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Health and the elusive gender equality: Can the impact of gender equality on health be measured?
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: All over the world men and women show different health patterns, and therecan be many and various reasons for these differences. This thesis therefore evaluates theimpact of gender equality on health. To do this, we must be able to measure gender equality.In this thesis, we develop two new measurements of gender equality and evaluate the relationshipbetween gender equality and health.

Methods: Two cross-sectional studies, one register-based and one survey study, are used tocompare different measurements of gender equality and different measurements of health,and the relationship between them. Differences between men and women in relation to healthoutcome are also discussed in the thesis. The register study, comprising 1 097 202 individuals,is based on public registers and includes information on workplace, income, sickness absence,full-time/part-time work, level of education, parental leave and temporary parental leave.A gender equality measurement, the Organizational Gender Gap Index or OGGI, was constructedand 123 companies in two sectors were ranked using the index. Employees in 21 of the mostand least gender-equal companies were invited to participate in a survey. A second genderequality index was constructed based on respondents’ own reports regarding gender equalityin their partner relationship. The variables measured were income, full-time/part-time work,educational level, and responsibilities for and sharing of household duties and parental leave.Both indices were evaluated using the single question: How gender equal is your workplace/your relationship with your partner? The four measurements were dichotomized and testedfor a relationship to health. Health was measured by three different measurements: registerbasedsickness absence, self-reported sickness absence in the past year, and self-rated health.

Results: The thesis has produced two new measurements of gender equality, described above.On gender equality in the partner relationship, we found a difference between men and women.Men perceive higher gender equality than they report, while women report more gender equalitythan they perceive. When it comes to gender equality at work, we found that employees perceivetheir company to be more gender equal than the OGGI index shows. This thesis confirms thefindings that men have better health than women regardless of measurement. However, inthis study we also found that increased gender equality decreases these differences. If employeesperceive their company to be gender equal, they have higher odds of rating their health asgood, and this is especially so for women.

Conclusion: This thesis supports the hypothesis that differences in health between men andwomen can be related to a lack of gender equality. When men and women have differentpossibilities and power to shape society and their own lives, their health will be affected throughembodiment of both biological and sociological determinants in accordance with the eco-socialtheory. Increased gender equality will decrease the differences in health between men andwomen through convergence. The theory of convergence explains why men and women areaffected differently by greater gender equality. Greater gender equality will also decrease thesocial injustice between men and women and improve justice in accordance with the theoryof justice to gender.The differences found between the indices and the single question on perceived genderequality make clear the need for “hard facts” as an complement to people’s own views on gender equality.

Place, publisher, year, edition, pages
Umeå: Umeå universitet , 2011. , 110 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1420
Keyword [en]
gender equality, health, gender gap, index, organizations, companies, couple relations
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
URN: urn:nbn:se:umu:diva-46298ISBN: 978-91-7459-206-1 (print)OAI: oai:DiVA.org:umu-46298DiVA: diva2:437750
Public defence
2011-09-23, Aulan, Vårdvetarhuset, Umeå universitet, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-09-02 Created: 2011-08-30 Last updated: 2015-04-29Bibliographically approved
List of papers
1. Measuring the gender gap in organizations
Open this publication in new window or tab >>Measuring the gender gap in organizations
Show others...
2011 (English)In: Gender in Management, ISSN 1754-2413, E-ISSN 1754-2421, Vol. 26, no 4, 275-288 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Bingley: Emerald, 2011
Keyword
Business, Equality, Gender, Organizations, Policy, Sweden
Identifiers
urn:nbn:se:umu:diva-46201 (URN)10.1108/17542411111144292 (DOI)
Available from: 2011-08-29 Created: 2011-08-29 Last updated: 2017-12-08Bibliographically approved
2. Sickness absence in gender-equal companies: a register study at organizational level
Open this publication in new window or tab >>Sickness absence in gender-equal companies: a register study at organizational level
2011 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, 548- p.Article in journal (Refereed) Published
Abstract [en]

Background: The differences in sickness absence between men and women in Sweden have attracted a great deal of interest nationally in the media and among policymakers over a long period. The fact that women have much higher levels of sickness absence has been explained in various ways. These explanations are contextual and one of the theories points to the lack of gender equality as an explanation. In this study, we evaluate the impact of gender equality on health at organizational level. Gender equality is measured by an index ranking companies at organizational level; health is measured as days on sickness benefit.

Methods: Gender equality was measured using the Organizational Gender Gap Index or OGGI, which is constructed on the basis of six variables accessible in Swedish official registers. Each variable corresponds to a key word illustrating the interim objectives of the "National Plan for Gender Equality", implemented by the Swedish Parliament in 2006. Health is measured by a variable, days on sickness benefit, also accessible in the same registers.

