Chapter 10: Sex Differences in Health

The paradox of gender and health: Women report higher morbidity but men have higher mortality rates.
- Women report more days in bed due to illness, increased pain, higher rates of depression, and more physical symptoms.
- Men are more likely to die from 12 out of the 15 leading causes of death in the United States.
Health is defined broadly, encompassing emotional well-being (psychological distress, life satisfaction, happiness) and physical problems (physical symptoms, coronary heart disease).
This chapter will overview sex differences in health, the implications of sexual orientation and gender identity for health, and review explanations for these differences.

Men die younger than women throughout the life span.
- Ratio of boys to girls at birth: 104 boys for every 100 girls; however, more boys die at every age
- Not until age 18 is the number of males equal to females.
Male to female mortality ratio for ages 1-4 is 1.22 (28 boys die for every 23 girls).
- Increased mortality for males peaks during adolescence due to riskier behavior, which declines with age.
Female mortality during pregnancy exceeds male mortality, leading to the higher male ratio at birth.

In 2016, average life expectancy in the U.S. was 78.6 years, which has plateaued since 2010.
- Life expectancy dropped by 0.3% partially due to the opioid epidemic.
Life expectancy varies by race/ethnicity (e.g., 81 years for White women vs. 76 for White men; 78 years for Black women vs. 72 for Black men).
- Hispanic women have longer life expectancies than both Black and White women.
Historical context: In 1900, average lifespan was 46 years for men and 48 years for women, with a difference of just 2 years. The difference peaked in 1979 at 7.8 years due to reductions in female mortality (childbirth) and increased male mortality from heart disease and lung cancer.
Recent decades have seen a narrowing sex gap in mortality, attributed to reductions in heart disease and cancer deaths among men, while lung cancer incidence has increased among women.

The primary causes of death have shifted from communicable diseases in the early 20th century to lifestyle-related diseases today.
- Leading causes in 2016: heart disease, cancer, accidents, chronic lower respiratory disease, and cerebrovascular disease.
- Note that 13 of the top 15 causes of death have higher rates in men than women.
- Only Alzheimer's disease has a higher mortality rate for women.
Notable statistics: Men are 4 times more likely than women to be victims of homicide.

Age influences leading causes of death: accidents are leading cause for ages 10-44, while cancer leads ages 45-65, and heart disease for ages 65+.
- For Black men aged 15-24, homicide is the leading cause of death.
HIV is a higher cause of death among Black individuals, particularly males, although it is declining among older demographics.

Limited data exists on mortality and causes of death among LGBTQ persons, but studies indicate women in same-sex couples are at increased risk of suicide.

Morbidity, reflecting illness, has increased even as mortality rates have fallen; people now live longer with chronic illnesses.
- Chronic conditions have risen due to successes in treating infectious diseases.
Women have higher morbidity rates (arthritis, immune disorders, painful disorders) than men.
- Women's subjective health perceptions are poorer due to the prevalence of nonfatal chronic diseases.
- Differences in health care utilization: women use more health services than men, especially during childbearing years.

Differences in morbidity do not appear until adolescence, influenced by gender roles during childhood.
Boys visit health care providers more often during childhood, while girls surpass boys in adolescence.
- Reflects possible expectations from parents toward boys and girls in relation to health complaints.

Sexual minorities demonstrate higher susceptibility to morbidity, with transgender individuals facing substantial health disparities, including increased risk for violence and mental health issues.

Genetic differences can play a role; females with two X chromosomes may fare better against certain disorders compared to males with one.
Hormones: Estrogen impacts cardiovascular health significantly, especially after menopause leading to increased heart disease.
Immune System: Women generally have stronger immune responses but higher rates of autoimmune diseases.

Artifacts causing differences include socioeconomic status (SES) and potential physician bias.
- Women and LGBTQ individuals may suffer worse health outcomes related to lower SES and discrimination.

Differences in health behaviors significantly impact health outcomes; women are more likely to engage in preventive care while men demonstrate riskier behaviors (smoking, violence).

Male gender roles often involve behaviors that risk health (driving, risky leisure activities), whereas female roles encourage health awareness but can lead to caretaking stress that impacts self-care.

Potential sex differences in how symptoms are perceived and acted upon may contribute; women may report symptoms more readily than men.

Whether men and women seek care for symptoms also varies, influenced by gender expectations.

Understanding gender differences in health is essential, as they influence service utilization and treatment effectiveness. Recognizing the cultural, social, and biological factors can lead to improved health outcomes for both genders.
Take Home Points:
- Males die younger than females at all ages, although this gap has decreased over the past decades to 5 years today.
- Recognize the leading causes of death influenced by lifestyle factors, which differ by gender.
- Women use health services more and report worse health perceptions based on higher morbidity rates.
- The differences in health behaviors, societal roles, and expectations significantly contribute to these disparities in health outcomes.

Critical thinking and What I found interesting

The chapter examines gender differences in health, highlighting the paradox of women reporting higher morbidity but men having higher mortality rates.
Interesting psych perspectives identified include:
- Influence of societal norms on health behaviors and perceptions.
- Critical questions:
- How do traditional gender roles affect self-care practices in men and women, leading to health disparities?
- What implications arise from differences in healthcare utilization, especially during high-stress times like childbearing for women?
Focus on sexual orientation and gender identity:
- Limited data on LGBTQ health disparities highlights a significant concern.
- The need for more inclusive research considering diverse sexual orientations and identities.
Biological explanations for health differences prompt critical evaluation:
- To what extent do biological factors account for the observed morbidity and mortality discrepancies?
Overall, the chapter not only provides important statistics and trends but also invites a deeper analysis of cultural, social, and biological factors shaping gendered health issues.