Women's status and the health of women and men: a view from the States
Women's status and the health of women and men: a view from the States
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DOI：
10.1016/s0277-9536(98)00286-x
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发表时间：
1999-01-01
影响因子：
5.4
通讯作者：
Prothrow-Stith, D
中科院分区：
文献类型：
--
作者：
Kawachi, I;Kennedy, BP;Prothrow-Stith, D
我们研究了美国50个州的妇女地位与妇女和男子健康水平的关系。每个州的妇女地位是通过衡量妇女政治参与、经济自主、就业和收入以及生殖权利的四个综合指数来评估的。研究设计是横断面和生态学的。我们的主要结果指标是女性和男性的总死亡率，女性特定原因死亡率和女性在上个月报告的活动受限的平均天数。在州一级，妇女地位的衡量标准与这些健康结果中的每一个都有着惊人的相关性。妇女参政程度高与女性死亡率低（r = -0.51）以及活动限制低（-0.47）相关。男女之间较小的工资差距与较低的女性死亡率（-0.30）和较低的活动限制（-0.31）相关（所有相关性，P < 0.05）。妇女地位指数也与男性死亡率密切相关，这表明妇女地位可能反映了与物质匮乏和收入不平等有关的更普遍的基本结构进程。然而，在对收入不平等、贫困率和家庭收入中位数进行调整后，妇女地位指数仍然能够预测妇女死亡率和发病率。观察到与具体死亡原因的关联，包括中风、宫颈癌和杀人。我们的结论是，妇女经历较高的死亡率和发病率的国家，他们有较低水平的政治参与和经济自主。生活在这种状态下也会对男性的健康产生不利影响。两性不平等和妇女的机会被剥夺可能是收入分配不均对妇女健康产生不利影响的途径之一。(C)1998爱思唯尔科技有限公司版权所有。
We examined the status of women in the 50 American states in relation to women's and men's levels of health. The status of women in each state was assessed by four composite indices measuring women's political participation, economic autonomy, employment and earnings, and reproductive rights. The study design was cross-sectional and ecologic. Our main outcome measures were total female and male mortality rates, female cause-specific death rates and mean days of activity limitations reported by women during the previous month. Measures of women's status were strikingly correlated with each of these health outcomes at the state level. Higher political participation by women was correlated with lower female mortality rates (r = -0.51), as well as lower activity limitations (-0.47). A smaller wage gap between women and men was associated with lower female mortality rates (-0.30) and lower activity limitations (-0.31) (all correlations, P < 0.05). Indices of women's status were also strongly correlated with male mortality rates, suggesting that women's status may reflect more general underlying structural processes associated with material deprivation and income inequality. However, the indices of women's status persisted in predicting female mortality and morbidity rates after adjusting for income inequality, poverty rates and median household income. Associations were observed for specific causes of death, including stroke, cervical cancer and homicide. We conclude that women experience higher mortality and morbidity in states where they have lower levels of political participation and economic autonomy. Living in such states has detrimental consequences for the health of men as well. Gender inequality and truncated opportunities for women may be one of the pathways by which the maldistribution of income adversely affects the health of women. (C) 1998 Elsevier Science Ltd. All rights reserved.