Influence of macrosocial policies on women's health and gender inequalities in health

Epidemiol Rev. 2014;36:31-48. doi: 10.1093/epirev/mxt002. Epub 2013 Sep 11.


Gender inequalities in health have been widely described, but few studies have examined the upstream sources of these inequalities in health. The objectives of this review are 1) to identify empirical papers that assessed the effect of gender equality policies on gender inequalities in health or on women's health by using between-country (or administrative units within a country) comparisons and 2) to provide an example of published evidence on the effects of a specific policy (parental leave) on women's health. We conducted a literature search covering the period from 1970 to 2012, using several bibliographical databases. We assessed 1,238 abstracts and selected 19 papers that considered gender equality policies, compared several countries or different states in 1 country, and analyzed at least 1 health outcome among women or compared between genders. To illustrate specific policy effects, we also selected articles that assessed associations between parental leave and women's health. Our review partially supports the hypothesis that Nordic social democratic welfare regimes and dual-earner family models best promote women's health. Meanwhile, enforcement of reproductive policies, mainly studied across US states, is associated with better mental health outcomes, although less with other outcomes. Longer paid maternity leave was also generally associated with better mental health and longer duration of breastfeeding.

Keywords: health status; public policy; sex factors; socioeconomic factors; women's health.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Breast Feeding / methods
  • Breast Feeding / statistics & numerical data
  • Employment / organization & administration
  • Family Planning Policy
  • Female
  • Health Behavior
  • Health Status
  • Humans
  • Internationality
  • Parental Leave / statistics & numerical data
  • Policy Making*
  • Politics*
  • Public Policy*
  • Sexism*
  • Socioeconomic Factors
  • Stereotyping
  • Women's Health*
  • Women, Working / statistics & numerical data