Research

Our research in FutureGEN is organised in four Work Packages (WPs) each with its set of objectives, research questions and methods.

WP1: Determinants of sex/gender differences in health and function and cohort effects 

WP2: Gendered care provision/receiving

WP3: Engendering best methods in research

WP4: Future trajectories of gendered health and care and policy implications


WP1: Determinants of sex/gender differences in health and function and cohort effects 

Objectives

The focus of WP1 is sex differences in late life disabilities in Europe and Canada. Previous research has established a robust pattern where disabilities are more common among older women, than among older men. In this work package we are studying how these inequalities vary across space and time, and to what extent they can be attributed to gendered differences in social conditions and behaviours. By reviewing the literature and analysing survey data collected in Europe and Canada, we are we are seeking to answer two overarching research questions:

1. How have the sex differences in late life disabilities changed across subsequent cohorts of older adults?

Do later born cohorts have more or less disabilities at any given age than previous cohorts? Do these patterns vary by sex and between countries? These are some of the specific questions we are addressing in the work package, by analysing the longitudinal disability trajectories experienced by subsequent birth cohorts of older women and men in different European regions.

2. To what extent can the observed sex differences in late life disabilities be attributed to gendered differences in social and behavioural patterns?

This is a question that we are addressing in a two-pronged fashion. In the first step, we are reviewing the literature to compile what is known about the role of socioeconomic conditions in shaping sex differences in late life disabilities. In the second step, we will use survey data from Europe and Canada to analyse the contribution of different gendered social and behavioural factors to the observed sex differences in disabilities in old age.

Expected results

As we eventually sum up the work package, we hope to have contributed with a helicopter view of how ageing has changed over time among women and men in Europe, in terms of their disability trajectories. We also expect to have contributed to an increased understanding of the social and behavioural conditions that contribute to the sex differences in the likelihood of experiencing disabilities during old age. We believe that these findings will contribute to the accumulation of knowledge on sex differences in late life health. Moreover, we hope that the results can contribute to a discussion on the future needs for social services among older adults, as well as on the potential impact of different public health measures on the sex gap in disabilities during old age.


WP2: Gendered care provision/receiving

Objectives

A large body of evidence collected across countries, cultures and welfare systems, confirms the persistence of a gender gap in care: women are more likely to provide informal care throughout the life course but also more likely to rely on formal care services should they develop care needs. WP2 aims to understand and explain the gender care gap, looking beyond the longevity advantage of women, to the explanatory roles of gendered living arrangements, institutional arrangements and cultural norms. We focus specifically on two intertwined research questions:

1. How do marital status and living arrangements impact (formal and informal) care receiving in old age?

The availability of care resources in old age is closely tied to family and household characteristics and their stability through the life course. We will analyze how access to and use of (formal and informal) care vary between sexes and socio-economic groups and how they are affected by key transition points in marital status and living arrangements during later life. 

2. Are gender differences in informal care provision attenuated with age and over time?

While remarkably stable, the gender care gap is mutable and amenable to social, cultural and policy variation. Using longitudinal data and age-period-cohort analyses, we attempt to establish if gender differences in care attenuate as individuals progress through their life course (i.e. age effect) and as younger age groups progress to old age (i.e. cohort effect).

Expected results

Our results will contribute to the growing body of evidence on the determinants of gender inequality in care, adding novel insights on the understudied role of key marital status transitions. By taking a dynamic approach to the study of the gender care gap, we will shed light on the impact of past and current policies and societal changes and will allow public policies to proactively mitigate future drivers of gender inequalities. 

Ilinca, S., Rodrigues, R., Zólyomi, E. , Fors, S., Jull, J., Rehnberg, J., Vafaei, A. and Phillips, S. “Gender Differences in Access to Home and Community-Based Care: a Longitudinal Analysis of the Effects of Widowhood and Living Arrangements” Working Paper, Vienna: European Centre.


WP3: Engendering best methods in research

Objectives

In every developed country those with greater wealth live longer. However, women generally have fewer material resources than men and yet outlive men, although often with poorer self-reported health. This paradox begs for consideration of how sex/gender shape lived experiences that in turn determine health. 

Measures of health, care and social position can have gender stereotypes and inequalities hidden in them. Women tend to report poorer self-rated health (SRH) and underestimate their physical function relative to men. Similarly, men’s reporting of fewer illnesses may reflect stereotypic avoidance of acknowledging illness.Informal care-giving is influenced by gender differences in how care is defined. Despite this, little is known about gender bias in measures, particularly of self-reported indicators of health or function.

To fully capture the health and care variability of gender, measures such as sex and place (country) are necessary but insufficient. Similarly, the simple addition of multiple discrete social locations will not capture within category variability or across category interactions. This calls for an intersectional approach.

Ours will be the first research we are aware of to link sex/gender considerations in methodology with actual research in an iterative manner where theory informs methods, and outcomes then inform further refinement of those methods.

Expected results

We will examine the current ‘state’ of integration of sex/gender in health research via a systematic review of methods used to study intersections of sex and social locations among middle aged and older adults. Based on this review we will then describe innovative epidemiologic methods to avoid simplistic categorization and to best acknowledge sex/gender variation and social complexity without sacrificing external validity. More specifically, we will report on how multiple and intersecting measures of social location (e.g. education, race, individual and household income, domestic decision-making, etc.)  can yield more meaningful measures of lived access to resources and gender equality. Novel insights will be generated by merging life-course and intersectionality approaches.

The findings from this section of FutureGEN will be applied across the whole project, translated into educational workshops and papers, and disseminated among journal editors and funders.

S.P. Phillips, Vafaei A., Yu S., Rodrigues, R. Ilinca, S. Zolyomi, E., Fors, S., (2020) Systematic review of methods used to study the intersecting impact of sex and social locations on health outcomesSSM – Population Health (Early View)


WP4: Future trajectories of gendered health and care and policy implications

Objectives

This WP incorporates findings from WPs1-3 and looks at future trajectories of gender inequalities in health and care to provide recommendations for policy. A key objective of FutureGEN is to understand how associations between contexts and life choices and gender inequalities in health and care may evolve in the future. In this WP, we approach this by answering two research questions:

1. How ageing well and care-giving/receiving defined and perceived by older men and women and what resources are most meaningful for them?

The perspectives of knowledge users are important to better understand what factors impact experiences of ageing and what resources are needed for ageing well – both important for priority-setting in policy. We explore this by conducting a qualitative study interviewing older knowledge users (60+) in Austria, Canada and Sweden. 

2. What is the distribution of health behaviours and resources in future cohorts of older adults across sex/gender and other social categories?

Using data from international surveys, we will compare the gendered distribution of health behaviours and resources among current (60+) and coming cohorts of older adults (ages 50-60) and assess how future cohorts and current cohorts of older people differ in ways that affect health and sex/gender inequalities in health and care-giving/receiving. 

Expected results

The qualitative study will provide insights about intersections of ageing, health and gender through the lens of the lived experiences of knowledge users. It will also inform about ways in which indicators used in population studies can be gendered and to possibly identify new concepts that were not generated in the quantitative research in FutureGEN.

We will build on findings from WPs1-3, the qualitative study, and foresight on future inequalities to draw policy recommendations to help tackle gender inequalities in health and care-giving/receiving and to achieve SDG3 (ensure healthy lives and promote well-being for all at all ages) and SDG5 (achieve gender equality and empower all women and girls). Findings generated in this WP will be important for future research on the intersectionality of ageing, sex/gender and health.