Gender differences in health and care

In industrialised nations, the number of care workers is increasing at a much slower pace than the demand for care. Policy-makers are forced to put together one care package after another. As recently as May 2022, the Austrian Parliament approved a supplement of EUR 570 million for the salaries of nursing staff in Austria for the years 2022 and 2023. However, there is a much greater care “subsidy” paid by someone else: 80 percent of people in need of care are cared for at home by family members, by far the majority of these are women. It is well known that we have a gender gap in terms of health and care. What is less well-known is whether and in what way that gap is changing. Researchers have now been investigating this issue in the context of the international FutureGEN project, which was co-financed by the Austrian Science Fund FWF. The project coordination was managed by the European Centre for Welfare Policy and Social Research in Vienna; universities in Canada and Sweden were also involved.

The researchers examined the fields of “health” and “care”. “Both topics are characterised by a clear gender gap,” says Ricardo Rodrigues, project coordinator at the European Centre and now with the University of Lisbon. “Women live longer than men, but have a lower proportion of healthy years. Especially in old age, their status of health is significantly worse than that of men.” In addition, women are much more likely to care for sick relatives. “This is well researched. But we wanted to see whether there were any changes.” People who are in their 50s today live differently than their parents did in their 50s. The decade of life between 50 and 60 is considered particularly interesting because statistically that is where care of relatives is most frequent.

Men are getting older and sicker

The researchers successfully searched for existing data sets for their research in Europe, and began to compare results across age cohorts. One of the aspects they compared was the health of today's 50-60 year olds with the health of those who are now 70-80 years old when they were 50 years old.

“We had several hypotheses,” says Rodrigues. “We assumed that there would be more similarity as regards health, and that’s what we found.” Unfortunately, this does not mean that everyone is healthier now. Men in old age are statistically less healthy than they used to be and are getting closer to women, one possible reason being that men are now surviving diseases that used to kill them earlier. “A much higher proportion of people are surviving into old age,” says Rodrigues. “We are good at keeping people alive longer. But we are not good at keeping them healthy.”

Regional differences

Since the data sets covers different regions in Europe, regional differences can also be described. In Northern and Western Europe, the basic pattern is similar: both women and men live longer but are not healthier. There was one exception, however: in Eastern Europe, the younger cohorts of women are healthier than the cohorts before. “We can't really glean a reason from this data,” Rodrigues notes. One of the possible explanations: Eastern European societies might have become more equal in general (i.e. in terms of income, education, etc.), which would also have affected health. The fact that this only happened in Eastern Europe could be explained by the fact that regions like Western and Northern Europe were already at this point before. “If that's the case, then this effect should be tailing off,” Rodrigues says. Overall, however, patterns of health in old-age varied more depending on sex, age, and region than depending on cohort.

In the field of care, the results are sobering. The researchers had two hypotheses: as women participate more often in the labour market today, the proportion of women between 50 and 60 who are caring for relatives should have decreased. And they expected that men would have taken over some of these care commitments, as one observes in childcare, for example.

The burden is still – largely – on the women

The first hypothesis was not confirmed. The proportion of women in their 50s who were caring for relatives was just as high as in the older cohort at the same age, although the proportion of those who were in gainful employment had increased. The situation is more complicated when it comes to the second hypothesis: men in their 50s and 60s still have not taken on a relevant share of care. But this changes in old age. “A logical explanation would be that men, who are now getting older, are caring for their wives in old age,” Rodrigues says. “But caring for parents, which takes place outside your own home, still continues to be done by women.” The researchers found slight differences in these results between European regions, but would have expected them to be much higher. “The legal models underlying care are very different from region to region.” The fact that the trend is the same everywhere indicates that policy is not having as large an influence on this issue as demography.

“Probably the most important finding for policy-makers is that our longer life expectancy so far does not go hand in hand with better health,” says Rodrigues. Knowing this is relevant in order to estimate the future need for care. It also seems likely that women will continue to be the ones providing care for relatives. The expert says this shows that concerns about a 'grey tsunami' and unmanageable care costs may be exaggerated, but the cost in terms of gender (in)equality is very high.

Personal details

Ricardo Rodrigues was previously Deputy Director of the European Centre for Welfare Policy and Social Research in Vienna and he is currently a Professor at the University of Lisbon. He holds a Master's degree in Economics from the University of Lisbon and a PhD in Social Policy and Social Work from the University of York. As an expert on ageing society, care and health, Rodrigues has been involved in numerous research and EU projects. The international FutureGEN project “Evolving gender differences in health & care across cohorts” ran from 2019 to 2022 and received EUR 268,000 in funding from the Austrian Science Fund FWF. 

Publications

Fors S., Illinca S., Jull J. et al.: Cohort-specific disability trajectories among older women and men in Europe 2004–2017, in: European Journal of Ageing 2022

Ilinca S., Rodrigues R., Fors S. et al.: Gender differences in access to community-based care: a longitudinal analysis of widowhood and living arrangements, in: European Journal of Ageing 2022

Augustsson E., Rehnberg J., Simmons C. et al.: Can Sex Differences in Old Age Disabilities be Attributed to Socioeconomic Conditions? Evidence from a Mapping Review of the Literature, in: Journal of Population Ageing 2022