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Gender differences in structural and behavioral determinants of health: an analysis of the social production of health


  • Denton, Margaret
  • Walters, Vivienne


This paper explores aspects of the social production of health by focussing on the ways in which levels of health are shaped by structures of social inequality and behaviors or 'lifestyles'. We address two questions: What is the relative importance of the social, structural and behavioral determinants of health? And, are there gender differences in the determinants of health? These questions are explored using multiple regression analyses of data from the 1994 Canadian National Population Health Survey. Two measures of health are used: subjective health status and the Health Utilities Index (a measure of functional health status). By structural determinants we refer to age, family structure, main activity, education, occupation, income and social support. Behavioral determinants include lifestyle factors related to smoking, drinking, weight and physical activity. Findings indicate that the structures of social inequality are the most important determinants of health acting both independently and through their influence on the behavioral determinants of health. There are very real differences in the factors that predict women's and men's health. For women, social structural factors appear to play a more important role in determining health. Being in the highest income category, working full-time and caring for a family and having social support are more important predictors of good health for women than men. Smoking and alcohol consumption are more important determinants of health status for men than women, while body weight and being physically inactive are more important for women than men. Our findings suggest the value of models which include a wide range of structural and behavioral variables and affirm the importance of looking more closely at gender differences in the determinants of health.

Suggested Citation

  • Denton, Margaret & Walters, Vivienne, 1999. "Gender differences in structural and behavioral determinants of health: an analysis of the social production of health," Social Science & Medicine, Elsevier, vol. 48(9), pages 1221-1235, May.
  • Handle: RePEc:eee:socmed:v:48:y:1999:i:9:p:1221-1235

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    Cited by:

    1. Weden, Margaret M & Astone, Nan M & Bishai, David, 2006. "Racial, ethnic, and gender differences in smoking cessation associated with employment and joblessness through young adulthood in the US," Social Science & Medicine, Elsevier, vol. 62(2), pages 303-316, January.
    2. Chun, Heeran & Khang, Young-Ho & Kim, Il-Ho & Cho, Sung-Il, 2008. "Explaining gender differences in ill-health in South Korea: The roles of socio-structural, psychosocial, and behavioral factors," Social Science & Medicine, Elsevier, vol. 67(6), pages 988-1001, September.
    3. James M. Raymo, 2015. "Living alone in Japan: Relationships with happiness and health," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 32(46), pages 1267-1298, June.
    4. Christian Kroll, 2011. "Different Things Make Different People Happy: Examining Social Capital and Subjective Well-Being by Gender and Parental Status," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 104(1), pages 157-177, October.
    5. Rainer Reile & Mall Leinsalu, 2013. "Differentiating positive and negative self-rated health: results from a cross-sectional study in Estonia," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(4), pages 555-564, August.
    6. Shen, Ke & Zeng, Yi, 2014. "Direct and indirect effects of childhood conditions on survival and health among male and female elderly in China," Social Science & Medicine, Elsevier, vol. 119(C), pages 207-214.
    7. Matheson, Flora I. & Moineddin, Rahim & Dunn, James R. & Creatore, Maria Isabella & Gozdyra, Piotr & Glazier, Richard H., 2006. "Urban neighborhoods, chronic stress, gender and depression," Social Science & Medicine, Elsevier, vol. 63(10), pages 2604-2616, November.
    8. Fritzell, Sara & Ringbäck Weitoft, Gunilla & Fritzell, Johan & Burström, Bo, 2007. "From macro to micro: The health of Swedish lone mothers during changing economic and social circumstances," Social Science & Medicine, Elsevier, vol. 65(12), pages 2474-2488, December.
    9. Lee, Chioun & Ryff, Carol D., 2016. "Early parenthood as a link between childhood disadvantage and adult heart problems: A gender-based approach," Social Science & Medicine, Elsevier, vol. 171(C), pages 58-66.
    10. Chen, Duan-Rung & Chang, Ly-Yun & Yang, Meng-Li, 2008. "Gender-specific responses to social determinants associated with self-perceived health in Taiwan: A multilevel approach," Social Science & Medicine, Elsevier, vol. 67(10), pages 1630-1640, November.
    11. Prus, Steven G., 2011. "Comparing social determinants of self-rated health across the United States and Canada," Social Science & Medicine, Elsevier, vol. 73(1), pages 50-59, July.
    12. Zunzunegui, Maria-Victoria & Alvarado, Beatriz-Eugenia & Béland, François & Vissandjee, Bilkis, 2009. "Explaining health differences between men and women in later life: A cross-city comparison in Latin America and the Caribbean," Social Science & Medicine, Elsevier, vol. 68(2), pages 235-242, January.
    13. Heflin, Colleen M. & Siefert, Kristine & Williams, David R., 2005. "Food insufficiency and women's mental health: Findings from a 3-year panel of welfare recipients," Social Science & Medicine, Elsevier, vol. 61(9), pages 1971-1982, November.
    14. Wisdom, Jennifer P. & Berlin, Michelle & Lapidus, Jodi A., 2005. "Relating health policy to women's health outcomes," Social Science & Medicine, Elsevier, vol. 61(8), pages 1776-1784, October.
    15. Desesquelles, Aline F. & Egidi, Viviana & Salvatore, Michele A., 2009. "Why do Italian people rate their health worse than French people do? An exploration of cross-country differentials of self-rated health," Social Science & Medicine, Elsevier, vol. 68(6), pages 1124-1128, March.
    16. Steven G. Prus, 2003. "A Life-course Perspective on the Relationship between Socio-economic Status and Health: Testing the Divergence Hypothesis," Social and Economic Dimensions of an Aging Population Research Papers 91, McMaster University.


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