Exploring the association between gender inequality and healthcare: A visualization study

Abstract

This study investigates the multiplex association between gender inequality and healthcare. The aim of the study is to comprehend how inequalities in gender affect healthcare across different populations worldwide. Visualization was conducted to study the effect of various gender inequality variables on different healthcare indicators. The study emphasizes the critical need for eliminating gender inequalities to reduce disparities in healthcare. By analyzing publicly available data from the World Bank, we find that higher access to anti-retroviral drugs is associated with a lower incidence of human immunodeficiency virus (HIV) among both genders and higher life expectancy. Importantly, increased female engagement in politics and government is linked to higher life expectancy. In addition, higher female representation is associated with lower fertility rates (particularly in high-income countries) and a declining incidence of HIV over time. Higher parity among the genders in school enrollment increases overall life expectancy, with female expectancy exceeding that of males. Simultaneously, higher parity is associated with reduced fertility rates. A lower enrollment among females is also correlated to higher fertility rates. Finally, higher parity also reduces the mortality rate for several diseases. Economic growth, education, income, political and government representation, population, and unemployment influence gender inequities, leading to disparities in healthcare delivery.

Keywords

Fertility rate / Gender inequality / Incidence of human immunodeficiency virus / Health / Life expectancy / School enrollment / Self-employment / Unemployment

Funding

None.

Conflict of interest

Conflict of interest

The authors declare that they have no competing interests.

References

[1] Anderson M., Pitchforth E., Asaria M., Brayne C., Casadei B., Charlesworth, A., et al. (2021). LSE-Lancet Commission on the future of the NHS: Re-laying the foundations for an equitable and efficient health and care service after COVID-19. The Lancet, 397(10288):1915-1978. https://doi.org/10.1016/S0140-6736(21)00232-4

[2] Annandale E., & Hunt K. (2000). Gender Inequalities in Health:Research at the Crossroads. Buckingham: Open University Press.

[3] Arber S., & Khlat M. (2002). Social and economic patterning of women's health in a changing world. Social Science and Medicine, 54: 643-647. https://doi.org/10.1016/s0277-9536(01)00114-9

[4] Artazcoz L., Benach J., Borrell C., & Cortes I. (2007). Health inequalities in a combined framework of work, gender and social class. In: Work and Social Inequalities in Health in Europe. Switzerland: Peter Lang, p. 479.

[5] Backhans M.C., Burström B., Lindholm L., & Månsdotter A. (2009). Pioneers and laggards-is the effect of gender equality on health dependent on context? Social Science and Medicine, 68(8): 1388-1395. https://doi.org/10.1016/j.socscimed.2009.01.023

[6] Börner K., Bueckle A., & Ginda M. (2019). Data visualization literacy: Definitions, conceptual frameworks, exercises, and assessments. Proceedings of the National Academy of Sciences United States of America, 116: 1857-1864. https://doi.org/10.1073/pnas.1807180116

[7] Braveman P., & Gruskin S. (2003). Defining equity in health. Journal of Epidemiology and Community Health, 57: 254-258. https://doi.org/10.1136/jech.57.4.254

[8] Cao N., Koch S., & Gotz D. (2018). ACM TIST special issue on visual analytics. ACM Transactions on Intelligent Systems and Technology, (TIST), 10: 1-4.

[9] Cislaghi B., Weber A.M., Gupta G.R., Darmstadt G.L. (2020). Gender equality and global health: Intersecting political challenges. Journal of Global Health, 10(1): 010701. https://doi.org/10.7189/jogh.10.010701

[10] Coles C.E., Anderson B.O., Cameron D., Cardoso F., Horton R., Knaul F.M., et al. (2022). The lancet breast cancer commission: Tackling a global health, gender, and equity challenge. The Lancet, 399(10330):1101-1103. https://doi.org/10.1016/S0140-6736(22)00184-2

[11] Dahlin J., & Härkönen J. (2013). Cross-national differences in the gender gap in subjective health in Europe: Does country-level gender equality matter? Social Science and Medicine, 98: 24-28. https://doi.org/10.1016/j.socscimed.2013.08.028

[12] Darmstadt G.L., Heise L., Gupta GR, Henry S, Cislaghi B, Greene ME, et al. Why now for a Series on gender equality, norms, and health? Lancet. 2019; 393:2374-2377. https://doi.org/10.1016/S0140-6736(19)30985-7

[13] De Laat K., Kaplan S., & Lu L. (2024). Accelerating progress towards gender equity in health and science. The Lancet. 403(10430):883-886. https://doi.org/10.1016/S0140-6736(24)00404-5

