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When asked to rate their own health, women, on average, consistently report being in worse health than men do, and a new study from researchers in Spain says this is because women have a higher rate of chronic diseases — contradicting a previous theory that women's lower self-rated health is simply a reporting bias.
"In general practice, there has been this idea that women over-report health problems, or are more likely to say they are ill or pay attention to their symptoms than men," said first author of the study Davide Malmusi, of the Public Health Agency of Barcelona. "We wanted to test whether their differences in self-reported health could in fact be explained by the difference in the prevalence of chronic conditions."
The new findings were published Dec. 16 in the European Journal of Public Health.
Self-reporting health
Malmusi and colleagues across Spain gathered data from Spain's 2006 National Health Survey, which included data from face-to-face interviews with more than 29,000 people on their health. About half of the study participants were between the ages of 16 and 44; the other half was older.
The survey included the question, "Over the last 12 months, would you say your overall health has been very good, good, fair, poor, or very poor?" as well as a question on whether health problems had limited people's activities over the previous six months.
Of the women interviewed, 38.8 percent rated their health as poor or very poor, and 25.7 percent reported chronic limitation of activity. Of the men in the study, only 27 percent had poor self-rated health, and 19.3 percent reported chronic limitation of activity.
But when the researchers matched up the number of chronic conditions each person had with his or her health rating, the gender difference disappeared. Having a higher number of chronic conditions correlated with poorer self-rated health to the same degree in both genders.
For men and women with the same conditions, or the same number of conditions, women were no more likely to claim poorer health.
"There's been a longstanding debate about whether women's self-reported health is a reporting bias or not," said sociologist Ellen Annandale of the University of Leicester in the United Kingdom, who was uninvolved in the new work. "Some researchers argue that women might over-report health problems, and men might under-report. This study supports wider research that women's poorer self-reported health reflects underlying chronic health problems."
The root of chronic health problems
What the new study doesn't answer, Annandale said, is why women have a higher rate of chronic health problems. The data did reveal that women's higher rate of chronic problems can be most strongly attributed to five chronic disorders: arthritis, mental disorders, neck pain, headaches and back pain. But further research will be needed to explain why.
Malmusi said it is likely a mix of biological and social factors.
"Gender influences that way that people are treated and diagnosed in health systems," Annandale said. "It influences the kind of health conditions that men and women suffer from, the way people relate to their own bodies, and what kind of access to health care they have."
Understanding gender differences in health can help scientists and doctors find ways to better treat patients, she said.
"Women generally live longer than men, but in many countries that gap in life expectancy has been decreasing over time. One of the reasons for that is thought to be that men's health is improving, but women's is not."
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Women are helicopters, men are airplanes. (Too many moving parts).
"The data did reveal that women's higher rate of chronic problems can be most strongly attributed to five chronic disorders: arthritis, mental disorders, neck pain, headaches and back pain."
I'd say the typeface in bold in the above statement is the biggest problem. Women (in general... NOT all, but in general) are nuttier than a fruitcake!
From my experience, men (myself included), are simply too stubborn to admit anything is wrong. If it's not impeding you from doing most everyday things, it's not worth mentioning. Ergo, if it ain't broke, don't fix it. Maybe women are simply more honest about their overall health.
Wouldn't be a surprise, my Father hates Doctor's, and typically refuses to go unless there's something seriously, seriously wrong with him, and even then we usually have to badger him into making the appointment.
This is so true! My grandfather had a heart attack one Thanksgiving and was literally turning gray in front of our eyes. All the time swearing up and down that he felt fine. We finally dragged him to the ER, where he admitted to the doctor that he'd been having pains in his chest and right arm since the night before (something he had flatly denied to us when we had asked him). He wound up needing an emergency quadruple bypass.
I don't believe that women are more likely to actually have chronic health problems, but I absolutely believe they are more likely to be diagnosed with them because they are more willing to seek medical treatment.
...but the study clearly states that the researchers controlled for the biases you are talking about. The conclusion is that women report poorer health because they actually have poorer health.
Brenda- The only way I'll believe their claim is if they went in and did all the testing to see if the people had the conditions or not. Men will say there's nothing wrong with them, even if they've been diagnosed. Even worse, men will skip checkups if they're feeling ok, so regular tests are missed.
