Who benefits from social investment? The gendered effects of family and employment policies on cardiovascular disease in Europe

Morris, Katherine; Beckfield, Jason; Bambra, Clare

doi:10.1136/jech-2018-211283

Cited by 13 publications

(16 citation statements)

References 48 publications

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“…Where this was assessed, primary studies were commonly found to have a high risk of bias. Further, the small size of the evidence base and the lack of reviews of family policies is another limitation in terms of drawing strong conclusions [43]. All studies measured health inequalities in terms of the health of the most vulnerable (rather than on the social gradient in health [40]).…”

Section: Discussionmentioning

confidence: 99%

The effects of social protection policies on health inequalities: Evidence from systematic reviews

Hillier-Brown

Thomson

McGowan

et al. 2019

Scand J Public Health

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Background: The welfare state distributes financial resources to its citizens – protecting them in times of adversity. Variations in how such social protection policies are administered have been attributed to important differences in population health. The aim of this systematic review of reviews is to update and appraise the evidence base of the effects of social protection policies on health inequalities. Methods/design: Systematic review methodology was used. Nine databases were searched from 2007 to 2017 for reviews of social policy interventions in high-income countries. Quality was assessed using the Assessment of Multiple Systematic Reviews 2 tool. Results: Six systematic reviews were included in our review, reporting 50 unique primary studies. Two reviews explored income maintenance and poverty relief policies and found some, low quality, evidence that increased unemployment benefit generosity may improve population mental health. Four reviews explored active labour-market policies and found some, low-quality evidence, that return to work initiatives may lead to short-term health improvements, but that in the longer term, they can lead to declines in mental health. The more rigorously conducted reviews found no significant health effects of any of social protection policy under investigation. No reviews of family policies were located. Conclusions: The systematic review evidence base of the effects of social protection policy interventions remains sparse, of low quality, of limited generalizability (as the evidence base is concentrated in the Anglo-Saxon welfare state type), and relatively inconclusive. There is a clear need for evaluations in more diverse welfare state settings and particularly of family policies.

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Section: Discussionmentioning

confidence: 99%

The effects of social protection policies on health inequalities: Evidence from systematic reviews

Hillier-Brown

Thomson

McGowan

et al. 2019

Scand J Public Health

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“…These are in part implemented to reduce the gendered burden of family care-work and strengthen gender equity [ 28 ]. However, research suggests that the impacts of these social investment policies on gender inequalities in health are mixed [ 29 , 30 ]. In terms of mortality, public childcare provision is associated with lower cardiovascular disease mortality rates for both men and women equally, whilst government spending on paid parental leave and employment training decreases cardiovascular disease mortality for women [ 29 ].…”

Section: The Gender Health Paradoxmentioning

confidence: 99%

“…However, research suggests that the impacts of these social investment policies on gender inequalities in health are mixed [ 29 , 30 ]. In terms of mortality, public childcare provision is associated with lower cardiovascular disease mortality rates for both men and women equally, whilst government spending on paid parental leave and employment training decreases cardiovascular disease mortality for women [ 29 ]. In terms of morbidity, women’s health benefits more than men’s, from social investment policies with government investments in childcare, active labour market programmes and long-term care reducing disability levels.…”

Section: The Gender Health Paradoxmentioning

confidence: 99%

COVID-19 and the gender health paradox

Bambra

Albani

Franklin

2020

Scand J Public Health

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This article examines gender-based health inequalities arising from the COVID-19 pandemic by drawing on insights from research into the ‘gender health paradox’. Decades of international research shows that, across Europe, men have shorter life expectancies and higher mortality rates than women, and yet, women report higher morbidity. These gender-based health inequalities also appear to be evident within the pandemic and its aftermath. The article starts by providing an overview of the ‘gender health paradox’ and the biological, social, economic and political explanations for it. It then outlines the international estimates of gender-based inequalities in COVID-19 morbidity and mortality rates – where emerging data suggests that women are more likely to be diagnosed with COVID-19 but that men have a higher mortality rate. It then explores the longer term consequences for gender-based health inequalities of the aftermath of the COVID-19 pandemic, focusing on the impacts of government policy responses and the emerging economic crisis, suggesting that this might lead to increased mortality amongst men and increased morbidity amongst women. The essay concludes by reflecting on the pathways shaping gender-based health inequalities in the COVID-19 pandemic and the responses needed to ensure that it does not exacerbate gender-based health inequalities into the future.

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“…In this sense, the scientific literature has shown that the health of both men and women is not only different, but can also be inequitable, and the result of modifiable social factors such as social policies or distribution of resources and is therefore unfair. [22][23][24] For example, the increasing participation of women in paid work and public life has led, for many reasons, to better health outcomes for women themselves and their children, including greater access and control over economic resources. [25][26][27] Policies that promote greater gender equality, therefore, have the potential to modify the gender gap in LE.…”

Section: Introductionmentioning

confidence: 99%

Gender Equality and the Global Gender Gap in Life Expectancy: An Exploratory Analysis of 152 Countries

Mateos

Fernández-Sáez

Marcos-Marcos

et al. 2020

Int J Health Policy Manag

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When looking at life expectancy (LE) by sex, women live longer than men in all countries. Biological factors alone do not explain gender differences in LE, and examining structural differences may help illuminate other explanatory factors. The aim of this research is to analyse the influence of gender inequality on the gender gap in LE globally. We have carried out a regression analysis between the gender gap in relativised LE and the UN Gender Inequality Index (GII), with a sensitivity analysis conducted for its three dimensions, stratified by the six World Health Organization (WHO) regions. We adjusted the model by taking into consideration gross national income (GNI), democratic status and rural population. The results indicated a positive association for the European region (ß=0.184) and the Americas (ß=0.136) in our adjusted model. Conversely, for the African region, the relations between gender equality and the LE gender gap were found to be negative (ß=-0.125). The findings suggest that in the WHO European region and the Americas, greater gender equality leads to a narrowing of the gender LE gap, while it has a contrary relationship in Africa. We suggest that this could be because only higher scores in the GII between men and women show health benefits.

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Who benefits from social investment? The gendered effects of family and employment policies on cardiovascular disease in Europe

Cited by 13 publications

References 48 publications

The effects of social protection policies on health inequalities: Evidence from systematic reviews

The effects of social protection policies on health inequalities: Evidence from systematic reviews

COVID-19 and the gender health paradox

Gender Equality and the Global Gender Gap in Life Expectancy: An Exploratory Analysis of 152 Countries

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