Gender inequality in health outcome and health care utilization in India: its changes through the different stages of life course

Biplap Dhak, Institute for Social and Economic Change

Introduction: In India, there has been evidence of gender differential in mortality, particularly up to the age 30. After the age 30, however, a female experience lower level of mortality than their counterpart does. This study has shown the changes of gender inequality in mortality, morbidity, health care utilization and disease pattern through the different stages of life course. The aim of this study was to examine why after the age 30 female experiences lower level of mortality than that of male. Data and method: Data from the National Sample Survey (NSS), India, a cross sectional survey conducted in 2004, were used. A total of 1,95,712 males and 1,87,626 females were included for the analysis. To represent the health outcomes, mortality, morbidity, restriction of activity, disease pattern were considered. Health service use variables analyzed were medical attention from out-patient care, hospitalization, per capita expenditure for medical care. Odds Ratios (OR) for each age group was derived from logistic regression equations, after controlling the few socio-economic variables. Main result: Except for the infants, females’ chances of mortality were higher than that of males in the childhood, adolescent and in the early reproductive age group. After the age 30, male’s chances of mortality exceed the chances of female mortality. There were no substantial gender differentials in the utilization of health care for out-patient care. But, differentials exist in the care of hospitalization and per capita expenditure, where females were in disadvantage position. In the consideration of severity of disease, males were in disadvantage position. Conclusion: These results indicate that from the age 30, females’ lower chances of mortality were because of their less severity in illness, despite of having lower level of health care utilization. The higher level of female morbidity is the result of their inclination to report more about their minor illness.