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Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: evidence from India

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  • Roy, Kakoli
  • Chaudhuri, Anoshua

Abstract

Empirical studies from developed countries observe that women report worse health and higher healthcare utilization than men, but the health disadvantage diminishes with age; gender differences in self-rated health often vanish or are reversed in older ages. Comparable assessments of health during later life from developing countries are limited because of the lack of large-scale surveys that include older women. Our study attempts to address the shortage of developing country studies by examining gender differences in health and healthcare utilization among older adults in India. Both ordered and binary logit specifications were used to assess significant gender differences in subjective and objective health, and healthcare utilization after controlling for demographics, medical conditions, traditional indicators of socioeconomic status like education and income, and additional wealth indicators. The wealth indicators, measured by property ownership and economic independence, are regarded as financially empowering older adults to exercise greater control over their health and well-being. Data are drawn from a nationally representative decennial socioeconomic and health survey of 120,942 Indian households conducted during 1995-1996. The study sample comprises 34,086 older men and women aged >=60 years. Our results indicate that older women report worse self-rated health, higher prevalence of disabilities, marginally lower chronic conditions, and lower healthcare utilization than men. The health disadvantage and lower utilization among women cannot be explained by demographics and the differential distribution of medical conditions. While successive controls for education, income, and property ownership narrows the gender gap in both health and healthcare utilization, significant differentials still persist. Upon controlling for economic independence, gender differentials disappear or are reversed, with older women having equal or better health than otherwise similar men. Financial empowerment might confer older women the health advantage reflected in developed societies by enhancing a woman's ability to undertake primary and secondary prevention during the life course.

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  • Roy, Kakoli & Chaudhuri, Anoshua, 2008. "Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: evidence from India," Social Science & Medicine, Elsevier, vol. 66(9), pages 1951-1962, May.
    • Handle: RePEc:eee:socmed:v:66:y:2008:i:9:p:1951-1962
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    8. Jayanta Kumar Bora & Nandita Saikia, 2015. "Gender Differentials in Self-Rated Health and Self-Reported Disability among Adults in India," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-14, November.
    9. Carr-Hill, Roy, 2020. "Inequalities in access to higher education in Africa: How large are they? Do they mirror the situation in the metropole 60 years ago?," International Journal of Educational Development, Elsevier, vol. 72(C).
    10. Franque Grimard & Sonia Laszlo & Wilfredo Lim, 2008. "Health, Aging And Socio-Economic Conditions In Mexico," Departmental Working Papers 2008-06, McGill University, Department of Economics.
    11. Dona Ghosh & Jaydeep Sengupta & Aviral Kumar Tiwari, 2020. "Revisiting the Role of Gender in Health Taxonomy: Evidence from the Elderly in India," Advances in Decision Sciences, Asia University, Taiwan, vol. 24(2), pages 104-133, June.
    12. Ilana G. Raskind & Shailaja S. Patil & Regine Haardörfer & Solveig A. Cunningham, 2018. "Unhealthy Weight in Indian Families: The Role of the Family Environment in the Context of the Nutrition Transition," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 37(2), pages 157-180, April.
    13. Azharuddin Akhtar & Indrani Roy Chowdhury, 2023. "The socioeconomic inequity in healthcare utilization among individuals with cardiovascular diseases in India," Health Economics, John Wiley & Sons, Ltd., vol. 32(5), pages 1000-1018, May.
    14. Julián Alfredo Fernández-Niño & Betty Soledad Manrique-Espinoza & Ietza Bojorquez-Chapela & Aarón Salinas-Rodríguez, 2014. "Income Inequality, Socioeconomic Deprivation and Depressive Symptoms among Older Adults in Mexico," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-8, September.
    15. Mondal, Bidisha & Dubey, Jay Dev, 2020. "Gender discrimination in health-care expenditure: An analysis across the age-groups with special focus on the elderly," Social Science & Medicine, Elsevier, vol. 258(C).
    16. Biswajit Mandal, 2015. "Demand for maternal health inputs in West Bengal-Inference from NFHS 3 in India," Economics Bulletin, AccessEcon, vol. 35(4), pages 2685-2700.
    17. Kazembe, Lawrence N., 2020. "Women empowerment in Namibia: Measurement, determinants and geographical disparities," World Development Perspectives, Elsevier, vol. 19(C).
    18. Grimard, Franque & Laszlo, Sonia & Lim, Wilfredo, 2010. "Health, aging and childhood socio-economic conditions in Mexico," Journal of Health Economics, Elsevier, vol. 29(5), pages 630-640, September.
    19. Mandal, Biswajit, 2015. "Demand for Maternal health inputs in West Bengal-Inference from NFHS 3," MPRA Paper 68224, University Library of Munich, Germany.
    20. Sojin Yu & Feinian Chen & Sonalde Desai, 2023. "Aligning household decision-making with work and education: A comparative analysis of women’s empowerment," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 48(19), pages 513-548.
    21. Roy, Ramananda & Bhattacharyya, Bhaskar & Mandal, Biswajit, 2022. "Demand for Maternal Health Care in The Eastern States of India: Evidence From A National Health Survey," MPRA Paper 116649, University Library of Munich, Germany.

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