Document Type : Research Article


1 Department of Psychiatry, University of Michigan, Ann Arbor, MI

2 Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan


Objectives: This study compared 15 countries for multiplicative effects of gender by education and by income on self-rated health of individuals with chronic medical conditions.
Methods: We analyzed data from the Research on Early Life and Aging Trends and Effects (RELATE) Study. Participants were sampled from 15 countries including Argentina, Barbados, Brazil, Chile, Cuba, Costa Rica, China, India, Ghana, Russia, Puerto Rico, South Africa, Mexico, Uruguay, and the United States. The analytical sample was limited to individuals with at least one chronic medical condition. The main outcome of interest was self-rated health (SRH). Country-specific logistic regressions were used for data analysis. We ran separate models with gender × education and gender × income interactions.
Results: In Ghana, Uruguay, and India, gender moderated the effects of socioeconomic status (SES) on SRH. In Ghana and Uruguay, education and in Mexico and India, income had a stronger effect on SRH for women than men.
Conclusions: Countries vary in gender differences in vulnerability to SES indicators on SRH of patients with chronic medical conditions. Women are more vulnerable than men to the effect of low SES on SRH in Ghana, Uruguay, Mexico, and India.