Gender-specific differences in physical and mental health across European countries: variation in levels and explanatory factors at older age

Dorly J.H. Deeg, Vrije Universiteit Amsterdam

Gender differences in health are well-established. Studies of factors explaining these differences have not done justice to the different importance such factors may have for men and women across cultures. This study focuses on gender-specific differences in health across six countries, and explanatory factors for observed inter-country differences. Data were harmonised in the framework of the Comparison of Longitudinal European Studies on Aging (CLESA) project, which included population-based studies from Finland, Sweden, the Netherlands, Spain, Italy and Israel with common agegroup of 75-84 years. Indicators of health were disability, depressed mood, and self-rated health. Potential explanatory factors included socio-demographics, diseases, lifestyle, and social engagement. The findings show inter-country differences for men and women in all three health indicators. These differences persisted after accounting for explanatory factors. Disability showed a North-South gradient, in that men and women in Northern countries showed less disability than those in Southern countries. Depressed mood showed similar country differences, although the prevalence in Finland was closer to that in Southern countries for both men and women, and in Spanish men lower than in men in other Southern countries. Self-rated health was poorer in Southern countries than in the Netherlands, with levels in Finland in-between. Among the explanatory factors, chronic morbidity showed the most consistent associations. The role of lifestyle and social factors varied across countries and genders. Lifestyle, especially exercise and walking, was most often associated with health in men, but in women, social factors were more prominent. Among these, active involvement in religion appeared to have a favourable role, whereas the role of living arrangements differed across physical and mental health indicators. Gender differences suggest that a gender-specific approach to the prevention of poor health is warranted. Cross-national differences suggest both cultural differences and country differences in the facilitation of healthy lifestyles. Acknowledgement: the CLESA-group.