Domain of health
Significant gender inequalities persist in the EU in all areas, despite progress in recent decades. In the health domain, these include major disparities in life expectancy and self-assessed health status. There are also large gender differences in health-impacting behaviour. Men tend to engage more in risky behaviour such as smoking and excessive drinking. They are less involved in healthy pursuits, including physical activity and eating fruit and vegetables. Access to health and dental care also reveals disparities, especially when gender is analysed with other social factors such as age, education and disability.
The COVID-19 pandemic has undoubtedly placed an unprecedented strain on health systems (OECD/European Union, 2020) It has also exposed how gender and social inequalities impact people’s health, for example the high toll paid by frontline and essential workers (EIGE, 2020b, 2020c; OECD, 2020a). The critical need for more gender-sensitive data and analysis to inform responses to the pandemic has been reiterated (European Commission, 2021a; GlobalHealth 50/50, 2020; WHO, 2020c).
The European Pillar of Social Rights Action Plan acknowledges the right to timely access to good-quality, affordable healthcare for all – both preventive and curative (European Commission, 2019). The action plan recognises the need for gender equality of access to long-term care services, healthy working environments and social protection, and emphasises that health status does not depend only on biological factors but is also influenced by numerous social determinants. Health, therefore, requires a multidisciplinary approach. The EU gender equality strategy has reaffirmed this commitment to integrating gender with all European Commission health initiatives (European Commission, 2020b).
Measures to better monitor access to healthcare, to improve access to healthcare for key population groups such as people with disabilities and to reform long-term care provision in the EU are proposed in the social rights action plan (European Commission, 2021d).
This Index’s thematic focus on health (Chapter 9) explores in greater detail the three dimensions of the health domain – health status, health behaviour and access to health services. It also analyses, from gender and intersectional perspectives, three other specific areas: SRH, mental health and the COVID-19 pandemic.
 The domain of health measures three health-related aspects of gender equality: health status, health behaviour and access to health services. Health status looks at the gender differences in life expectancy, self-perceived health and healthy life years (also called disability-free life expectancy). This is complemented by a set of health behaviour factors based on WHO recommendations: fruit and vegetable consumption, engagement in physical activity, smoking and excessive alcohol consumption. Access to health services looks at the percentage of people who report unmet medical and/or dental needs.