欧洲性别平等政策对健康领域性别不平等的影响。

The influence of gender equality policies on gender inequalities in health in Europe.

机构信息

CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Health Information Systems Unit, Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.

Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Belgium.

出版信息

Soc Sci Med. 2014 Sep;117:25-33. doi: 10.1016/j.socscimed.2014.07.018. Epub 2014 Jul 8.

Abstract

Few studies have addressed the effect of gender policies on women's health and gender inequalities in health. This study aims to analyse the relationship between the orientation of public gender equality policies and gender inequalities in health in European countries, and whether this relationship is mediated by gender equality at country level or by other individual social determinants of health. A multilevel cross-sectional study was performed using individual-level data extracted from the European Social Survey 2010. The study sample consisted of 23,782 men and 28,655 women from 26 European countries. The dependent variable was self-perceived health. Individual independent variables were gender, age, immigrant status, educational level, partner status and employment status. The main contextual independent variable was a modification of Korpi's typology of family policy models (Dual-earner, Traditional-Central, Traditional-Southern, Market-oriented and Contradictory). Other contextual variables were the Gender Empowerment Measure (GEM), to measure country-level gender equality, and the Gross Domestic Product (GDP). For each country and country typology the prevalence of fair/poor health by gender was calculated and prevalence ratios (PR, women compared to men) and 95% confidence intervals (CI) were computed. Multilevel robust Poisson regression models were fitted. Women had poorer self-perceived health than men in countries with traditional family policies (PR = 1.13, 95%CI: 1.07-1.21 in Traditional-Central and PR = 1.27, 95%CI: 1.19-1.35 in Traditional-Southern) and in Contradictory countries (PR = 1.08, 95%CI: 1.05-1.11). In multilevel models, only gender inequalities in Traditional-Southern countries were significantly higher than those in Dual-earner countries. Gender inequalities in self-perceived health were higher, women reporting worse self-perceived health than men, in countries with family policies that were less oriented to gender equality (especially in the Traditional-Southern country-group). This was partially explained by gender inequalities in the individual social determinants of health but not by GEM or GDP.

摘要

很少有研究探讨性别政策对妇女健康和健康方面的性别不平等的影响。本研究旨在分析欧洲国家公共性别平等政策的方向与健康方面的性别不平等之间的关系,以及这种关系是否通过国家一级的性别平等或其他个别社会健康决定因素来调解。本研究采用欧洲社会调查 2010 年提取的个人层面数据进行了多水平横断面研究。研究样本由来自 26 个欧洲国家的 23782 名男性和 28655 名女性组成。因变量是自我感知健康。个体自变量为性别、年龄、移民身份、教育程度、伴侣状况和就业状况。主要的情境自变量是 Korpi 的家庭政策模式分类(双职工、传统-中心、传统-南方、市场导向和矛盾)的修正版。其他情境变量是衡量国家一级性别平等的性别赋权措施(GEM)和国内生产总值(GDP)。计算了每种国家和国家类型中男女自我感知健康状况的公平/较差比例,并计算了患病率比(PR,女性与男性相比)和 95%置信区间(CI)。拟合了多水平稳健泊松回归模型。在传统家庭政策国家中,女性的自我感知健康状况比男性差(PR=1.13,95%CI:1.07-1.21,在传统-中心国家中;PR=1.27,95%CI:1.19-1.35,在传统-南方国家中),在矛盾国家中也是如此(PR=1.08,95%CI:1.05-1.11)。在多水平模型中,只有传统-南方国家的性别不平等显著高于双职工国家。在性别平等政策不太倾向于性别平等的国家(尤其是在传统-南方国家组),自我感知健康方面的性别不平等更高,女性报告的自我感知健康状况比男性差。这在一定程度上是由个别社会健康决定因素方面的性别不平等解释的,但 GEM 或 GDP 则不然。

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