When Does Gender Equality Improve Health? Institutional Contexts and Gendered Life Course Trajectories

Abstract

This study investigates how gendered life course trajectories and meso-level institutional contexts jointly shape health in later life. Drawing on cumulative disadvantage and institutional moderation perspectives, I examine whether exposure to gender equality across adulthood—measured via Women’s Political Empowerment Index—conditions the health consequences of work–family trajectories differently for men and women. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) across 14 countries, I construct multichannel sequence typologies of employment and family formation histories between ages 18 and 50. These trajectories are linked to later-life self-rated health, depressive symptoms, and CASP-12 quality of life. Results show that sustained labour market exclusion is the most consistent predictor of poorer later-life health across domains. These cumulative penalties are more pronounced for men, suggesting that employment marginalisation is more tightly coupled to male role expectations and wellbeing. Greater exposure to gender-equal contexts is broadly associated with improved health for both sexes. However, institutional gender equality does not uniformly compensate for disadvantage. Benefits are concentrated among individuals with stable employment and family resources, while chronically unemployed men derive limited or no gains. Women benefit collectively, irrespective of employment or family formation trajectories. Gender equality thus amplifies existing cumulative advantages in some domains while offering broader protective effects in others. Later-life health reflects not only individual biographies, but the institutional environments that structure how advantage and disadvantage accumulate over time.

Recommended citation: Wang, W.J. (2026). When does gender equality improve health? Institutional contexts and gendered life course trajectories. Working paper.