Gender differences in health in later life: the new paradox?
Section snippets
Gender differences in health
It has become accepted wisdom that ‘men die and women become disabled’. Women have an expectation of life which is 5–6 years longer than men (Waldron, 1976; ONS, 1996), but have higher morbidity rates. This was discussed by Nathanson (1975)as a ‘contradiction’ which required explanation. She put forward various alternative explanations for this apparent contradiction. Other authors in the US repeatedly demonstrated that “females have higher rates of illness than males” (Verbrugge, 1979a, p.
Gender and living in residential care
Most national health surveys are drawn from samples of residents living in private households and thereby exclude people living in institutions. This is unimportant when analysing the health of people at younger ages, but among the older population is increasingly important with advancing age. It is particularly pertinent when considering gender differences in health, because gender is closely associated with entry into residential care. Over twice as many women over 65 (6.4%) as men (3%) lived
Methodology
The paper analyses data from the British General Household Survey (GHS), which is a nationally representative survey interviewing all adults aged 16 and over in about 10,000 private households each year in Great Britain (Bennett et al., 1996). The response rate was about 80% in 1992–94. The paper is primarily based on analyses of men and women aged 60 and over. To produce more robust results for specific age groups of older people aged 60+, we have pooled 3 years of GHS data, for 1992/93 (n
Gender differences in health
A commonly used global indicator of ill-health is self-assessed health, which is measured by the GHS question “Over the last twelve months, would you say that your health has on the whole been good, fairly good or not good?”. Poor self-assessed health has been shown to be a good predictor of mortality in other studies (Mossey and Shapiro, 1982; Idler and Benyamini, 1997).
The proportion of older people rating their health as ‘less than good’ rises from about 50% of men and women in their early 60
Class inequalities in health among men and women
Despite the very modest gender differences in self-assessed health in later life [shown in Table 2(a)], the health differences according to class based on last main occupation are very striking across the full age range of older men and women (see Fig. 1). In each 5 year age group under 80, about 30% more men previously in a professional occupation rate their health as ‘good’ than men previously in a semi- or unskilled occupation. Even among men in their 80 s, 20% more professional men report
Gender differences in health: multivariate analyses
This section uses logistic regression analysis to examine how gender differences in self-assessed health and in ‘severe’ disability change when social and structural characteristics of older men and women are included in the same analysis. One aim of this section is to assess whether gender differences in health can be explained by older women’s more disadvantaged social and economic circumstances.
Model 1 gives the odds ratio for ‘less than good’ health for women with men as the reference
Conclusion
This paper has examined gender differences in health among older people in Britain in the mid-1990 s, focusing on self-assessed health, and the likelihood of experiencing functional impairments that adversely affect activities of daily living. Our research shows that minimal gender differences in self-assessed health coexist alongside substantial gender differences in disability, representing a new paradox.
Older women are disadvantaged compared to older men both because of their greater level of
Acknowledgements
We are to grateful to the Office of National Statistics for permission to use data from the General Household Survey, and to the Data Archive and Manchester Computing Centre for access to the data. We would like to thank the Health Education Authority for funding research on which parts of this paper are based. We particularly appreciate the helpful comments of Jay Ginn on an earlier version of this paper and those of the anonymous referees.
References (48)
Class, paid employment and family roles: Making sense of structural; disadvantage, gender and health status
Social Science and Medicine
(1991)Comparing inequalities in women’s and men’s health: Britain in the 1990 s
Social Science and Medicine
(1997)- et al.
Gender and inequalities in health in later life
Social Science and Medicine
(1993) - et al.
Inequalities in women’s and men’s ill-health: Britain and Finland compared
Social Science and Medicine
(1993) Sex differences in mental illness among adult men and women: An evaluation of four questions raised regarding the evidence on the higher rates of women
Social Science and Medicine
(1978)Gender differences in the perception of common cold symptoms
Social Science and Medicine
(1993)- et al.
Gender differences in health: are things really as simple as they seem?
Social Science and Medicine
(1996) - et al.
Women’s health: dimensions and differentials
Social Science and Medicine
(1996) Illness and the feminine role: a theoretical review
Social Science and Medicine
(1975)Sex, illness and medical care: a review of data, theory and method
Social Science and Medicine
(1977)
Gender inequalities in health: Social position, affective disorders and minor physical morbidity
Social Science and Medicine
Sex differences in illness incidence, prognosis and mortality: Issues and evidence
Social Science and Medicine
Marital status and women’s health revisited: the importance of a proximate adult
Journal of Marriage and the Family
Integrating nonemployment into research on health inequalities
International Journal of Health Services
Paid employment and women’s health: A benefit or a source of role strain?
Sociology of Health and Illness
Domestic conditions, paid employment and women’s experience of ill-health
Sociology of Health and Illness
Patterns of employment, pensions and gender: the effect of work history on older women’s non-state pensions
Work, Employment and Society
Marital status and long-term illness in Great Britain
Journal of Marriage and the Family
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