Gender Differences In Self-rated Health Research Articles

Decomposition and comparative analysis of health inequities between the male and female older adults in China: a national cross-sectional study

BackgroundThis study aimed to examine the factors influencing self-rated health (SRH) among Chinese older adults by gender differences and provide suggestions and theoretical references to help make policies for older adults’ health concerns by government agencies.MethodsChinese Longitudinal Health Longevity Survey (CLHLS) in 2018 was adopted, the chi-squared test and the logistic regression analysis were performed to analyse self-rated health reported by Chinese female and male older adults and its influencing factors. In addition, Fairlie decomposition analysis was performed to quantify the contribution level of different influencing factors.ResultsAmong older adults, males (48.0%) reported a significantly higher level of good self-rated health than females (42.3%). Residence, body mass index (BMI), self-reported income, smoking, drinking, exercise, and social activity were the factors that influenced SRH reported by male and female respondents, with age, marital status and education reaching the significance level only in women. The Fairlie decomposition model can explain the underlying reasons for 86.7% of the gender differences in SRH, with self-reported income (15.3%), smoking (32.7%), drinking (42.5%), exercise (17.4%), social activity (15.1%) and education (-14.6%) being the major factors affecting gender differences in SRH.ConclusionsThe study results can help promote the implementation of the Healthy China Initiative, inform intervention measures, and offer new proposals on creating policies for older adults’ health issues by the Chinese government to improve health equity.

Gender differences in the association between perceived income sufficiency and self-rated health among older adults: A population-based study in India

This study explores whether gender differences in self-rated health can be attributed to socioeconomic status and self-perceived income sufficiency in particular. We used data from the Building a Knowledge Base on Population Ageing in India (BKPAI-2011) and carried out the descriptive and bivariate analysis along with a chi-square test to explore the significance of possible associations between explanatory and outcome variables in the study. Also, sex-stratified multiple logistic regression models were employed to fulfill the study objectives. The results show that a higher percentage of older women (58.4%) reported their health as fair/poor than older men (52%). Older women reported poor self-rated health than older men with similar self-perceived income sufficiency (OR: 2.04; p < .001 vs. OR: 1.56; p < .010). All the health indicators such as suffering from higher number of chronic conditions (AOR: 3.70; p < .001 vs. AOR: 2.73; p < .001) and disability (AOR: 3.79; p < .001 vs. AOR: 3.33; p < .001) increased odds of rating of poor health among older women than men, except having two plus difficulty in activities of daily living (ADL), which was positively associated with reporting poor health among men than women (OR: 4.03; p < .001 vs. OR: 2.36; p < .001). The study highlights the gender differences in self-rating of health associated with subjective income status and other socioeconomic and health-related variables that are important while framing social policies for the Indian graying population.

Is the story about sensitive women and stoical men true? Gender differences in health after adjustment for reporting behavior

Research indicates that women have higher levels of physical disability and depression and lower scores on physical performance tests compared to men, while the evidence for gender differences in self-rated health is equivocal. Scholars note that these patterns may be related to women over-reporting and men under-reporting health problems, but gender differences in reporting behaviors have not been rigorously tested. Using Wave 1 of the Survey of Health, Ageing and Retirement in Europe (SHARE), the present study investigates the extent to which adjusting for differences in reporting behavior modifies gender differences in general health. We also examine whether men and women's reporting behaviors are consistent across different levels of education. After adjusting for reporting heterogeneity, gender differences in both poor and good health widened. However, we found no clear gender-specific patterns in reporting either poor or good health. Our findings also do not provide convincing evidence that education is an important determinant of general health reporting, although the female disadvantage in poor health and the male advantage in good health were more apparent in lower than higher education groups at all ages. The results challenge prevailing stereotypes that women over-report and men under-report health problems and highlight the importance of attending to health problems reported by women and men with equal care.

Trends in Gender Differences in Self-Rated Health in Korea: Evidence from the Korean National Health and Nutrition Examination Survey, 2001-2012

Despite rapid economic growth during the last half of the twentieth century, gender inequality has remained high in Korea. Using data from the 2001 Korean National Health and Nutrition Examination Survey (KNHANES), previous research found that gender differences in sociostructural and psychosocial factors contributed to a substantial female excess in poor self-rated health. To the extent that women’s overall social status relative to men has improved over time in Korea, it is possible that the gender gap in perceived health has decreased. This study used repeated cross-sectional KNHANES data from 2001-2012 to examine temporal trends in gender differences in self-rated health. In age-adjusted models, we found no significant trend in the female excess of poor self-rated health among respondents aged 25-44 (p=0.685). In contrast, we found a statistically significant downward trend among those aged 45-64 (p&lt;0.001). In fully adjusted models controlling for age and behavioral, sociostructural, and psychosocial covariates, we found a marginally significant upward trend (p=0.08) among younger respondents, while the downward trend among older respondents remained significant (p&lt;0.001). More work is needed to determine why gendered health disparities decreased among older adults in Korea but not among those aged 25-44.

