Is gender equality associated with a longer healthier life? Ecological evidence from 27 European countries

Background The association between gender equality and higher life expectancies has been described. Yet, little is known about its association with healthy life expectancy (HLE), or which domains are consistently associated with longer and healthier lives. We aimed to study the association between country-level gender equality, its domains and subdomains, with life expectancy and HLE in Europe, from 2013 to 2019. Methods We combined life and HLE estimates from Eurostat with the Gender Equality Index and its 'work', 'knowledge', 'money', 'time' and 'power' domains and respective subdomains, for 27 European countries. Associations were estimated using panel data regression analyses adjusted for Gross Domestic Product, healthcare expenditure and Gini coefficient. Results Higher life and healthy life expectancies were found in country years with higher gender equality, both for men and women. Associations were particularly consistent for the 'work' (beta(HLE-men) = 0.59; beta(HLE-women) = 0.59; P < 0.05) and 'power' domains (beta(HLE-men) = 0.09; beta(HLE-women) = 0.12, P < 0.01), especially for the 'work participation', 'political' and 'economic power' subdomains. Conclusion These results point to a country-level association between gender equality and life and healthy life expectancies, suggesting that gender disparities in 'work participation' and 'political' and 'economic power' play a role in the health of women and men through their aging course.