THE TWAIN MEET - EMPIRICAL EXPLANATIONS OF SEX-DIFFERENCES IN HEALTH AND MORTALITY
THE TWAIN MEET - EMPIRICAL EXPLANATIONS OF SEX-DIFFERENCES IN HEALTH AND MORTALITY
复制标题
DOI：
10.2307/2136961
复制
发表时间：
1989-09-01
影响因子：
5
通讯作者：
VERBRUGGE, LM
中科院分区：
文献类型：
--
作者：
VERBRUGGE, LM
卫生统计数据通常显示，妇女的发病率和保健服务使用率较高，而男子的死亡率较高。这一分析从经验上确定了妇女健康状况较差的原因。它基于底特律健康研究的回顾性（访谈）和前瞻性（健康日记）数据。考虑了三种可能有助于解释女性过度行为的风险因素：后天风险、心理社会方面和健康报告行为。男性和女性在后天风险方面存在明显差异：男性吸烟和工作风险较高，但女性不活动、失业、压力和许多其他因素较高。心理社会方面使妇女更容易生病和接受保健。女性对调查的兴趣也更大。当所有风险因素都得到控制时，发病率差距就会大大缩小。事实上，一般健康和长期健康指标反过来显示男子的发病率较高。同样，当风险和发病率得到控制时，妇女过度的治疗护理（短期和长期残疾、就医、非专业咨询、吸毒）也会减少。他们实际上转向了男性过剩的残疾和医疗保健。尽管大多数男性的过度行为在统计上并不显著，但他们的模式可以做出合理的解释。我们的研究结果与最近对加州几个地点的性别死亡率差异的分析密切一致，这些分析不能通过控制社会因素来消除男性的死亡率过高。总之，当代妇女健康状况较差主要是由于她们的角色和压力（后天的风险），在较小程度上是由于她们对健康的态度。如果考虑到社会因素，健康数据表明男子处于不利地位，而死亡率数据则表明男子处于不利地位。原因在于生物学吗？
Health statistics routinely show higher morbidity and health services use for women, while mortality rates are higher for men. This analysis empirically identifies reasons for women''s poorer health. It is based on retrospective (interview) and prospective (health diaries) data from the Health in Detroit Study. Three kinds of risk factors, which may help explain females'' excess, are considered: acquired risks, psychosocial aspects, and health-reporting behavior. Men and women differ markedly in acquired risks: smoking and job hazards are higher for men, but inactivity, nonemployment, stress, and many other factors are higher for women. Psychosocial aspects predispose women to more illness and health care. Women also had keener interest in the survey. When all of the risk factors are controlled, the morbidity gap narrows considerably. In fact, indicators of general and chronic health reverse to reveal higher morbidity for men. Similarly, females'' excesses for therapeutic care (short- and long-term disability, medical visits, lay consultation, drug use) diminish when risks and morbidity level are controlled. They actually reverse to a male excess for disability and medical care. Though most of the unveiled male excesses are statistically nonsignificant, their pattern allows a reasonable interpretation. Our results are closely compatible with recent analyses of sex mortality differences in several California sites, which could not eliminate men''s mortality excess by controlling for social factors. In conclusion, contemporary women''s poorer health profile stems largely from their roles and stress (acquired risks), and to a smaller degree from their health attitudes. When social factors are taken into account, health data suggest a disadvantage for men, and mortality data maintain men''s disadvantage. Do the reasons lie in biology?