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

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 i nequality and behaviors or 'lifestyles'. We address two questions: What is the relative importance of the social, structural and behavioral determinan ts of health? And, are there gender differences in the determinants of heal th? 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 t o smoking, drinking, weight and physical activity. Findings indicate that t he structures of social inequality are the most important determinants of h ealth acting both independently and through their influence on the behavior al determinants of health. There are very real differences in the factors t hat 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 hi ghest income category, working full-time and caring for a: family and havin g:social support are more important predictors of good health for women tha n men. Smoking and alcohol consumption are more important determinants of h ealth status for men than women, while body weight and being physically ina ctive are more important for women than men. Our findings suggest the value of models which include a wide range of structural and behavioral variable s and affirm the importance of looking more closely at gender differences i n the determinants of health. (C) 1999 Published by Elsevier Science Ltd. A ll rights reserved.