Comparison of Pre-Operative Endoscopic Retrograde Cholangiopancreatography Followed by Laparoscopic Cholecystectomy and Laparoscopic Cholecystectomy with Intraoperative Cholangiography in Acute Biliary Pancreatitis

Despite rapid economic growth during the last half of the twentieth century, gender inequality has remained high in Korea. Using data from the 2001 Korean National Health and Nutrition Examination Survey (KNHANES), previous research found that gender differences in sociostructural and psychosocial factors contributed to a substantial female excess in poor self-rated health. To the extent that women’s overall social status relative to men has improved over time in Korea, it is possible that the gender gap in perceived health has decreased. This study used repeated cross-sectional KNHANES data from 2001-2012 to examine temporal trends in gender differences in self-rated health. In age-adjusted models, we found no significant trend in the female excess of poor self-rated health among respondents aged 25-44 (p=0.685). In contrast, we found a statistically significant downward trend among those aged 45-64 (p&lt;0.001). In fully adjusted models controlling for age and behavioral, sociostructural, and psychosocial covariates, we found a marginally significant upward trend (p=0.08) among younger respondents, while the downward trend among older respondents remained significant (p&lt;0.001). More work is needed to determine why gendered health disparities decreased among older adults in Korea but not among those aged 25-44.

Gender differences in self-rated health and their determinants in Turkey: A further analysis of Turkish health survey

Objective: This study analysed gender differences in self rated health status and their determinants by gender in Turkey. Methods: This is a further analysis of a 2010 Health Survey conducted by Turkish Statistical Institute (TurkStat) A total of 5488 men and 7149 women in Turkey were included in this cross-sectional study. Self-rated health was analysed using three logistic regression models. Results: The rates of poor health were 9.8% among women and 5.2% among men, with the gender gap increasing with age. Low level of education, chronic diseases and poverty were associated with poor perceived health in both genders. For women, marriage and retirement from secure jobs were associated with good health; obesity and smoking were factors that caused poor health. For men, unemployment had a negative impact on health. Conclusion: The determinants of poor health were associated with not only on socioeconomic status but also on gender in the Turkey. Marriage may provide social protection for women where there are insufficient social policies to protect them

Re-evaluating gender differences in self-rated health: The importance of cohort

ABSTRACT Research examining gender differences in self-rated health (SRH) has typically not distinguished between age and cohort-related changes in the health of men and women over time. Using longitudinal data from the Panel Study of Income Dynamics, this study finds gender diffegrences in SRH may actually be an artifact of cohort. Prior to examining health across cohorts, women reported worse health than men. With the introduction of cohort to the models, no gender difference was found except in the earliest cohort (born 1924–1933). Historical context is therefore critical to understanding the health trajectories of women and men, which are not uniform across cohorts.

Gender Differences in Self-Rated Health among University Students in England, Wales and Northern Ireland: Do Confounding Variables Matter?

&lt;p&gt;&lt;strong&gt;INTRODUCTION:&lt;/strong&gt; We assessed gender differences in self-rated health (SRH) while considering physical health, health complaints, health service use, wider wellbeing, and health behaviours.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;METHODS:&lt;/strong&gt; 3706 undergraduates at 7 Universities in the United Kingdom completed a self-administered questionnaire (2009–2008). Logistic regressions with excellent/very good SRH as dependent variable assessed the variables that explained the SRH sex difference. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;RESULTS:&lt;/strong&gt; Females had more health complaints, illness periods, lower quality of life, more burdens, and took medication/s more often. The crude (unadjusted) odds ratio (OR) proposed that females were less likely to report excellent/very good SRH than males [OR 0.79, 95% CI 0.68-0.94]. Adjusting only for physical health and health service use, females’ OR increased considerably, and the association between female sex and SRH was no longer significant. Also, when adjusting only for wider well-being or when adjusting only for health behaviour, the negative association between females and SRH was no longer significant. Adjusting for all the variables simultaneously (physical health, health service use, wider well-being, health behaviours) resulted in considerable increase of females’ OR indicating now a positive association between female sex and SRH [OR 1.33, 95% CI 1.04-1.74]. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;CONCLUSION:&lt;/strong&gt; Females’ lower SRH found in the crude analyses was confounded by their higher stress level, lower quality of life, lower physical activity and by more illnesses or health complaints when compared with males. Gender-related SRH research should control for many potential confounders to prevent overestimation of the gender effect. Health promotion programs should consider these factors when tackling gender health disparities.&lt;/p&gt;

Women's relative immunity to the socio-economic health gradient: artifact or real?

