained" component due to the differential effects of these characteristics. Decomposition was repeated for 18 countries in the World Health Organization (WHO) African region and 19 countries in the WHO European region. Results: Women's health was significantly lower than men's. Health was associated with education, household economic status, employment, and marital status after controlling for age. In the pooled analysis decomposition showed that 30% of the inequality was "explained", of which almost 75% came from employment, education, marital status. The differential effects of being in paid employment increased the inequality. When countries in Africa and Europe were compared, the "explained" component (31% and 39% respectively) was largely attributed to the social determinants in the African countries and to women's longevity in the European countries. Being in paid employment had a greater positive effect on the health of males in both regions. Conclusions: Ways in which age and the social determinants contribute to the poorer health status of women compared with men varies between groups of countries. This study highlights the need for action to address social structures, institutional discrimination and harmful gender norms and roles that differently influence health with ageing.
AB - Background: Women and men share similar health challenges yet women report poorer health. The study investigates the social determinants of self-reported health in women and men, and male-female differences in health. Methods: Data on 103154 men and 125728 women were analysed from 57 countries in the World Health Survey 2002-2004. Item Response Theory was used to construct a composite measure of health. Associations between health and determinants were assessed using multivariate linear regression. Blinder-Oaxaca decomposition partitioned the inequality in health between women and men into an "explained" component that arises because men and women differ in social and economic characteristics, and an "unexplained" component due to the differential effects of these characteristics. Decomposition was repeated for 18 countries in the World Health Organization (WHO) African region and 19 countries in the WHO European region. Results: Women's health was significantly lower than men's. Health was associated with education, household economic status, employment, and marital status after controlling for age. In the pooled analysis decomposition showed that 30% of the inequality was "explained", of which almost 75% came from employment, education, marital status. The differential effects of being in paid employment increased the inequality. When countries in Africa and Europe were compared, the "explained" component (31% and 39% respectively) was largely attributed to the social determinants in the African countries and to women's longevity in the European countries. Being in paid employment had a greater positive effect on the health of males in both regions. Conclusions: Ways in which age and the social determinants contribute to the poorer health status of women compared with men varies between groups of countries. This study highlights the need for action to address social structures, institutional discrimination and harmful gender norms and roles that differently influence health with ageing.
UR - http://www.scopus.com/inward/record.url?scp=84859729460&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0034799
DO - 10.1371/journal.pone.0034799
M3 - Article
SN - 1932-6203
VL - 7
JO - PLoS ONE
JF - PLoS ONE
IS - 4
M1 - e34799
ER -