Explaining the gender gap in health services use among Ghanaian community-dwelling older cohorts.

Although gender differences in use of health services have been documented, little is known about whether such disparities vary by marital and socioeconomic status in later life, especially in low- and middle-income countries. We examined the relation of gender to use of health care among community-dwelling older Ghanaians (N =  1200) and whether marital status and income moderated this relationship using data from the Aging, Health, Psychological Wellbeing and Health-seeking Behavior Study conducted in 2016/2017. Multivariate logistic regression modeling showed no significant gender disparities in use of health care, adjusting for covariates. However, married women were less likely to use health care than married men (adjusted Odds Ratio [aOR] = 0.324, 95% confidence interval [CI]: 0.146-0.718). Further, while married older people with higher incomes had lower odds of using health care (aOR = 0.355, 95% CI: 0.137-0.924), use of health services was greater in married women with higher incomes compared with their male counterparts (aOR = 8.695 (95% CI: 1.233-61.296). The modifying effects of marital status and income appeared substantial in explaining gender differences in use of health services in later life. These findings have implications for health policy, health promotion and quality of life of older people.