BackgroundIndividual and area socio-economic status (SES) are significant predictors of morbidity and mortality in developed and developing countries. However, the span in health from poorest to richest, that is, the socio-economic gradient, appears steeper for men than women.ObjectiveOur aim is to understand women's apparent immunity to the health harms of the SES gradient.DesignFindings from a non-systematic search of Medline for population-based, SES gradient studies reporting results for both men and women and with health outcomes of morbidity, mortality or self-rated health (SRH) were reflectively analyzed.ResultsThe 36 papers reviewed generally showed women to be relatively immune to the SES gradient for all but cardiovascular health outcomes. However, addressing the interconnected nature of socio-economic circumstances, exploring whether some measures of SES had ambiguous meanings for either women or men, including modifiers of SES such as household circumstances, social capital or area gender equity, or using indicators of area SES that were contextual rather than aggregates of individual, compositional measures increased the SES gradient for women. Outcome measures that combined mental and physical health, accounted for gender differences in SRH and adjusted for sex-specific differences in causes of mortality also explained some of the observed amelioration of the SES gradient among women.ConclusionsSocio-economic circumstances have a real and sustained impact on individual health. The SES gradient appears stronger for men than for women for all health outcomes other than heart disease. However, some of the observed variability between men and women may be an artifact of biased methodology. Considering webs of causation rather than individual markers of SES along with other sources of gender bias can explain much of women's blunted socio-economic gradient and deepen understanding of the pathways from SES to morbidity and mortality overall.

Effect of Cardiac Rehabilitation in Patients with ICD: Are Gender Differences Present? Results from the COPE‐ICD Trial

The COPE-ICD (Copenhagen Outpatient ProgrammE-implantable cardioverter defibrillator) trial studied comprehensive cardiac rehabilitation for patients with ICDs. The purpose of this paper was to explore: (1) gender differences in self-rated health and quality of life (QoL) at hospital discharge after ICD implantation, (2) gender differences in effect of cardiac rehabilitation, and (3) predictors of effect of cardiac rehabilitation. Patients with first-time ICD implantation were randomized to comprehensive cardiac rehabilitation versus usual care. Gender differences in self-rated health and QoL and effect of rehabilitation were tested using t-tests. Predictors of effect of rehabilitation were tested using logistic regression. A total of 196 patients (mean age 58 ± 13 years; 155 men, 41 women) were included. At hospital discharge, significant differences were found in physical component scale, mental component scale, social functioning, physical functioning, bodily pain, vitality, mental health, and QoL with men having higher scores. Among men only, significant differences were found in VO2 (rehabilitation: 20.9 mL/min/kg [standard deviation (SD) 8.1] vs 23.4 mL/min/kg [SD 9.5] and usual care: 22.1 mL/min/kg [SD 8.1] vs 21.8 mL/min/kg [SD 8.3], P = 0.01), total exercise time (rehabilitation: 587.0 seconds [SD 249.6] vs 650.7 seconds [SD 279.8] and usual care: 613.8 seconds [SD 264.7] vs 606.1 seconds [SD 277.3], P = 0.01), and the mental component scale (rehabilitation: 47.7 points [SD 10.1] vs 54.8 points [7.1] and usual care: 48.1 points [SD 10.9] vs 51.9 points [SD 9.6], P = 0.05). After ICD implantation, significant gender differences were found in physical health, mental health, and QoL. Effects of rehabilitation were found among men only and gender predicted effect of rehabilitation on the mental component scale.

Gender Differences in Trajectories of Self-Rated Health in Middle and Old Age

This research examined gender differences in self-rated health (SRH) using the differential exposure and differential vulnerability explanations of gender differences in health. Trajectories of SRH were estimated using data that spanned 12 years (1992-2004) from the Health and Retirement Study. There was no gender difference in SRH at baseline, but SRH declined faster for males over time. Factors that mediated the gender difference included changes in employment status, smoking behavior, and the onset of health conditions. Moreover, were it not for gender differences in various structural and health status factors, females would have better SRH at baseline and over time. Our results differ from previous research, which often shows a female disadvantage that is reduced or disappears at older ages. Furthermore, gender differences in the predictors of SRH (exposure) contribute more to understanding gender differences in SRH than different responses to the predictors (vulnerability).

