Background
Comparative policy studies with a health focus
Gender equality as a health determinant
The male/female mortality gap
Aims and hypotheses
Data and methods
Data
Exposures
Male breadwinner | Compensatory breadwinner | Universal citizen | Earner-carer | |
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Generous parental leaves |
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High social services |
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Separate taxation |
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High pension universality |
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High monetary support to breadwinner |
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Compensatory measures in pension system | (√) |
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Outcomes
Confounders and mediators
Methods
Base model | Model 1 | Model 2 | Model 3 | Model 4 | |
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Time trend terms
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Linear | 9.79 (2.00) | 9.76 (2.01) | 18.86 (2.73) | 18.87 (2.75) | 16.36 (3.03) |
Quadratic | −10.76 (1.08) | −10.72 (1.08) | −7.39 (1.30) | −7.38 (1.31) | −9.55 (1.39) |
Cubic | −18.81 (4.15) | −18.67 (4.15) | −14.81 (4.38) | −14.79 (4.38) | −18.19 (4.66) |
Time-varying factors
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GDP/1000 dollars | −0.32 (0.07) | −0.32 (0.07) | −0.25 (0.07) | ||
Alcohol consumption | −0.21 (0.14) | ||||
Time invariant factors
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Intercept (constant) | 59.75 (1.27) | 62.32 (1.70) | 56.41 (9.13) | 56.27 (14.52) | 58.04 (15.51) |
Universal citizen | −1.81 (3.66) | −2.25 (3.08) | −2.27 (3.27) | −2.66 (3.41) | |
Compensatory breadwinner | −2.82 (2.60) | −1.86 (2.21) | −1.87 (2.23) | −2.63 (2.35) | |
Earner-carer | −6.49 (2.45) | −3.43 (2.70) | −3.44 (2.93) | −4.20 (3.12) | |
Gini 2005 (0–10) | 3.43 (2.75) | 3.44 (2.90) | 3.19 (3.06) | ||
GEM04 (0–10) | 0.01 (1.21) | 0.06 (1.26) | |||
Random part
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Variance (constant) | 35.05 (10.62) | 31.99 (9.69) | 26.73 (8.11) | 26.72 (8.10) | 26.21 (7.95) |
Covariance (linear/constant) | −23.59 (12.39) | −28.98 (12.46) | −29.82 (11.57) | −29.80 (11.57) | −28.64 (11.81) |
Variance (linear) | 78.27 (24.17) | 78.32 (24.19) | 74.59 (23.09) | 74.59 (23.09) | 83.27 (25.75) |
Base model | Model 1 | Model 2 | Model 3 | Model 4 | |
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Time trend terms
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Linear | −1.99 (2.28) | 5.35 (2.66) | 12.79 (2.87) | 55.14 (12.18) | 48.42 (11.82) |
Quadratic | −10.59 (0.76) | −10.61 (0.76) | −7.88 (0.90) | −7.96 (0.90) | −1.77 (1.05) |
Cubic | 30.55 (2.95) | 30.60 (2.95) | 34.13 (3.06) | 33.97 (3.06) | 25.60 (3.22) |
Time-varying factors
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GDP/1000 dollars | −0.25 (0.05) | −0.25 (0.05) | −0.26 (0.05) | ||
Female smoking (%) | 0.04 (0.04) | ||||
Male smoking (%) | −0.10 (0.04) | ||||
Alcohol consumption/l | 0.05 (0.11) | ||||
Calorie intake/100 | 0.13 (0.10) | ||||
Time invariant factors
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Intercept (constant) | 64.54 (0.98) | 62.70 (1.23) | 85.03 (8.01) | 66.43 (11.89) | 73.08 (12.19) |
Universal citizen | −1.01 (2.88) | −1.33 (2.72) | −2.96 (2.66) | −3.41 (2.60) | |
Compensatory breadwinner | 1.09 (2.05) | 0.64 (1.97) | 0.16 (1.84) | −0.47 (1.80) | |
Earner-carer | 6.17 (1.94) | 3.11 (2.39) | 1.37 (2.41) | 1.80 (2.42) | |
Gini 2005 (0–10) | −5.62 (2.43) | −4.03 (2.37) | −4.45 (2.27) | ||
GEM04 (0–10) | 1.88 (0.98) | 0.93 (1.01) | |||
Change over time
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Universal citizen | −7.18 (6.19) | −8.30 (5.82) | −2.84 (4.90) | −0.05 (4.64) | |
Compensatory breadwinner | −9.04 (4.40) | −9.00 (4.13) | −6.86 (3.35) | −5.91 (3.18) | |
Earner-carer | −17.05 (4.16) | −16.42 (3.91) | −7.63 (3.98) | −7.23 (3.85) | |
