In this chapter, we present evidence that illustrates how a country's decisions about social provisions and safety nets, as well as other governmental actions at the national level of policymaking, can contribute to differences in men's and women's opportunities and choices in ways that ultimately affect their health. To elaborate the model of constrained choice described in Chapter 2 (Figure 2.2), we consider a wide range of national policies and regulations that can, and do, directly or indirectly affect individual health either by differentially limiting or broadening men's and women's options or by affecting other aspects of their lives in ways that shape perceptions of their expectations, priorities, and needs. Such policies also affect the organization and quality of men's and women's lives by establishing universal regulations that often deliberately encourage or discourage individual and family choices. Examples include laws and regulations regarding marriage and parental rights, antidiscrimination ordinances, employment equity/workplace regulations, and reproductive rights, among others. Less obvious examples might include tax benefit policies, occupational safety regulations, land use planning, or immigration and defense policies.

Some public policies are intended to directly regulate individual behavior and protect the public's health by stipulating who, where, and how much one can consume alcohol, drive, use tobacco products, or own firearms; other policies indirectly discourage potentially deleterious behaviors by limiting access to tobacco and alcohol through hefty “sin” taxes on these products. Such policies are not our primary focus nor are those that are directly related to the provision of health care.