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Tang H, Li M, Zheng H, Zhang X, Liu X. Gender income differences among general practitioners with compulsory services in early career stage in underdeveloped areas: evidence from a prospective cohort study in China. HUMAN RESOURCES FOR HEALTH 2024; 22:45. [PMID: 38937757 PMCID: PMC11209954 DOI: 10.1186/s12960-024-00930-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Gender equality and the gender income gap in medicine are long-standing global problems. Although gender-related differences have been widely studied in developed countries, they remain unclear in underdeveloped regions. In 2010, China initiated a national compulsory service program (CSP) to train qualified general practitioners in rural and remote areas. This study aimed to evaluate gender income differences for early career CSP and non-CSP (NCSP) graduates in underdeveloped areas. METHODS A cohort study was conducted with 3620 CSP and NCSP graduates from four medical universities in Central and Western China. Baseline surveys and six follow-up surveys were conducted between 2015 and 2022. Incomes, including monthly mean income and proportion of performance-based income, were measured as the key outcome variables. Multivariate linear regression models were used to identify the gender income gap. RESULTS NCSP graduates had higher average monthly incomes than CSP graduates. In the seventh year after graduation, the average monthly income for NCSP graduates was 7859 CNY while was 5379 CNY for CSP graduates. After controlling for demographic characteristics, the gender monthly income gap for CSP graduates was expanded from the fourth year (3.0%) to the sixth year (5.9%) after graduation, and that for NCSP graduates was expanded from the fifth year (11.9%) to the seventh year (16.3%) after graduation. Regarding performance-based income, it was 58.9% for NCSP graduates and 45.8% for CSP graduates in the seventh year after graduation. After controlling for performance-based income proportion, the gender income gap was reduced from 5.9 to 4.0% in the sixth year after graduation for CSP graduates, and from 16.3 to 14.4% for NCSP graduates in the seventh year after graduation. CONCLUSION An extensive and ever-increasing gender income gap exists among young doctors in the early stages of their careers in underdeveloped areas of China. The high proportion of performance-based income among men is one of the main explanations for the observed difference. A more explicit compensation system must be established to enhance support for female health workers.
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Affiliation(s)
- Haoqing Tang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Mingyue Li
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Huixian Zheng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Xiaotian Zhang
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Xiaoyun Liu
- China Center for Health Development Studies, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China.
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Ruggeri K, Tutuska OS, Ladini GAR, Al-Zahli N, Alexander N, Andersen MH, Bibilouri K, Chen J, Doubravová B, Dugué T, Durrani AA, Dutra N, Farrokhnia RA, Folke T, Ge S, Gomes C, Gracheva A, Grilc N, Gürol DM, Heidenry Z, Hu C, Krasner R, Levin R, Li J, Messenger AME, Nilsson F, Oberschulte JM, Obi T, Pan A, Park SY, Pelica S, Pyrkowski M, Rabanal K, Ranc P, Recek ŽM, Pascu DS, Symeonidou A, Vdovic M, Yuan Q, Garcia-Garzon E, Ashcroft-Jones S. The psychology and policy of overcoming economic inequality. Behav Brain Sci 2023; 46:e174. [PMID: 37646271 DOI: 10.1017/s0140525x23001103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Recent arguments claim that behavioral science has focused - to its detriment - on the individual over the system when construing behavioral interventions. In this commentary, we argue that tackling economic inequality using both framings in tandem is invaluable. By studying individuals who have overcome inequality, "positive deviants," and the system limitations they navigate, we offer potentially greater policy solutions.