Determinants of Gender Differences in Self-Rated Health Among Older Population

The purpose of this study is to examine gender difference in self-rated health among older population in India. Data from the 60th round of National Sample Survey Organization on 34,831 older persons are used. The present study measured self-rated health categorized as “poor” and “good.” We used bivariate and binary logistic regression model to investigate differences and factors that best explain and predict the self-rated health among older persons. Results show that poor self-rated health was more common among women than men. Furthermore, the poor self-rated health was higher among Muslims, Scheduled Castes, and women residing in rural areas. Findings suggest a clear need for gender-sensitive health interventions.

Gender and Physical Health

Although gender disparities in health in the United States remain a primary concern among health professionals, less is known about this phenomenon within the black American population. Using the National Survey of American Life, the author examines gender differences in self-rated health, chronic illness, and functional limitations among African Americans (n = 3,330) and Caribbean blacks (n = 1,562) and the extent to which the availability of resources explains these differences. The results reveal a consistent disadvantage among African American women across indicators of health. The gender-health relationship among Caribbean blacks is somewhat weaker, but there is a health disadvantage for immigrant women and U.S.-born Caribbean men when certain resources are taken into account. These findings illustrate the importance of the intersections of race, ethnicity, and nativity in our understanding of gender differences in health.

Gender Differences in Self-Rated Health and Mortality Association: Role of Pain-inducing Musculoskeletal Disorders

We aimed to examine whether pain-inducing musculoskeletal disorders might explain the gender difference in the strength of the self-rated health (SRH)-mortality association. We pooled data from two National Health and Nutrition Examination Surveys (conducted in 1998 and 2001), which were linked to national mortality data of Korea using 13-digit unique personal identification numbers. There were 9,912 study participants, and 456 deaths were recorded (average length of follow-up = 5.7 years). Using a checklist of chronic conditions, the prevalences of major pain-causing musculoskeletal disorders (arthritis, sciatica, and herniated intervertebral disc) were obtained. The relative risk (RR) of mortality for the poor and very poor categories of SRH tended to be greater in men than in women. Compared with those without musculoskeletal disorders, the RR for those with musculoskeletal disorders was similar in men but lower in women. Women had a greater prevalence of musculoskeletal disorders than men, and women with musculoskeletal disorders reported poorer health than did men with these disorders. In individuals without major musculoskeletal disorders, the strength of the SRH-mortality association was reduced in men but increased in women. Similar patterns in RRs for SRH by gender were observed when sociodemographic characteristics (education and marital status), number of severe chronic illnesses, and health behaviors (cigarette smoking, alcohol consumption, and regular physical exercise) were additionally adjusted for. Nonfatal musculoskeletal disorders may explain gender differences in the SRH-mortality association. Larger prospective studies in different cultural settings may help advance our understanding of the role of pain and pain-inducing musculoskeletal disorders in explaining gender differences in the SRH-mortality association.

Gender differences in self-rated health, quality of life, quality of care, and metabolic control in patients with diabetes

Because the projected increase in the number of diabetic patients is expected to strain the capabilities of health care providers worldwide, we are challenged to find ways of reducing the burden of diabetes. Maintaining and improving health-related quality of life (QoL) for diabetic patients may be viewed as public health goals. The aim of this cross-sectional study was to compare different aspects of health, QoL, and quality of care (QoC) between men and women with diabetes as a basis for planning and managing diabees care. All patients in 2 age groups (aged 20-30 years [younger age group] and aged 50-60 years [middle-aged group]) who were registered with the Department of Endocrinology, Metabolism, and Diabetes at Karolinska University Hospital, Stockholm, Sweden, in October 2004, were recruited for a survey. Questions were included about self-rated health (SRH), QoL, QoC, diabetes-related worries, occupational status, physical activity level, living arrangements, and educational background. Glycosylated hemoglobin (HbA1c) values were obtained from medical records. Of the 223 eligible patients (109 men, 114 women) in the younger age group, 49 men and 74 women responded to the questionnaire; of the 300 eligible patients (170 men, 130 women) in the middle-aged group, 120 men and 93 women responded. Middle-aged women rated their mental well-being and QoL as worse compared with men (P < 0.001 and P < 0.05, respectively). In both age groups, women reported more diabetes-related worries and less ability to cope (P < 0.05 for the younger age group and P < 0.001 for the middle-aged group for both variables), thus the differences were more marked for middleaged women. Although there were no gender differences in metabolic control, middle-aged women reported less satisfaction with diabetes care (P < 0.001). Higher HbA1c was related to worse SRH in both men and women when analyzing the age groups together (P < 0.05). This association was most prominent in young women, in whom having more diabetes-related worries was also related to higher HbA1c (P < 0.01). In this study, women with diabetes appeared to have worse QoL and mental well-being compared with men with diabetes. Therefore, identifying strategies to improve SRH and QoL among diabetic patients, especially among women, is of great importance.

