Health gender gap in Uganda: Do weather effects and water play a role?

Background: Vulnerability of men and women to adverse health effects of weather variability and climate change is not equal. Mainly because of differences in access to opportunities and resources, risk exposures and sensitivity. This article analyses the effect of weather variability on illness, and the extent to which water collection ‘time burden’ mediates the relationship between weather anomalies and illness among men and women of the working age. Moreover, gender differential factors explaining the health gender gap are investigated, and health inequalities to be eliminated if resources are equalized quantified. Methods: Socioeconomic, health and time use data for individuals was obtained from the World Bank Living Standards Measurement Studies - Integrated Surveys on Agriculture (LSMS –ISA), combined with objective weather data. Two-parts and non-linear decomposition regression analysis were used on a national representative dataset from 2009 to 2014, comprising a total of 22,469 men and women aged between 15-64 years. Results: The prevalence of illness, days of illness and work days lost was higher in women than in men. Empirical results show that low rainfall below the long-term mean increased the likelihood of illness and work days lost significantly by at least 8 and 6 percentage points in women and men respectively. The indirect effect of low rainfall and increased temperature on illness through water access pathway was significant and estimated at 0.12-0.15 percentage points in women, implying full mediation. Domestic rain water harvesting significantly reduced water time burdens and illness. Moreover, decomposition results reveal that health inequalities among women and men would have been narrowed by 27%-57%, if endowments were equalized. Determinants of health accounting for a substantial proportion of the gap include differences in temperature exposure, age, education, wealth, marital status and health-seeking behaviors. Conclusions: Strategies that promote women empowerment, health adaptation and time poverty reduction would enhance better health amidst the changing climatic conditions.