The Spatial Distribution of Women’s Health

Abstract

Understanding the distribution of women's health in contexts of inequality is crucial for the definition of equitable strategies aimed to improve female's well-being. Among the wide set of indicators of women's health, self-perception of health and preventive practices for breast and cervical cancers are increasingly considered as key context-sensitive indicators. Given the structural social inequalities that characterize Argentina, considerable spatial and social disparities in the distribution of these three key dimensions of women's health may exist. This work aims to describe the distribution of women's self-perception of health and preventive practices for breast and cervical cancers and to analyze the socio-spatial inequalities underlying its configuration in Argentina in the years 2005, 2009 and 2013. Data on self-perception of health, mammography and Pap tests came from the 2005, 2009 and 2013 National Surveys of Risk Factors of Argentina (“Encuesta Nacional de Factores de Riesgo”), which has a cross-sectional probabilistic multistage sampling design. According to the available data, the following indicators were considered: self-perception of health as fair or poor, mammography in the last 2 years in women aged 50–70 years, and Pap tests in the last 2 years in women aged 25–65 years. Data regarding the following social indicators came from the 2010 National Census of Argentina: proportion of households with unsatisfied basic needs—UBN, proportion of population without health coverage, proportion of women aged 25 or over who are currently studying or had completed university studies, and urban population (proportion of residents in localities with more than 2,000 inhabitants). An exploratory analysis was performed in order to characterize the distribution of self-perception of health, mammography and Pap tests by the selected social indicators. For each indicator and year, choropleth maps at the provincial level were constructed. Complementarily, a set of box plots showing the distribution of main descriptive statistics were included. The results indicated that the spatial distribution of self-perception of health, mammograms and Pap tests follows a clear social gradient in Argentina. The provinces with higher proportion of poor households and of population without health coverage, as well as those with lower proportion of urban population and with lower percentage of population at the university education level are the most disadvantaged. Overall, stronger social patterning was found for both self-perception of health as fair or poor and for mammography practice by the proportion of households with UBN, proportion of population without health coverage, and of population with university studies. Less clear gradients were evidenced across the urbanization indicator. These results suggest that improving women’s self-perception of health, mammograms and Pap test in Argentina necessarily requires strategies to reduce social inequalities. Policies and programs to improve women’s health should include social and gender equity criteria.