Result: We found significant associations between company gender equality and days on sickness benefit. In gender-equal companies, the risk for days on sickness benefit was 1.7 (95% CI 1.6-1.8) higher than in gender-unequal companies. The differences were greater for men than for women: OR 1.8 (95% CI 1.7-2.0) compared to OR 1.4 (95% CI 1.3-1.5).

Conclusions: Even though employees at gender-equal companies had more days on sickness benefit, the differences between men and women in this measure were smaller in gender-equal companies. Gender equality appears to alter health patterns, converging the differences between men and women.

Place, publisher, year, edition, pages
BioMed Central, 2011
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-46202 (URN)10.1186/1471-2458-11-548 (DOI)000293897700001 ()21745375 (PubMedID)
Note

Funding: Umeå Centre for Global Health, Umeå University, and the Umeå Centre for Gender Studies, Umeå University.

Available from: 2011-08-29 Created: 2011-08-29 Last updated: 2017-12-08Bibliographically approved
3. Can the impact of gender equality on health be measured? a cross-sectional study comparing measures based on register data with individual survey-based data
Open this publication in new window or tab >>Can the impact of gender equality on health be measured? a cross-sectional study comparing measures based on register data with individual survey-based data
2012 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, no 1, 795- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The aim of this study was to investigate potential associations between gender equality at work and self-rated health. METHODS: 2861 employees in 21 companies were invited to participate in a survey. The mean response rate was 49.2%. The questionnaire contained 65 questions, mainly on gender equality and health. Two logistic regression analyses were conducted to assess associations between (i) self-rated health and a register-based company gender equality index (OGGI), and (ii) self-rated health and self-rated gender equality at work. RESULTS: Even though no association was found between the OGGI and health, women who rated their company as "completely equal" or "quite equal" had higher odds of reporting "good health" compared to women who perceived their company as "not equal" (OR = 2.8, 95% confidence interval = 1.4 -- 5.5 and OR = 2.73, 95% CI = 1.6-4.6). Although not statistically significant, we observed the same trends in men. The results were adjusted for age, highest education level, income, full or part-time employment, and type of company based on the OGGI. CONCLUSIONS: No association was found between gender equality in companies, measured by register-based index (OGGI), and health. However, perceived gender equality at work positively affected women's self-rated health but not men's. Further investigations are necessary to determine whether the results are fully credible given the contemporary health patterns and positions in the labour market of women and men or whether the results are driven by selection patterns.

Place, publisher, year, edition, pages
BioMed Central, 2012
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-59802 (URN)10.1186/1471-2458-12-795 (DOI)22985388 (PubMedID)
Note

Artikeln har vid publiceringen fått en annan titel än den hade vid publiceringen av avhandlingen. Tidigare titel: Do gender-equal workplaces contribute to good health?

Available from: 2012-09-26 Created: 2012-09-26 Last updated: 2017-12-07Bibliographically approved
4. Gender equality in couples and self-rated health: a survey study evaluating measurements of gender equality and its impact on health
Open this publication in new window or tab >>Gender equality in couples and self-rated health: a survey study evaluating measurements of gender equality and its impact on health
2011 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 10, no Art.nr. 37Article in journal (Refereed) Published
Abstract [en]

Background: Men and women have different patterns of health. These differences between the sexes present a challenge to the field of public health. The question why women experience more health problems than men despite their longevity has been discussed extensively, with both social and biological theories being offered as plausible explanations. In this article, we focus on how gender equality in a partnership might be associated with the respondents' perceptions of health.

Methods: This study was a cross-sectional survey with 1400 respondents. We measured gender equality using two different measures: 1) a self-reported gender equality index, and 2) a self-perceived gender equality question. The aim of comparison of the self-reported gender equality index with the self-perceived gender equality question was to reveal possible disagreements between the normative discourse on gender equality and daily practice in couple relationships. We then evaluated the association with health, measured as self-rated health (SRH). With SRH dichotomized into 'good' and 'poor', logistic regression was used to assess factors associated with the outcome. For the comparison between the self-reported gender equality index and self-perceived gender equality, kappa statistics were used.

Results: Associations between gender equality and health found in this study vary with the type of gender equality measurement. Overall, we found little agreement between the self-reported gender equality index and self-perceived gender equality. Further, the patterns of agreement between self-perceived and self-reported gender equality were quite different for men and women: men perceived greater gender equality than they reported in the index, while women perceived less gender equality than they reported. The associations to health were depending on gender equality measurement used.

Conclusions: Men and women perceive and report gender equality differently. This means that it is necessary not only to be conscious of the methods and measurements used to quantify men's and women's opinions of gender equality, but also to be aware of the implications for health outcomes.

Place, publisher, year, edition, pages
BioMed Central, 2011
Keyword
gender equality, health, index, gender differences
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-46204 (URN)10.1186/1475-9276-10-37 (DOI)000294596100001 ()21871087 (PubMedID)
Available from: 2011-08-29 Created: 2011-08-29 Last updated: 2017-12-08Bibliographically approved

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