GEM04 (0–10) | −6.06 (1.71) | −5.54 (1.64) | |||
Random part
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Variance (constant) | 20.83 (6.31) | 13.48 (4.09) | 12.01 (3.65) | 10.29 (3.13) | 9.58 (2.94) |
Covariance (linear/constant) | −18.50 (10.97) | −1.77 (6.19) | −3.46 (5.54) | 2.61 (4.09) | 5.20 (3.87) |
Variance (linear) | 109.15 (33.25) | 61.07 (18.64) | 53.70 (16.53) | 33.82 (10.48) | 28.69 (9.45) |
Results
Policy indicators | Model 1 | Model 2 | Model 3 | Model 4 | All earner-carer | All compensatory breadwinner |
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External cause mortality
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Maternity score (weeks*RR) | −0.09 (0.03) | −0.09 (0.03) | −0.09 (0.03) | −0.09 (0.03) | −0.04 (0.04) | |
Reserved paternity leave >=2 wks | −2.01 (0.45) | −1.77(0.45) | −1.76 (0.45) | −1.82 (0.46) | −1.58 (0.51) | |
Social services (% of GDP) | −0.95 (0.34) | −0.98 (0.35) | −0.98 (0.36) | −0.99 (0.37) | −0.81 (0.36) | |
Separate taxation | −1.98 (2.32) | −0.76 (1.89) | −1.07 (1.96) | −1.51 (2.07) | −1.01 (1.96) | |
Min pension requirement <=1 yr | −3.80 (1.23) | −3.13 (1.23) | −3.15 (1.28) | −2.97 (1.31) | −6.59 (2.53) | |
Circulatory disease mortality
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Maternity score (weeks*RR) | 0.04 (0.02) | 0.02 (0.02) | 0.03 (0.02) | 0.04 (0.03) | 0.05 (0.03) | |
Reserved paternity leave >=2 wks | 0.23 (0.35) | 0.13 (0.35) | 0.18 (0.35) | 0.27 (0.37) | 0.09 (0.40) | |
Social services (% of GDP) | 0.19 (0.25) | −0.31 (0.27) | −0.22 (0.27) | −0.04 (0.29) | −0.13 (0.29) | |
Separate taxation | −0.56 (1.87) | −2.39 (1.58) | −1.44 (1.61) | −1.84 (1.59) | −2.10 (1.55) | |
Min pension requirement <=1 yr | 1.59 (0.95) | 0.97 (0.98) | 0.79 (1.00) | 1.00 (2.07) | 1.37 (1.95) | |
Child credits >= 4 yrs/child | −1.11 (0.38) | −1.15 (0.37) | −1.10 (0.37) | −0.81 (0.38) | −0.74 (0.38) | |
Retiregap>=1 yr | −0.04 (0.53) | 0.08 (0.52) | 0.08 (0.51) | −0.29 (0.56) | −0.31 (0.60) | |
Extended leave score >= 10 | −0.29 (0.34) | −0.40 (0.33) | −0.39 (0.33) | −0.95 (0.33) | −0.90 (0.33) |
Discussion
Gender policy cluster | Mortality cause | 1973 | 1981 | 1990 | 1999 | 2003 | % change | |
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Male breadwinner
| External causes | Men | 99.06 | 89.38 | 79.05 | 65.46 | 61.51 | −37.9 |
Women | 41.30 | 35.94 | 30.45 | 24.15 | 22.92 | −44.5 | ||
Stand difference | 57.95 | 59.25 | 61.23 | 63.38 | 62.95 | +8.6 | ||
Circulatory | Men | 143.09 | 122.84 | 94.13 | 70.78 | 62.16 | −56.6 | |
disease | Women | 65.32 | 49.36 | 35.41 | 26.25 | 22.56 | −65.5 | |
Stand difference | 53.78 | 59.52 | 62.70 | 63.38 | 64.30 | +19.6 | ||
Universal citizen
| External causes | Men | 100.97 | 80.53 | 75.61 | 60.21 | 55.41 | −45.1 |
Women | 50.49 | 35.18 | 27.86 | 24.83 | 23.38 | −53.7 | ||
Stand difference | 50.04 | 56.37 | 63.05 | 58.76 | 57.93 | +15.8 | ||
Circulatory | Men | 229.41 | 169.87 | 107.46 | 66.15 | 51.62 | −77.5 | |
disease | Women | 94.40 | 65.58 | 43.74 | 26.13 | 20.26 | −78.5 | |
Stand difference | 58.83 | 61.45 | 59.80 | 60.77 | 61.07 | +3.81 | ||
Compensatory
| External causes | Men | 102.75 | 90.24 | 71.45 | 60.71 | 56.31 | −45.2 |
breadwinner
| Women | 45.78 | 39.49 | 28.84 | 24.02 | 23.07 | −49.6 | |
Stand difference | 54.18 | 55.31 | 59.57 | 60.39 | 59.00 | +8.9 | ||
Circulatory | Men | 166.74 | 144.80 | 97.50 | 71.74 | 56.51 | −66.1 | |
disease | Women | 67.04 | 52.97 | 35.37 | 27.98 | 21.18 | −68.4 | |
Stand difference | 59.12 | 63.26 | 63.76 | 61.21 | 62.65 | +5.97 | ||
Earner-carer
| External causes | Men | 103.38 | 85.68 | 81.39 | 65.65 | 61.49 | −40.5 |
Women | 45.75 | 36.03 | 32.52 | 26.36 | 25.19 | −44.9 | ||
Stand difference | 53.76 | 56.05 | 57.54 | 57.92 | 57.04 | +6.1 | ||
Circulatory | Men | 167.99 | 152.69 | 108.65 | 70.50 | 58.87 | −65.0 | |
disease | Women | 54.22 | 43.02 | 34.38 | 24.04 | 20.25 | −62.7 | |
Stand difference | 67.02 | 71.50 | 67.51 | 65.09 | 64.74 | −3.40 |