[14] Denton M., Prus S., & Walters V. (2004). Gender differences in health: A Canadian study of the psychosocial, structural and behavioural determinants of health. Social Science and Medicine, 58(12):2585-2600. https://doi.org/10.1016/j.socscimed.2003.09.008

[15] Domado H. (2024). Health equity and gender equality in conflict environments. The Lancet, 403(10437):1630-1631. https://doi.org/10.1016/S0140-6736(23)02626-0

[16] Doyal L. (2012). Gender Equity in Health*:Debates and Dilemmas. In: Gender, Healthand Healing. England, UK: Routledge, p. 183-197.

[17] Doyal L., Payne S., & Cameron A. (2003). Promoting gender equality in health. Interpreting, 4: 3EQ.

[18] Ekbrand H., & Halleröd B. (2018). The more gender equity, the less child poverty? A multilevel analysis of malnutrition and health deprivation in 49 low-and middle-income countries. World Development, 108: 221-230. https://doi.org/10.1016/j.worlddev.2018.01.028

[19] Espelt A., Font-Ribera L., Rodriguez-Sanz M., Artazcoz L., Ferrando J., Plaza A., et al. (2010). Disability among older people in a southern European city in 2006: Trends in gender and socioeconomic inequalities. Journal of Women's Health (Larchmt), 19(5): 927-933. https://doi.org/10.1089/jwh.2009.1608

[20] Franklin P., Bambra C., & Albani V. (2021). Gender Equality and Health in the EU. Luxembourg: Publications Office of the European Union.

[21] George A.S., Amin A., Garcia-Moreno C., & Sen G. (2019). Gender equality and health: Laying the foundations for change. The Lancet, 393(10189):2369-2371. https://doi.org/10.1016/S0140-6736(19)30987-0

[22] Greene M.E., & Patton G. (2020). Adolescence and gender equality in health. Journal of Adolescent Health, 66(1): S1-S2. https://doi.org/10.1016/j.jadohealth.2019.10.012

[23] Grown C., Gupta G.R., & Pande R. (2005). Taking action to improve women's health through gender equality and women's empowerment. The Lancet, 365(9458): 541-543. https://doi.org/10.1016/S0140-6736(05)17872-6

[24] Gupta G.R., Oomman N., Grown C., Conn K., Hawkes S., Shawar Y.R., et al. (2019). Gender equality and gender norms: Framing the opportunities for health. The Lancet, 393(10190): 2550-2562. https://doi.org/10.1016/S0140-6736(19)30651-8

[25] Hay K., McDougal L., Percival V., Henry S., Klugman J., Wurie H., et al. (2019). Disrupting gender norms in health systems: Making the case for change. The Lancet, 393(10190):2535-2549. https://doi.org/10.1016/S0140-6736(19)30648-8

[26] Heidari S., & Bachelet V.C. (2018). Sex and gender analysis for better science and health equity. The Lancet, 392(10157): 1500-1502. https://doi.org/10.1016/S0140-6736(18)32619-9

[27] Heise L., Greene M.E., Opper N., Stavropoulou M., Harper C., Nascimento M., et al. (2019). Gender inequality and restrictive gender norms: Framing the challenges to health. The Lancet, 393(10189): 2440-2454. https://doi.org/10.1016/S0140-6736(19)30652-X

[28] Heymann J., Levy J.K., Bose B., Ríos-Salas V., Mekonen Y., Swaminathan H., et al. (2019). Improving health with programmatic, legal, and policy approaches to reduce gender inequality and change restrictive gender norms. The Lancet, 393(10190): 2522-2534. https://doi.org/10.1016/S0140-6736(19)30656-7

[29] Jones C.M., Gautier L., Kadio K., Mac-Seing M., Miranda É., Omenka C., et al. (2018). Equity in the gender equality movement in global health. The Lancet, 392(10142):e2-e3. https://doi.org/10.1016/S0140-6736(18)31561-7

[30] Keim D., Kohlhammer J., Ellis G., & Mansmann F. (2010). Mastering the Information age Solving Problems with Visual Analytics. Saarbrücken, Germany: Eurographics Association.

