Gender Differences in Healthcare Utilisation: Causal Evidence from Unexpected Adverse Health Shocks

Abstract

Women live longer than men yet report worse health. One common reading of this male-female health-survival paradox is that women also engage more with healthcare. We challenge that reading with causal evidence from the plausibly random timing of first-time non-fatal heart attacks and strokes in Danish administrative data. After such a shock, men increase their statin use and their general-practitioner visits substantially more than women. We find no evidence that the gap reflects a lower willingness among women to seek or take up care: men and women fill the same number of prescriptions, but women receive lower doses per fill, and the gap widens across drug classes where physicians have more discretion over what to prescribe. This points to provider behaviour rather than patient demand. Despite the additional treatment, men fare no better than women on mortality or morbidity, or on the labour-market outcomes we can measure. Given women's general survival advantage, this suggests women might have fared even better had they been treated as intensively as men. The gap arises even within a universal healthcare system and a country with comparatively low gender inequality, so removing barriers to access is not by itself sufficient to close it.