Gender inequalities in health and health care services use in Catalonia (Spain)

Background and objectives-While socioeconomically derived differences in he alth and health services use have long been a subject of study, differences based on gender, considered as the explicative variable, have scarcely bee n quantified from population-based data. The aim of this investigation was to analyse inequalities in health and health care services utilisation betw een men and women in Catalonia (Spain). Design, setting, participants, and measures-Data from the Catalan Health In terview Survey, a cross sectional survey conducted in 1994, were used. A to tal of 6604 women and 5641 men aged 15 years or over were included for anal ysis. Health related variables studied were self perceived health, restrict ion of activity (past two weeks), and presence of chronic conditions; healt h services use variables analysed were having visited a health professional (past two weeks), an optometrist (12 months), or a dentist (12 months); an d hospitalisation (past 12 months). Age standardised proportions were compu ted according to gender, and prevalence odds ratios (OR) were derived from logistic regression equations. Main results-Women more frequently rated their health as fair or poor than men (29.8% v 21.4%; OR=1.22; 95% CI: 1.10, 1.34). More women than men repor ted having restricted activity days (OR=1.86; 95% CI: 1.59, 2.18) and chron ic conditions (OR=1.74; 95% CI: 1.60, 1.89). The proportion of women visiti ng a health professional was slightly greater than that for men (OR=1.20; 9 5% CI: 1.09, 1.31), as was the proportion of women visiting an optometrist (OR=1.21; 95% CI: 1.11, 1.33), and a dentist (OR=1.43; 95% CI: 1.31, 1.55), The proportion of hospitalisation was lower in women (6.6%) than in men (7 .7%; OR=0.73; 95% CI: 0.63, 0.85). When health services use was analysed ac cording to self perceived health, women declaring good health reported a gr eater probability of consulting a health professional (OR=1.35; 95% CI: 1.2 0, 1.52). There were no differences in respect to hospitalisation, visits t o the optometrist and to the dentist. Conclusions-These results indicate a pattern close to the inverse care law, as women, who express a lower level of health and thus would need more hea lth care, are not, however, using health services more frequently than men.