The gender health gap in Europe’s ageing societies: universal findings across countries and age groups?

Schmitz, Alina; Lazarevič, Patrick

doi:10.1007/s10433-020-00559-6

Cited by 26 publications

(18 citation statements)

References 47 publications

(59 reference statements)

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“…Gender-based health inequality in older age has been reported in studies in European countries and the USA. Although the level of inequality differs from one country to another, women on average display a worse health status than men (Schmitz and Lazarevič 2020 ). Our study confirms such a gender difference: Chinese older women are significantly less likely than men to achieve healthy ageing.…”

Section: Discussionmentioning

confidence: 99%

Childhood adversity and healthy ageing: a study of the Chinese older population

2021

Eur J Ageing

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This study examines the relationship between childhood adversities and healthy ageing in the Chinese older population. The data come from the China Health and Retirement Longitudinal Survey (CHARLS), a national survey that collected life history and ageing-related information on 9248 older people aged over 60 in 2014 and 2015. The analysis of healthy ageing focuses on seven indicators: IADL limitations, ADL limitations, cognitive functioning, depressive symptoms, life satisfaction, self-reported health, and chronic illness. Using k-means clustering, an unsupervised learning technique, we identified four qualitatively different groups according to their achievement in healthy ageing. We studied 17 types of childhood adversities and found that experiencing multiple childhood adversities is associated with a lower probability of achieving healthy ageing. This relationship is moderated by age and gender. Women are more vulnerable than men to the negative impacts of childhood adversities. The threat of childhood adversities to healthy ageing is greatly attenuated among people aged over 80. We argue that the policy response to healthy ageing should not be confined to those services and programmes that directly target older people. Instead, healthy ageing can be better addressed by concerted efforts in different areas of social policy.

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Section: Discussionmentioning

confidence: 99%

Childhood adversity and healthy ageing: a study of the Chinese older population

2021

Eur J Ageing

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“…Previous literature also reports conflicting associations between sex and the clinical severity of OA ( 42 ). Data from the European SHARE cohort reveal that women have overall disadvantages in terms of activity limitations, pain, depression, and self-reported health status compared with men ( 43 ). On the other hand, a systematic review by Bastick et al found strong evidence that sex is not associated with radiographic severity ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Clinical and Radiographic Severity in People With Osteoarthritis: A Cross-Sectional Population-Based Study

et al. 2021

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Background: Hip/knee osteoarthritis (HKOA) is a leading cause of disability and imposes a major socioeconomic burden. The aim of this study is to estimate the prevalence of HKOA in Portugal, characterised the clinical severity of HKOA in the population, and identified sociodemographic, lifestyle, and clinical factors associated with higher clinical and radiographic severity.Methods: Participants with a diagnosis of HKOA from the EpiReumaPt study (2011–2013) were included (n = 1,087). Hip/knee osteoarthritis diagnosis was made through a structured evaluation by rheumatologists according to American College of Rheumatology criteria. Clinical severity was classified based on Hip Disability and Osteoarthritis Outcome Scale (HOOS) and Knee Injury and Osteoarthritis Outcome Scale (KOOS) score tertiles. Radiographic severity was classified based on the Kellgren-Lawrence grades as mild, moderate, or severe. Sociodemographic lifestyle and clinical variables, including the presence of anxiety and depression symptoms, were analysed. Factors associated with higher clinical and radiographic severity were identified using ordinal logistic regression models.Results: Hip/knee osteoarthritis diagnosis was present in 14.1% of the Portuguese population [12.4% with knee osteoarthritis (OA) and 2.9% with hip OA]. Clinical severity was similar between people with hip (HOOS = 55.79 ± 20.88) and knee (KOOS = 55.33 ± 20.641) OA. People in the high HOOS/KOOS tertile tended to be older (64.39 ± 0.70 years), female (75.2%), overweight (39.0%) or obese (45.9%), and had multimorbidity (86.1%). Factors significantly associated with higher clinical severity tertile were age [55–64 years: odds ratio (OR) = 3.18; 65–74 years: OR = 3.25; ≥75 years: OR = 4.24], female sex (OR = 1.60), multimorbidity (OR = 1.75), being overweight (OR = 2.01) or obese (OR = 2.82), and having anxiety symptoms (OR = 1.83). Years of education was inversely associated with higher clinical severity. Factors significantly associated with higher radiographic severity were age (65–74 years: OR = 3.59; ≥75 years: OR = 3.05) and being in the high HOOS/KOOS tertile (OR = 4.91). Being a female and live in Lisbon or in the Centre region were inversely associated with the higher radiographic severity.Conclusion: Hip/knee osteoarthritis is present in ~1.1 million of Portuguese people. Age, educational level, and obesity are independently associated with HKOA clinical severity, whereas age, sex, geographic location, and clinical severity are independently associated with radiographic severity.

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“…For example, Serrano-Alarcón and Perelman ( 44 ) found that women 65–79 years old in Spain, Portugal, and Italy were 3.3% more likely than men to have severe function limitations; increasing the age bracket to those age 80 or older increased this likelihood to 15.5%. A recent study spanning 16 European countries found that gender disparities in activity limitations that disfavored women were larger in southern Europe and generally increased with age; however, these trends were not universally present in every country studied ( 45 ). Moreover, a systemic review of 21 longitudinal studies conducted mostly in high-income countries failed to show a consistent gender difference in the incidence of functional disability ( 18 ).…”

Section: Discussionmentioning

confidence: 90%

Disability Incidence Rates for Men and Women in 23 Countries: Evidence on Health Effects of Gender Inequality

Lee

Meijer

Phillips

et al. 2020

The Journals of Gerontology: Series A

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Background Inequality in gender varies across social contexts, which may influence the health of both men and women. Based on theories of gender as a social system, we examine whether systematic gender inequality at the macro-level influences health of men and women. Method Using harmonized panel data from the Gateway to Global Aging Data in 23 high- and middle-income countries (N = 168 873), we estimate disability prevalence and incidence for men and women ages 55–89 (2000–2016). Within each country or geographic region, we also investigate gender differences in age gradients of the probability of disability onset. We, then, pool data from all countries and test the hypothesis that gender inequality increases the probability of disability onset. Results We found substantial cross-country variation in disability incidence rates, and this variation is greater for women than for men. Among ages 65–69, disability incidence rates ranged from 0.4 to 5.0 for men and from 0.5 to 9.4 for women. Our within-country analysis showed significant gender differences in age gradients of the probability of disability onset in the United States, Korea, Southern Europe, Mexico, and China, but not in Northern, Central, and Eastern Europe, England, and Israel. Testing hypothesized effects of gender inequality, we find that gender inequality is significantly associated with the probability of disability onset for women, but not for men. Conclusions Macro-level societal gender inequality is significantly associated with the probability of disability onset for women. Reducing and eliminating gender inequality is crucial to achieving good health for women.

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The gender health gap in Europe’s ageing societies: universal findings across countries and age groups?

Cited by 26 publications

References 47 publications

Childhood adversity and healthy ageing: a study of the Chinese older population

Childhood adversity and healthy ageing: a study of the Chinese older population

Factors Associated With Clinical and Radiographic Severity in People With Osteoarthritis: A Cross-Sectional Population-Based Study

Disability Incidence Rates for Men and Women in 23 Countries: Evidence on Health Effects of Gender Inequality

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