In Health, Gender Matters
In a recent TV ad featuring a flu remedy, we are reassured it's effective on both men and women. The subtext of the commercial is that there are two types of flu: females patiently waiting out an unpleasant situation, and males griping and being overdramatic about it. This gender difference is no invention of the advertising industry, however. In England, you even say: "It's not a regular cold, it's a man's cold!», to refer to a person who's exaggerating symptoms. There is no biological basis for a medical difference, but men and women seem to have different psychological reactions to same set of symptoms.
Beyond anecdotes, the interesting question from an economic point of view is if we can expect diverging health needs between men and women in the course of their lives. From a public health perspective, the answer requires the analysis of men's and women's health consumption in all age brackets. Age is an important factor, because women live on average for 5 years longer than men, and it's logical to expect that as they age, women would consume more economic resources in absolute terms.
In a study that I conducted together with Carlo La Vecchia and Eva Negri (Istituto Mario Negri), Piergiorgio Crosignani (Policlinico di Milano) and Carlo Zocchetti (Regione Lombardia), we analyzed health consumption and spending by age and gender in the Lombardy region. Given that the region's database contains data on all health procedures (hospitalization, pharmaceuticals, day-care) which are reimbursed by the region, the dataset covers 80% of health spending in Italy's largest region (10 million inhabitants).
On the basis of simple but clear graphic analysis, it is self-evident that there is a gender difference in health spending. Women, who live longer, need more resources than men. But if you look at per capita spending by age cohort, you'll find three striking facts. Firstly, a woman consumes much more health than a man in the 25-40 age bracket, particularly due to childbearing. But in the 60-90 age span, a man costs the health care system much more than a woman. In fact, if Lombardy had to spend for old women what it is spending for old men, health expenditure would increase by 7.8%. Even controlling for gender differences concerning major pathologies, the man/ woman divide remains. Is it due to real gender differences or to misallocation of resources? What's at stake is gender equality in access to health care. Yes, you've heard well, because the data from Lombardy clash with those from the US, where women consume around 70% of total health spending. Given that the US health care system is strongly privatized, it could well be that their system is biased instead (e.g. the high cost of plastic surgery). However, the scientific literature has so far remained inconclusive on the gender divide in health care.