Influence of socioeconomic status, wealth and financial empowerment on gender differences in health and healthcare utilization in later life: evidence from India

Empirical studies from developed countries observe that women report worse health and higher healthcare utilization than men, but the health disadvantage diminishes with age; gender differences in self-rated health often vanish or are reversed in older ages. Comparable assessments of health during later life from developing countries are limited because of the lack of large-scale surveys that include older women. Our study attempts to address the shortage of developing country studies by examining gender differences in health and healthcare utilization among older adults in India. Both ordered and binary logit specifications were used to assess significant gender differences in subjective and objective health, and healthcare utilization after controlling for demographics, medical conditions, traditional indicators of socioeconomic status like education and income, and additional wealth indicators. The wealth indicators, measured by property ownership and economic independence, are regarded as financially empowering older adults to exercise greater control over their health and well-being. Data are drawn from a nationally representative decennial socioeconomic and health survey of 120,942 Indian households conducted during 1995–1996. The study sample comprises 34,086 older men and women aged ≥60 years. Our results indicate that older women report worse self-rated health, higher prevalence of disabilities, marginally lower chronic conditions, and lower healthcare utilization than men. The health disadvantage and lower utilization among women cannot be explained by demographics and the differential distribution of medical conditions. While successive controls for education, income, and property ownership narrows the gender gap in both health and healthcare utilization, significant differentials still persist. Upon controlling for economic independence, gender differentials disappear or are reversed, with older women having equal or better health than otherwise similar men. Financial empowerment might confer older women the health advantage reflected in developed societies by enhancing a woman's ability to undertake primary and secondary prevention during the life course.

Discussion: Gender Differences in Self-Rated Health, in Mortality, and in the Relationship Between the Two

The set of articles making up this special section were all driven by the authors’ interest in self-ratings of health and these ratings’ potential for indicating risk for mortality. Studies of this association began to appear in the mid 1980s, and in a relatively short time, dozens had been published, primarily in North America, Europe, and Asia. There was a consistent finding, with few exceptions, that respondents to health surveys who rated their health as ‘‘poor,’’ ‘‘fair,’’ or sometimes just ‘‘good’’ had a significantly higher risk of mortality than those who considered their health ‘‘excellent’’ or the equivalent, even when other measures of health were considered. In some of these studies, the effects were similar for men and women; in others, there were differences. Contributors to this special section have chosen to look at their data with an eye to the differences and with the hope that an analysis of the differences may help reseachers better understand the similarities. Should one expect a gender difference? For multiple reasons, beginning with the dependent variable (mortality), the answer would be yes. Life expectancy is greater for women in virtually every country on earth, at birth and at every other age. It is certainly true for all of the countries for which there are published reports of self-rated health–mortality analyses (Benyamini & Idler, 1999; Idler & Benyamini, 1997). As a result, the age-adjusted risk of mortality in these samples will be lower for the women than for the men, and the number of deaths among women will be proportionately fewer given the number of women in the sample. Another consequence of gender differentials in mortality risk is that (unless sampling weights are used) the number of women in a representative sample will be larger, providing more statistical power and reducing the possibility of Type II errors in subsamples of women compared with subsamples

Self-rated health and self-assessed change in health in elderly men and women — A five-year longitudinal study

The purpose of the present investigation was two fold: (1) to examine how men and women self-rate their health as they age from 75 to 80 yr and how they assess the change in their health over the five year period; and (2) to ascertain how self-assessed change in health over the follow-up period corresponded to the difference in self-ratings of health between the assessments performed at baseline and at follow-up. The study was part of the Evergreen-project with the study group comprising all inhabitants born in 1914 ( N = 388) living in Jyväskylä, central Finland. At baseline, 93.4%, and at follow-up, 93.3%, of those who were eligible participated in the interview. Self-rated health, when asked using the same questions, did not change at follow-up compared to baseline. However, nearly half of the follow-up group reported that their health had become worse over the five year period. Gender differences in self-rated health were not found, although women reported more often than men that their health had become worse and some of the men said their health had become better. It is concluded that self-rated health seems to be age-adjusted; elderly people who say their health has become worse as they age actually self-rate their health as the same or better than before.