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Affiliation(s)
- Kai Ruggeri
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA ; https://www.publichealth.columbia.edu/people/our-faculty/dr2946
- Policy Research Group, Centre for Business Research, Judge Business School, University of Cambridge, Cambridge, UK
| | | | | | - Narjes Al-Zahli
- Department of Computer Science, Columbia University, New York, NY, USA
- Department of Psychology, Columbia University, New York, NY, USA
| | - Natalia Alexander
- Department of Conflict Resolution, Columbia University, New York, NY, USA
| | - Mathias Houe Andersen
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | | | - Jennifer Chen
- Department of Economics, Columbia University, New York, NY, USA
| | - Barbora Doubravová
- Department of Psychology, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Tatianna Dugué
- Department of Psychology, Columbia University, New York, NY, USA
| | - Aleena Asfa Durrani
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA ; https://www.publichealth.columbia.edu/people/our-faculty/dr2946
| | - Nicholas Dutra
- Department of Psychology, Columbia University, New York, NY, USA
| | | | - Tomas Folke
- Policy Research Group, Centre for Business Research, Judge Business School, University of Cambridge, Cambridge, UK
| | - Suwen Ge
- Columbia University Business School, New York, NY, USA
| | - Christian Gomes
- Department of Psychology, Columbia University, New York, NY, USA
| | - Aleksandra Gracheva
- Department of Political Science, Columbia University, New York, NY, USA
- Department of Political Science, Paris Institute of Political Studies (Sciences Po), Paris, France
| | - Neža Grilc
- Department of Life Sciences, University of Roehampton, London, UK
| | | | - Zoe Heidenry
- Department of Psychology, Columbia University, New York, NY, USA
| | - Clara Hu
- Department of Psychology, Columbia University, New York, NY, USA
| | - Rachel Krasner
- Department of Psychology, Columbia University, New York, NY, USA
| | - Romy Levin
- Department of Psychology, Columbia University, New York, NY, USA
| | - Justine Li
- Department of Biological Sciences, Columbia University, New York, NY, USA
| | | | - Fredrik Nilsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Solna, Stockholm, Sweden
| | | | - Takashi Obi
- Department of Public Administration, School of International and Public Affairs, Columbia University, New York, NY, USA
| | - Anastasia Pan
- Department of Psychology, Columbia University, New York, NY, USA
| | - Sun Young Park
- Department of Psychology, Columbia University, New York, NY, USA
| | - Sofia Pelica
- Psicologia Social e das Organizações, Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | | | | | - Pika Ranc
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
| | - Žiga Mekiš Recek
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
| | - Daria Stefania Pascu
- Department of Developmental Psychology and Socialisation, University of Padua, Padua, Italy
| | | | - Milica Vdovic
- Department of Psychology, Faculty of Media and Communications, Singidunum University, Belgrade, Serbia
| | - Qihang Yuan
- Department of Psychology, Columbia University, New York, NY, USA
| | - Eduardo Garcia-Garzon
- School of Education and Health Sciences, Universidad Camilo José Cela, Madrid, Spain
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Gupta N, Balcom SA, Singh P. Gender composition and wage gaps in the Canadian health policy research workforce in comparative perspective. HUMAN RESOURCES FOR HEALTH 2022; 20:78. [PMID: 36344985 PMCID: PMC9639301 DOI: 10.1186/s12960-022-00774-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Gendered challenges have been shown to persist among health practitioners in countries at all levels of development. Less is known about non-clinical professionals, that is, those who do not deliver services directly but are essential to health systems performance, such as health policy researchers. This national observational study examined gender occupational segregation and wage gaps in the Canadian health policy research workforce using a cross-domain comparative labour market analysis approach. METHODS Sourcing data from the 2016 population census, we applied linear regression and Oaxaca-Blinder decomposition techniques to assess wage differentials by sex, traditional human capital measures (e.g., age, education, place of work), and social identity variables intersecting with gender (household head, childcare, migrant status) among health policy researchers aged 25-54. We compared the gender composition and wage gap with seven non-health policy and programme domains, as mapped under the national occupational classification by similarity in the types of work performed. RESULTS The health policy research workforce (N = 19 955) was characterized by gender segregation: 74% women, compared with 58% women among non-health policy research occupations (N = 102 555). Women health policy researchers earned on average 4.8% (95% CI 1.5‒8.0%) less than men after adjusting for other professional and personal variables. This gap was wider than among education policy researchers with similar gender composition (75% women; adjusted wage gap of 2.6%). Wages among health policy researchers were 21.1% (95% CI 19.4‒22.8%) lower than their counterparts in the male-dominated economics policy domain, all else being equal. Overall, women's earnings averaged 3.2% lower than men's due to factors that remained unexplained by policy domain or other measured predictors. CONCLUSIONS This investigation found that the gender inequalities already widely seen among clinical practitioners are replicated among health policy researchers, potentially hindering the competitiveness of the health sector for attracting and retaining talent. Our findings suggest intersectoral actions are necessary to tackle wage gaps and devaluation of female-dominated health professions. Accountability for gender equity in health must extend to the professionals tasked with conducting equity-informative health policy research.