[31] Keim D.A. (2001). Visual exploration of large data sets. Communications of the ACM. 44: 38-44. https://doi.org/10.1145/381641.381656

[32] Kent J.A., Patel V., & Varela N.A. (2012). Gender disparities in health care. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine, 79(5): 555-559. https://doi.org/10.1002/msj.21336

[33] Kim J. (2023). Female education and its impact on fertility. IZA World of Labor, 228. https://doi.org/10.15185/izawol.228.v2

[34] King T.L., Kavanagh A., Scovelle A.J., & Milner A. (2020). Associations between gender equality and health: A systematic review. Health Promotion International, 35(1): 27-41. https://doi.org/10.1093/heapro/day093

[35] Kohlhammer J., Keim D., Pohl M., Santucci G., & Andrienko G. (2011). Solving problems with visual analytics. Procedia Computer Science, 7: 117-120. https://doi.org/10.1016/j.procs.2011.12.035

[36] Lancet T. (2010). Gender equity is the key to maternal and child health. The Lancet, 375(9730): 1939. https://doi.org/10.1016/S0140-6736(10)60905-1

[37] Langer A., Meleis A., Knaul F.M., Atun R., Aran M., Arreola- Ornelas H., et al. (2015). Women and health: The key for sustainable development. The Lancet, 386(9999):1165-1210. https://doi.org/10.1016/S0140-6736(15)60497-4

[38] Macintyre S., Hunt K., & Sweeting H. (1996). Gender differences in health: Are things really as simple as they seem? Social Science Medicine, 42(4):617-624. https://doi.org/10.1016/0277-9536(95)00335-5

[39] Madell D.E., & Hayward B.P. (2019). Gender inequities and global health outcomes. Journal of Global Health Reports, 3: e2019017. https://doi.org/10.29392/joghr.3.e2019017

[40] Malmusi D., Artazcoz L., Benach J., & Borrell C. (2012). Perception or real illness? How chronic conditions contribute to gender inequalities in self-rated health. The European Journal of Public Health, 22(6):781-786. https://doi.org/10.1093/eurpub/ckr184

[41] Milner A., Kavanagh A., Scovelle A.J., O'Neil A., Kalb G., Hewitt B., et al. (2021). Gender equality and health in high-income countries: A systematic review of within-country indicators of gender equality in relation to health outcomes. Women's Health Reports (New Rochelle), 2(1): 113-123. https://doi.org/10.1089/whr.2020.0114

[42] Musani A. (2024). Health equity can contribute to cohesive and peaceful societies. The Lancet, 403(10437): 1630. https://doi.org/10.1016/S0140-6736(23)02625-9

[43] Palència L., Malmusi D., De Moortel D., Artazcoz L., Backhans M., Vanroelen C., et al. (2014). The influence of gender equality policies on gender inequalities in health in Europe. Social Science and Medicine, 117: 25-33. https://doi.org/10.1016/j.socscimed.2014.07.018

[44] Percival V., Thoms O.T., Oppenheim B., Rowlands D., Chisadza C., Fewer S., et al. (2023). The lancet commission on peaceful societies through health equity and gender equality. The Lancet, 402(10413): 1661-1722. https://doi.org/10.1016/S0140-6736(23)01348-X

[45] Raghupathi V., & Raghupathi W. (2020). The influence of education on health: An empirical assessment of OECD countries for the period 1995-2015. Archives of Public Health, 78: 20. https://doi.org/10.1186/s13690-020-00402-5

[46] Raghupathi W., & Raghupathi V. (2013). An overview of health analytics. Journal of Health and Medical Informatics, 4: 2. https://doi.org/10.4172/2157-7420.1000132

[47] Raghupathi W., & Raghupathi V. (2021). Contemporary business analytics: An overview. Data, 6: 86.

[48] Raghupathi W., Raghupathi V., & Saharia A. (2023). Analyzing health data breaches: A visual analytics approach. Applied Math, 3(1): 175-199. https://doi.org/10.3390/appliedmath3010011

[49] Raj A. (2011). Gender equity and universal health coverage in India. The Lancet, 377(9766): 618-619. https://doi.org/10.1016/S0140-6736(10)62112-5

[50] Read J.N.G., & Gorman B.K. (2010). Gender and health inequality. Annual Review of Sociology, 36(1): 371-386. https://doi.org/10.1146/annurev.soc.012809.102535

[51] Roxo L., Bambra C., & Perelman J. (2021). Gender equality and gender inequalities in self-reported health: A longitudinal study of 27 European countries 2004 to 2016. International Journal of Health Services, 51(2): 146-154.

[52] Sen G., & Östlin P. (2008). Gender inequity in health: Why it exists and how we can change it. Global Public Health, 27: 170077. https://doi.org/10.1080/17441690801900795

[53] Sen G., George A., Ostlin P., & Ramos S. (2007). Unequal, unfair, ineffective and inefficient gender inequity in health: Why it exists and how we can change it.

