title: Gender inequalities in health: exploring the contribution of living conditions in the intersection of social class.
abstract: BACKGROUND
  Women experience poorer health than men despite their longer life expectancy, due to a higher prevalence of non-fatal chronic illnesses. This paper aims to explore whether the unequal gender distribution of roles and resources can account for inequalities in general self-rated health (SRH) by gender, across social classes, in a Southern European population.
  
  
  METHODS
  Cross-sectional study of residents in Catalonia aged 25-64, using data from the 2006 population living conditions survey (n=5,817). Poisson regression models were used to calculate the fair/poor SRH prevalence ratio (PR) by gender and to estimate the contribution of variables assessing several dimensions of living conditions as the reduction in the PR after their inclusion in the model. Analyses were stratified by social class (non-manual and manual).
  
  
  RESULTS
  SRH was poorer for women among both non-manual (PR 1.39, 95% CI 1.09-1.76) and manual social classes (PR 1.36, 95% CI 1.20-1.56). Adjustment for individual income alone eliminated the association between sex and SRH, especially among manual classes (PR 1.01, 95% CI 0.85-1.19; among non-manual 1.19, 0.92-1.54). The association was also reduced when adjusting by employment conditions among manual classes, and household material and economic situation, time in household chores and residential environment among non-manual classes.
  
  
  CONCLUSIONS
  Gender inequalities in individual income appear to contribute largely to women's poorer health. Individual income may indicate the availability of economic resources, but also the history of access to the labour market and potentially the degree of independence and power within the household. Policies to facilitate women's labour market participation, to close the gender pay gap, or to raise non-contributory pensions may be helpful to improve women's health.
authors.affiliation: Centre for Biomedical Network Research on Epidemiology and Public Health (CIBERESP), Spain; Agència de Salut Pública de Barcelona, IIB-Sant Pau, Barcelona, Spain; Unitat Docent de Medicina Preventiva i Salut Pública PSMAR-UPF-ASPB, Barcelona, Spain; dmalmusi@aspb.cat.
authors.forename: Davide
authors.initials: D
authors.lastname: Malmusi
authors.affiliation: Health Inequalities Research Group - Employment Conditions Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain; Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Vives
authors.affiliation: Health Inequalities Research Group - Employment Conditions Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Benach
authors.affiliation: Centre for Biomedical Network Research on Epidemiology and Public Health (CIBERESP), Spain; Agència de Salut Pública de Barcelona, IIB-Sant Pau, Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
mesh_terms: D000328:Adult; D005191:Family Characteristics; D005260:Female; D006304:Health Status; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology
keywords: gender; health inequalities; intersectionality; material resources; self-rated health; social class