Are There Gender Differences in the Capability to Use Facilities of Health Care? A Multilevel Analysis of 22 Countries

Abstract Purpose Previous research shows differences between women and men in utilization of facilities of health care (FHC) across the general population in a number of countries. In this chapter, we focus on the capability to use FHC, because it refers to an individual freedom to choose between alternative FHC directed to restore or to improve own health in situations of health needs. Based on several empirical studies and on the insights of the capability approach, we propose that there are cross-national differences between women and men in the capability to use FHC, and that these differences are due to gender differences in the extent of educational skills, and due to differences in the extensiveness of social security policies across countries. The objective of this study was to question these propositions. Methodology/approach We tested the hypotheses using the data from the European Social Survey (in a sample of 38,992 respondents from 22 countries) which we analyzed performing multilevel analyses. Findings The findings show that in Central, North, West, and East European countries, women have more capabilities to use FHC than men. They suggest that the low-skilled women in Central, North, and West European countries have higher level of the capability to use FHC than women with more educational skills. Research limitations/implications The findings do not specify which particular social program or policy is more effective in enhancing women’s capability to use FHC. Originality/value This chapter focuses on women’s freedom or the capability to use FHC.