SEX-DIFFERENCES IN ILLNESS INCIDENCE, PROGNOSIS AND MORTALITY - ISSUES AND EVIDENCE
SEX-DIFFERENCES IN ILLNESS INCIDENCE, PROGNOSIS AND MORTALITY - ISSUES AND EVIDENCE
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DOI：
10.1016/0277-9536(83)90004-7
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发表时间：
1983-01-01
影响因子：
5.4
通讯作者：
WALDRON, I
中科院分区：
文献类型：
--
作者：
WALDRON, I
本文回顾了目前的研究，并提出了新的证据，性别差异的发病率和死亡率。注意力主要集中在以下主题：（1）几种主要类型慢性病的发病率、预后和死亡率的性别差异，（2）发病率和死亡率性别差异的原因，（3）医生就诊的性别差异，（4）方法学问题，报告发病率是否存在性别差异。发病率性别差异之间的关系，已经分析了各种类型的癌症、缺血性心脏病和类风湿性关节炎的预后和死亡率。发病率的性别差异和预后的性别差异之间几乎没有相关性。预后的性别差异一般小于发病率的性别差异。在大多数情况下，预后的性别差异对死亡率的性别差异的贡献相对较小，而发病率的性别差异是死亡率性别差异的主要决定因素。这些模式表明，发病率性别差异的原因往往对预后的性别差异影响不大。本文讨论了发病率和死亡率性别差异的原因，并着重讨论了遗传和环境因素、性别角色、应激反应的性别差异以及冒险和预防行为的性别差异。一个结论是，尽管男性在某些类型的风险中承担更多，但在承担风险或从事预防行为的倾向方面似乎没有一致的性别差异。相反，在冒险和预防行为方面的性别差异取决于具体的行为和所考虑的文化，医生就诊率的性别差异受到各种生物和文化因素的影响。例如，妇女的生殖功能更为复杂，要求更高，这是妇女就医率较高的一个主要原因，至少在西方国家是如此。文化因素的重要性表明跨文化和历史的变化，在性别差异的医生访问rates.To测试是否有性别差异的健康和疾病的报告，自我报告和医学评估的发病率的措施之间的差异进行了评估，男性和女性在12项研究。这些数据表明，报告中的性别差异因所考虑的发病率计量的具体类型而异。例如，自我评级的一般健康状况的妇女可能比男性更倾向于评价自己的健康差，但没有显着的性别差异，观察到在报告医生访问或住院accounting.The证据在本文中讨论的说明了多样性和复杂性的因素，影响性别差异的发病率和死亡率。这方面研究的一个主要挑战是对发病率和死亡率方面的性别差异作出尽可能广泛和一般的解释，同时充分考虑到数据的真实的复杂性。
This paper reviews current research and presents new evidence concerning sex differences in morbility and mortality. Attention is focused primarily on the following topics: (1) sex differences in incidence, prognosis and mortality for several major types of chronic disease, (2) causes of sex differences in morbility and mortality, (3) sex differences in physician visits and (4) a methodological issue, whether there are sex differences in reporting morbility.Relationships between sex differences in incidence, prognosis and mortality have been analyzed for various types of cancer, ischemic heart disease and rheumatoid arthritis. There was little or no correlation between sex differences in incidence and sex differences in prognosis. Sex differences in prognosis were generally smaller than sex differences in incidence. In most cases, sex differences in prognosis made a relatively small contribution to sex differences in mortality, and sex differences in incidence were the primary determinant of sex differences in mortality. These patterns indicate that the causes of sex differences in incidence frequently have little effect on sex differences in prognosis. Reasons for this are discussed in the text.The causes of sex differences in morbility and mortality are discussed, with attention to the contributions of genetic and environmental factors, sex roles, sex differences in stress responses and sex differences in risk-taking and preventive behaviors. One conclusion is that, although men take more risks of certain types, there does not appear to be a consistent sex difference in propensity to take risks or to engage in preventive behavior. Rather sex differences in risk-taking and preventive behavior vary depending on the specific behavior and the culture considered.Sex differences in physician visit rates are influenced by a variety of biological and cultural factors. For example, women's more complex and demanding reproductive functions are a major reason for women's higher rates of physician visits, at least in Western countries. The importance of cultural factors is indicated by the cross-cultural and historical variation in sex differences in physician visit rates.In order to test whether there are sex differences in the reporting of health and illness, discrepancies between self-report and medically-evaluated morbidity measures have been assessed for males and females in twelve studies. These data indicate that sex differences in reporting vary depending on the particular type of morbidity measure considered. For example, for self-ratings of general health women may be more predisposed than men to rate their health poor, but no significant sex differences were observed in reporting of physician visits or hospital admissions.The evidence discussed in this paper illustrates the diversity and complexity of factors that influence sex differences in morbidity and mortality. A major challenge for research in this area is to derive explanations of sex differences in morbidity and mortality that are as broad and general as possible and yet take adequate account of the real complexity of the data.