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欧洲主观健康性别差距的跨国差异:国家层面的性别平等是否重要?

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

机构信息

Department of Sociology, Stockholm University, SE-106 91 Stockholm, Sweden.

Department of Sociology, Stockholm University, SE-106 91 Stockholm, Sweden.

出版信息

Soc Sci Med. 2013 Dec;98:24-8. doi: 10.1016/j.socscimed.2013.08.028. Epub 2013 Sep 9.

Abstract

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.

摘要

多项研究发现,尽管女性的寿命更长,但她们的健康状况却更差。性别差距在各国之间存在差异,但对于造成这种差异的原因知之甚少。现有文献对于在性别平等程度较高的社会中,健康方面的性别差距是否更小,尚无定论。我们利用来自 28 个国家的 191104 名受访者的五轮欧洲社会调查数据,分析了自我评估健康状况(SRH)和长期限制疾病(LLI)方面的性别差距。我们使用平均值、优势比、逻辑回归和多层次随机斜率逻辑回归。欧洲各地的主观健康性别差距明显。在许多国家(尤其是东欧和南欧国家),女性报告的健康状况明显较差,而在其他国家(如爱沙尼亚、芬兰和英国),男女之间的差异较小或不存在。针对每个国家分别进行的逻辑回归显示,在一些国家,个体层面的社会经济和人口统计学变量解释了这些差距的大部分,但在大多数国家,这些变量对其理解贡献甚微。在其他一些国家,在控制了这些变量后,男性的健康状况更差。在考虑了个体层面的因素后,国家间的性别差距仍然存在。出乎意料的是,在多层次分析中,剩余的差距与社会层面的性别不平等之间没有系统的关系。我们的研究结果强调了健康方面性别差距在跨国间存在持续的可变性,并呼吁进一步分析。

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