In this investigation, we examined the associations between state-level structural sexism—a multidimensional index of gender inequities across economic, political, and cultural domains of the gender system—and health care access and quality among women and men in the United States. We linked administrative data gauging state-level gender gaps in pay, employment, poverty, political representation, and policy protections to individual-level data on health care availability, affordability, and quality from the national Consumer Survey of Health Care Access (2014–2019; N = 24,250). Results show that higher state-level sexism is associated with greater inability to access needed health care and more barriers to affording care for women but not for men. Furthermore, contrary to our hypothesis, women residing in states with higher state-level sexism report better quality of care than women in states with lower levels of sexism. These findings implicate state-level sexism in perpetuating gender disparities in health care.

在这项调查中，我们研究了州级结构性性别歧视（性别系统的经济、政治和文化领域的性别不平等的多维指数）与美国女性和男性的医疗保健获取和质量之间的关联。我们将衡量州级性别差距在薪酬、就业、贫困、政治代表性和政策保护方面的行政数据与来自全国医疗保健获取消费者调查（2014-2019 ;N = 24,250)。结果表明，较高的州级性别歧视与更无法获得所需的医疗保健以及为女性而非男性提供医疗保健的更多障碍有关。此外，与我们的假设相反，居住在性别歧视程度较高的州的妇女报告的护理质量高于性别歧视程度较低的州的妇女。这些发现暗示州一级的性别歧视使医疗保健中的性别差异长期存在。