[54] Sen G., Govender V., & El-Gamal S. (2018). Universal Health Coverage, Gender Equality and Social Protection:A Health Systems Approach. New York: UN Women.

[55] Shannon G., Jansen M., Williams K., Cáceres C., Motta A., Odhiambo A., et al. (2019). Gender equality in science, medicine, and global health: Where are we at and why does it matter? The Lancet, 393(10171): 560-569. https://doi.org/10.1016/S0140-6736(18)33135-0

[56] Singh D., & Singh B. (2020). Investigating the impact of data normalization on classification performance. Applied Soft Computing, 97: 105524. https://doi.org/10.1016/j.asoc.2019.105524

[57] Sörlin A., Lindholm L., Ng N., & Öhman A. (2011). Gender equality in couples and self-rated health-a survey study evaluating measurements of gender equality and its impact on health. International Journal for Equity in Health, 10: 37. https://doi.org/10.1186/1475-9276-10-37

[58] Sörlin A., Öhman A., Ng N., & Lindholm L. (2012). Can the impact of gender equality on health be measured? A cross-sectional study comparing measures based on register data with individual survey-based data. BMC Public Health, 12: 795. https://doi.org/10.1186/1471-2458-12-795

[59] Steinert J.I., Alacevich C., Steele B., Hennegan J., & Yakubovich A.R. (2021). Response strategies for promoting gender equality in public health emergencies: A rapid scoping review. BMJ Open, 11(8): e048292. https://doi.org/10.1136/bmjopen-2020-048292

[60] Su Z., Cheshmehzangi A., McDonnell D., Šegalo S., Ahmad J., & Bennett B. (2022). Gender inequality and health disparity amid COVID-19. Nursing Outlook, 70(1): 89-95. https://doi.org/10.1016/j.outlook.2021.08.004

[61] Thomas J., Cook K. (2005). Illuminating the Path: Research and Department Agenda for Visual Analytics. Washington, DC, USA: United States Department of Homeland Security; 2005.

[62] United Nations. (1995). Platform for Action. Report of the Main Committee t-f the Fourth Worm Conference on Women, A/Conf. 177/L.5/Add.7, Beijing.

[63] Van Wijk C.M.G., Van Vliet K.P., & Kolk A.M. (1996). Gender perspectives and quality of care: Towards appropriate and adequate health care for women. Social Science and Medicine, 43(5):707-720. https://doi.org/10.1016/0277-9536(96)00115-3

[64] Vélez A.C.G., Coates A., Garcia V.D., & Wolfenzon D. (2020). Gender equality and health equity: Strategic lessons from country experiences of gender mainstreaming in health. Revista Panamericana de Salud Pública, 44: e129. https://doi.org/10.26633/RPSP.2020.129

[65] Weber A.M., Cislaghi B., Meausoone V., Abdalla S., Mejía- Guevara I., Loftus P., et al. (2019). Gender norms and health: Insights from global survey data. The Lancet, 393(10189): 2455-2468. https://doi.org/10.1016/S0140-6736(19)30765-2

[66] Wong P.C., & Thomas J. (2004). Guest editors' introduction-visual analytics. IEEE Computer Graphics and Applications, 24: 20-21.

[67] World Health Organization. (2011). Human Rights and Gender Equality in Health Sector Strategies: How to Assess Policy Coherence. Switzerland: World Health Organization.

[68] World Health Organization. (2019). Health and Gender Equality: Policy Brief. Switzerland: World Health Organization.

[69] World Health Organization. (2019). Health Equity and Its Determinants in the Western Pacific Region. Switzerland: World Health Organization.

[70] World Health Organization. (2021). Closing the Leadership Gap: Gender Equity and Leadership in the Global Health and Care Workforce: Policy Action Paper. Switzerland: World Health Organization.

[71] Yoong J., Alonso S., Chan C.W., Clement M.V., Lim L.H., & Archuleta S. (2019). Investing in gender equity in health and biomedical research: A Singapore perspective. The Lancet, 393(10171):e21-e22. https://doi.org/10.1016/S0140-6736(18)32096-8

[72] Zhang D., Raghupathi W., & Raghupathi V. (2024). Exploring the association between climate change and human development: A visual analytics study. Atmospheric and Climate Sciences, 14(4):368-395. https://doi.org/10.4236/acs.2024.144023