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      Gender equality in couples and self-rated health - A survey study evaluating measurements of gender equality and its impact on health

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          Abstract

          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.

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          Most cited references21

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          Constructions of masculinity and their influence on men's well-being: a theory of gender and health.

          Men in the United States suffer more severe chronic conditions, have higher death rates for all 15 leading causes of death, and die nearly 7 yr younger than women. Health-related beliefs and behaviours are important contributors to these differences. Men in the United States are more likely than women to adopt beliefs and behaviours that increase their risks, and are less likely to engage in behaviours that are linked with health and longevity. In an attempt to explain these differences, this paper proposes a relational theory of men's health from a social constructionist and feminist perspective. It suggests that health-related beliefs and behaviours, like other social practices that women and men engage in, are a means for demonstrating femininities and masculinities. In examining constructions of masculinity and health within a relational context, this theory proposes that health behaviours are used in daily interactions in the social structuring of gender and power. It further proposes that the social practices that undermine men's health are often signifiers of masculinity and instruments that men use in the negotiation of social power and status. This paper explores how factors such as ethnicity, economic status, educational level, sexual orientation and social context influence the kind of masculinity that men construct and contribute to differential health risks among men in the United States. It also examines how masculinity and health are constructed in relation to femininities and to institutional structures, such as the health care system. Finally, it explores how social and institutional structures help to sustain and reproduce men's health risks and the social construction of men as the stronger sex.
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            Worldwide vitamin D status.

            The aim of the present study is to summarize existing literature on vitamin D levels in adults in different continents and different countries worldwide. The best determinant of vitamin D status is the serum concentration of 25-hydroxyvitamin D (25(OH)D). Most investigators agree that serum 25(OH)D should be higher than 50 nmol/l, but some recommend higher serum levels. Traditional risk groups for vitamin D deficiency include pregnant women, children, older persons, the institutionalized, and non-western immigrants. This chapter shows that serum 25(OH)D levels are not only suboptimal in specific risk groups, but also in adults in many countries. Especially, in the Middle-East and Asia, vitamin D deficiency in adults is highly prevalent. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Self-rated health. Comparisons between three different measures. Results from a population study.

              Self-rating of health is among the most frequently assessed health perceptions in epidemiological research. The aim of this study was to compare different measures of global self-rated health (SRH) with respect to differences in age and sex groups and relations to hypothesized determinants. Three single-question measures of SRH were included in a health questionnaire administered to 8200 randomly chosen men and women. Two SRH measures were non-comparative, one with seven (SRH-7) and one with five response options (SRH-5), while the third measure included a comparison with others of the same age (SRH-age). SRH-7 had specified response options only at the ends of the scale, while the other two measures gave specified statements for each option. Comparisons between the SRH assessments were studied with respect to response frequencies, frequency distributions, age and gender differences and differences in associations with hypothesized determinants. The differences between the SRH measures were in most cases marginal. Some diversities may, however, be worth considering: a high drop-out rate for the SRH-7 measure in the oldest age group; a trend that SRH-7 correlated most strongly with the independent variables; SRH-age showed improved health ratings with increasing age but a less skewed frequency distribution compared to the non-comparative measures. The results imply that non-comparative measures are more appropriate in longitudinal studies and that measures without specified response options might be less suitable for an older study group. The overall impression is, however, that the different measures represents parallel assessments of subjective health.
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                Author and article information

                Journal
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central
                1475-9276
                2011
                26 August 2011
                : 10
                : 37
                Affiliations
                [1 ]Dept of Public Health and Clinical Medicine, Epidemiology and Global Health, Centre for Global Health Research, Umeå University SE-901 87 Umeå, Sweden
                [2 ]Umeå Centre for Gender Studies, Umeå University SE-901 87 Umeå, Sweden
                Article
                1475-9276-10-37
                10.1186/1475-9276-10-37
                3167759
                21871087
                812e1f2d-a6b9-4bc9-b894-123047db344e
                Copyright ©2011 Sörlin et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 March 2011
                : 26 August 2011
                Categories
                Research

                Health & Social care
                gender equality,health,gender differences,index
                Health & Social care
                gender equality, health, gender differences, index

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