Factors associated with gender differentials in self-reported health and activities of daily living in the Former Communist Countries of Central and Eastern Europe and the Former Soviet Union

Michael Murphy, London School of Economics and Political Science (LSE)
Martin Bobak, University College London
Richard Rose, University of Aberdeen
Michael Marmot, University College London

While considerable attention has been given to the excess mortality of working age males, especially in Russia, less attention has been given to health status, and the health status of women in particular. We use data from the 2004 round of the New Europe Barometer surveys covering 13 countries of Central and Eastern Europe and the former Soviet Union (N=15,331 respondents). Subjects were asked an identical series of questions on self-rated physical and emotional health, and 10 indicators of ADL functioning. We constructed the estimated proportion of life spent in poor health and limited between ages 20 to 75 by men and women on each of these 12 indicators. We find marked differences among participating countries in proportion of lifetime spent in poor health: the countries of the former Soviet Union, such as Russia, Ukraine and Belarus, tend to have the worst health status across all indicators, and counties such as Slovenia and the Czech Republic the best health for both men and women. In almost all cases, women report worse health than men do and the largest differentials were found in countries with the largest overall values. In order to assess the macro-level factors associated with differences between men and women, we used a number of macro-level variables such as gross domestic product per capita, Gini coefficient of income inequality, Transparency International Corruption index, homicide rates, and indicators of overall mortality such as life expectancy at age 15. Among societal (country-level) measures examined, indicators of economic and educational status as well as corruption were strongly associated with gender health differentials (with the most advantaged countries having the smallest differentials). We conclude that the experience in Eastern European countries is substantially different from that in Western European ones.