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Affiliation(s)
- Neeru Gupta
- Department of Sociology, University of New Brunswick, PO Box 4400, Fredericton, NB, E3B 5A3, Canada.
| | - Sarah Ann Balcom
- Faculty of Nursing, University of New Brunswick, Fredericton, Canada
| | - Paramdeep Singh
- Institute for Research, Data and Training (IRDT), University of New Brunswick, Fredericton, Canada
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He F, Wu Y, Yang J, Chen K, Xie J, Tuersun Y, Li L, Wu F, Kan Y, Deng Y, Zhao L, Chen J, Sun X, Liao S, Chen J. Chinese adult segmentation according to health skills and analysis of their use for smart home: a cross-sectional national survey. BMC Health Serv Res 2022; 22:760. [PMID: 35689205 PMCID: PMC9184334 DOI: 10.1186/s12913-022-08126-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background Digital health has become a heated topic today and smart homes have received much attention as an important area of digital health. Smart home is a device that enables automation and remote control in a home environment via the internet. However, most of the existing studies have focused on discussing the impact of smart home on people. Only few studies have focused on relationship between health skills and use of smart home. Aims To analyze the health skills of Chinese adults and segment them to compare and analyze the use of smart home for each group. Methods We used data from 11,031 participants aged 18 and above. The population was clustered based on five health skills factors: perceived social support, family health, health literacy, media use, and chronic diseases self-behavioral management. A total of 23 smart homes were categorized into three sub-categories based on their functions: entertainment smart home, functional smart home, and health smart home. We analyzed demographic characteristics and utilization rate of smart home across different cluster. Each groups’ features and the differences in their needs for smart home functions were compared and analyzed. Results As a result of the survey on health skills, three groups with different characteristics were clustered: good health skills, middle health skills, and poor health skills. The utilization rate of smart home was the highest was good health skills group (total smart home: 92.7%; entertainment smart home: 61.1%, functional smart home: 77.4%, and health smart home: 75.3%; P < 0.001). For entertainment smart home, smart TV had the highest utilization rate (good health skills: 45.7%; middle health skills: 43.5%, poor health skills: 33.4%, P < 0.001). For functional smart home, smart washing machine (good health skills: 37.7%, middle health skills: 35.11%, poor health skills: 26.5%; P < 0.001) and smart air conditioner (good health skills: 36.0%, middle health skills: 29.1%, poor health skills: 24.6%) were higher than other of this category. For health smart home, sports bracelet has the highest utilization rate (good health skills: 37.3%, middle health skills: 24.5%, poor health skills: 22.8%). Conclusion People can be divided into different categories based on health skill profiles, those with good health skills had a better utilization rate of smart home. The government and smart home companies need to focus on people with poor smart home use in various ways to promote their use of smart homes for personal health management. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08126-8.
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Affiliation(s)
- Feiying He
- Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Yibo Wu
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing City, China
| | - Jiao Yang
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Keer Chen
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Jingyu Xie
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Yusupujiang Tuersun
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Lehuan Li
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Fangjing Wu
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Yifan Kan
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Yuqian Deng
- Xiangya School of Nursing, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, China
| | - Liping Zhao
- The Second Xiangya Hospital, Central South University, No.139 Renmin Road, Changsha City, Hunan Province, China
| | - Jingxi Chen
- School of Languages and Communication Studies of Beijing Jiaotong University, No.3 Shangyuancun, Haidian District, Beijing City, China
| | - Xinying Sun
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing City, China
| | - Shengwu Liao
- Department of Health Management, Southern Hospital of Southern Medical University, 1838 Guangzhou Avenue North, Baiyun District, Guangzhou, Guangdong, China.
| | - JiangYun Chen
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China. .,Institute of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China.
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