Seclusion, decision-making power, and gender disparities in adult health: Examining hypertension in India

•Women’s seclusion is associated with higher odds of women’s hypertension.•Women’s seclusion is associated with lower odds of men’s hypertension.•Women’s low decision-making power is associated with higher odds of women’s hypertension.•Women’s seclusion is associated with a larger gender gap in hypertension.•Women’s low decision-making power is associated with a larger gender gap in hypertension.

Research on the social determinants of health in developing countries is increasingly focusing on the importance of gender. Cardiovascular conditions such as hypertension are a growing concern in developing countries, where they are now the leading cause of death. Researchers have documented differences in hypertension between men and women, but the importance of gendered practices in shaping these differences has been left unexamined. Using national data from the India Human Development Survey 2005 (N = 101,593), this study assesses the moderating role of two salient and widespread gendered practices—women’s seclusion and decision-making power—on hypertension disparities between women and men. Both seclusion and low decision-making power are associated with increased odds of hypertension for women, but in the case of seclusion reduced hypertension for men. Results also show the gender gap in hypertension is exacerbated with women’s seclusion and low decision-making power.