At a Glance
Gender Differences in Health and Mortality: Comparative Approach
Anna Oksuzyan, Mine Kühn, Peng Li; in Collaboration with Domantas Jasilionis (MPIDR), Prashant Kumar Singh (National Institute of Cancer Prevention & Research, Uttar Pradesh, India), Tobias Vogt (University of Groningen, Netherlands)
International comparative studies allow researchers to assess how similar the directions and magnitudes of health inequalities are across various outcomes, life-course stages, and nations, and to suggest explanations for these differences. Most cross-national studies of gender differences in health have been based on surveys in high-income nations. We extended research to include low- and middle-income countries. Having analyzed the WHO Study on Global AGEing and Adult Health (SAGE), our results have revealed that the female disadvantage in general self-reported, physical, and cognitive health at older ages was apparent in the two most populous countries in the world, India and China, and that the gender inequalities in cognition were greater in rural than in urban subsamples. Selected major socioeconomic characteristics and risk factors accounted for only very small shares of the gender differences in self-rated health and grip strength, but education contributed substantially to the gender gaps in cognition. In our follow-up study, we have shown that the largest reduction in the gender gap in cognition was observed when adjusting for education, followed by other individual sociodemographic and health characteristics. Although state-level urbanization and the female workforce-participation rate were signiﬁcantly associated with cognition, these characteristics did not contribute to the reduction in gender difference in this health measure. Our follow-up study suggests that individual-level characteristics remain key determinants of gender difference in cognition among older adults in India. Importantly, this relationship holds in the context of very large cross-state variations in cognitive health and its determinants. It is likely that women in India and in China will make more gains in cognitive performance levels than men as educational opportunities and living conditions improve.
Another project study focused on gender differences in health in Latin American countries, i.e., Cuba, the vanguard of longevity in the Latin American and Caribbean regions, and Mexico, one of the leading economies in Latin America with still high prevalences of infectious and parasitic diseases. Our findings have demonstrated that the female disadvantage in health was most pronounced in Havana. Despite having higher overall life expectancy and more equitable and universal access to primary care and preventive medicine, women in Havana appear to have a larger burden of ill-health than their counterparts in less equitable societies. Our study provides indirect evidence that Cuba faces challenges in combating the health threats posed by chronic conditions common at older ages.
We also extended cross-national comparative studies of gender differences in health to include the measures of well-being. Our analyses of the German Socio-Economic Panel have revealed that the initial male advantage in health in eastern and western Germany in the years immediately following reuniﬁcation diminished over time and even reversed to become a female advantage in eastern Germany. Possibly, stress-inducing post-reuniﬁcation changes in the political and social landscape of eastern Germany, i.e., high levels of economic insecurity due to unemployment and increasing risky health behaviors, had lasting damaging consequences for the health of men. It is also possible that women have better compensatory mechanisms than men in dealing with psychosocial stress.
Aging, Mortality and Longevity, Data and Surveys, Health Care, Public Health, Medicine, and Epidemiology, Life Course
China, Cuba, Denmark, Germany, Germany/FRG, Germany/GDR, India, Japan, Mexico, Russian Federation, United Kingdom, USA
European Journal of Ageing, 1–10. (2020)
MPIDR Working Paper WP-2020-026. (2020)
International Journal of Epidemiology 49:2, 486–496. (2020)
SSM-Population Health 7:100326, 1–10. (2019)
International Journal of Public Health 64:3, 377–386. (2019)
The Gerontologist 58:6, 1156–1165. (2018)
SSM-Population Health 5, 180–187. (2018)
European Journal of Public Health 28:5, 847–852. (2018)
PLoS One 12:9, e0182684–e0182684. (2017)
European Journal of Epidemiology 29:4, 243–252. (2014)
Annals of Epidemiology 23:4, 161–166. (2013)
Geriatrics & Gerontology International 12:3, 431–439. (2012)
European Journal of Epidemiology 25:7, 471–480. (2010)