Research Findings: Gender: Sex differences in health and explanations for them Summary Papers

Gender differences in health:  are things really as simple as they seem?

In developed countries males tend to die earlier than females, yet females tend to report higher levels of ill health at all ages than men.  We compared data collected from all three age cohorts in the second wave of the Twenty-07 Study (i.e. at 18, 39 and 58 years) with data collected from subjects (aged 18-22, 36-40 and 56-60 years) from the Health and Lifestyles Survey (HALS) in 1984/5.  Our analysis suggests that the picture of greater female ill health for most health outcomes (the conventional wisdom in medical sociology and social epidemiology) is an oversimplification. Sex differences in health are not as clear or consistent as is often assumed.  We found that female excess is only consistently found across all ages for mental distress and is far less apparent, or indeed reversed, for a number of physical symptoms and conditions.  Following a review of other studies we suggest that female/male differences in health may have changed over time, so that whereas there was once a female excess, there is now less of one.  We highlight the importance of taking into account both the social and historical context when looking at gender differences in health. 
            
Macintyre, S., K. Hunt, et al. (1996). "Gender differences in health: are things as simple as they seem?" Social Science and Medicine 42 (4): 617-624.
pubmed

 

Do women exaggerate health problems?

Although women live longer than men in developed countries, it is frequently observed they tend to be sicker than men, in that they report higher rates of illness, disability and healthcare use.  One common explanation for this is that there are differences between male and females in terms of the way they perceive, evaluate and act upon symptoms of ill health.

This project compared men’s and women’s answers to a commonly used question about long-term illness and to a series of more specific prompts about their health, and measured severity of symptoms experienced.  A common expectation is that women report higher rates of illness and are more ready to tell us about their mental health problems.  We found no difference between the proportion of men and women reporting long-term illness in response to the initial question.  However, it was men rather than women who reported more health problems when prompted, and we found that women were no more likely than men to mention ‘minor’ health problems or mental health problems.

Macintyre, S., G. Ford, et al. (1999). "Do women 'over report' morbidity? Men's and women's responses to structural prompting on a standard question on long standing illness." Social Science and Medicine 48 (1): 89-98.
 


Are women more likely to consult their GP than men?

Some research evidence suggests that when consultations for all health reasons are combined, women are seen to consult their GP more than men through most of adult life.  It is, therefore, often assumed that women are more likely to consult for every condition.

Examining information from the 1950s and 1930s cohorts from the Twenty-07 Study we wanted to find out if women consult a GP more than men according to the underlying condition and symptoms experienced.  We took detailed information about current long-term conditions and experience of the amount of pain, severity of pain, limitation to normal activities and restricted activities among participants in the previous four weeks. 

In general, we found that women were no more likely than men to consult a GP when experiencing five of the most common conditions – musculoskeletal, respiratory, and digestive, heart and mental health problems.  Additionally, women were no more likely than men to consult their GP at a given level of severity for any type of condition, except for mental health.  Some aspect of mental health problems may therefore be more gender-specific than other conditions.  The result of this study therefore does not support the common view that women are more likely to over-rate or over-react to symptoms once recognised.

Hunt, K., G. Ford, et al. (1999). "Are women more ready to consult than men? Gender differences in general practitioner consultation for common chronic conditions." Journal of Health Services Research and Policy 4(2): 96-100
pubmed

Wyke, S., K. Hunt, et al. (1998). "Gender differences in consulting a general practitioner for common symptoms of minor illness." Social Science and Medicine 46: 901-906.
pubmed

Wyke, S., K. Hunt, et al. (1995). "Consulting the general practitioner for symptoms of minor illness: why are women more likely to consult?" Journal of Epidemiology and Community Health 49: 546.

 

Gap in gender-related experiences and health between women in early and late mid-life

This study shows that even within the same geographical area, over a relatively short period of time, there have been substantial differences in indicators of gender-related attitudes, experiences and health in two cohorts of women born just 20 years apart (early 1930s aged 55 and early 1950s aged 35). 

The Twenty-07 study found diversity in experiences for the two cohorts.  Compared to women born in the 1930s, women born in the 1950s got married and had their first child at an earlier age; appeared to express less traditional views about gender roles; and experienced better living standards over time, such as having an inside toilet, fixed hot water supply and bath or shower.  Factors that may have affected mental health in childhood such as happiness and quality of life at school did not appear to differ between the two samples.  In general, we found that the relationship between ‘masculinity’ and ‘femininity’ scores (as a measure of gender role orientation) and health were weak, but did differ between the two cohorts. This research suggests the importance of taking more account of the broader social, historical and political context when researching the relationship between gender and health.

Hunt, K. (2002). "A generation apart? An examination of changes in gender-related experiences and health in women in early and late mid-life." Social Science and Medicine 54: 663-676.
pubmed   open access