My husband got sick a few years ago, and after kicking him out of the bedroom so I could change sheets, I noticed he was so jaundiced that the whites of his eyes were actually gold. I had to force him to go to the doctor (and dragged his butt there). Luckily, after a week in the hospital with dialysis and IV fluids, his kidneys and liver started working again.
Unless the researchers took a random sample of men and women, put them through a thorough head-to-toe physical & a full battery of lab tests and found a higher rate of health problems in women, there is still the confounding variable of men avoiding the doctor. Those individuals who seek medical treatment (or even just a checkup) more frequently are more likely to be diagnosed with a chronic health condition. And if women are less likely to avoid doctors, a higher percentage of those with health problems are going to be diagnosed.
I have chronic health conditions. But as a man I know that I'm not dying from them and having them is just part of being alive.
@ Brenda: You can't control human nature. Sorry, but I've seen this type of behavior from men on a regular basis my entire life. I'm not saying that woman don't necessarily have poorer health than men, but it's pretty hard to get valid data on the subject when one side of your study group constantly neglects themselves, and typically tends to keep their true health private. Though, I'm no doctor, and this was entirely a theory.
Most men that I have known as they got older and had illness's when asked "how are you?" invariably say "Oh, fine thanks!" a few then have died a month or so later-----------what I say when asked that same question is "you don't want to know but thanks for asking!!"
I am convinced that with us men it is the "Macho thing."
Weight could be a big factor, I look around, and it is hard to find a woman with a small waist. More single mothers that are not cooking at home and like to rely on fast food. Yet women are still outliving men at an alarming rate.
I think there are just as many overweight men eating fast food. That is hardly a gender thing
I don't know. I always have listened to my body. Listening to my body saved my life. Had shortness of breath and chest pressure (not pain... pressure), went to the doctor and found out I had a 85% blockage in my left aortic ventricle. Emergency bypass surgery the very next day. Docs told me if I'd had a heart attack, I would not have survived it. They call the kind of blockage I had "The Widowmaker".
I think men in general tend to want other people to view them as healthy and strong, so even if something doesn't feel right, they tend to wait until it gets unbearable before reporting any health issues. Women, on the other hand, tend to be more cautious (overly cautious sometimes, perhaps?) in regards to their health.
To Calvin, #l.l and #6, doctors tend to diagnose a 'mental disorder' when they either can't or won't give a proper diagnosis for female patients...be it time or money. On a personal note, I'm glad that you are well and survived your heart attack. Unfortunately for women, their symptoms are different and heart disease is the #1 killer of women.
Women just feel sorry for themselves and complain more.
One gave birth to you.
Shrugs. I don't know. I've always heard that women live longer than men because [estrogen] affords them certain protections against disease and higher pain tolerance. I'll agree that competitiveness, stoicism and self-reliance are traits that [heterosexual] men tend to glorify, while women are more into social networking and communication. Men tend to think more in terms of the big picture, while women are more detail oriented. Women are compulsively neater and cleaner than men are.
But I have also met women who do tend to try to emulate men (in areas where women have to directly compete against men, this is very true). A female form of 'machismo' does exist.
And the stereotypes still persist. Thanks, thanks a lot (sarcasm).
Except for arthritis, the other problems mentioned in the article, back pain, headaches, mental problems, etc. can all be a matter of perception. However, chronic autoimmune diseases such as rheumatoid arthritis, thyroid diseases, fibromyalgia, lupus, etc. all have physical tests and measurements that have proven women have a much higher rate of those diseases than men. Why didn't they use those diseases rather than things like headaches? Or compare cancer rates for breast, ovaries, cervix to prostate cancers? So many diseases around that have definitive physical measurements, and that have differing rates for men and women and they use headaches and backaches? Or did the article writer just report selectively?
I think women report poorer health because we're subject to a much lower standard of health care than men. A woman who goes to the doctor with almost any symptom is more likely to be told to go on a diet or asked if she has problems at home and put on an antidepressant - where as a man with the same symptoms will be sent for further testing. Doctor's still assume a woman's health complaints stem from her weight or her emotions and not from a real medical problem.