Image: Flickr/dhammza
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.
See what we're tweeting about
24 Comments
Add CommentTruly the weaker sex?
Reply | Report Abuse | Link to thisThe problem with a study like this is that it relies so heavily on self-reporting. How many people of either gender had chronic symptoms, but didn't report them of a mentality of "well, they're not that bad, so they don't really count" or "if I complain I'll look like a wuss"?
Reply | Report Abuse | Link to thisword madscientist.
Reply | Report Abuse | Link to thisas for you candide, why dont you keep having it with men then. if you are a lady then i dont know what to say :(
"Understanding gender differences in health can help scientists and doctors find ways to better treat patients, she said.'
Reply | Report Abuse | Link to thisWow! nobody has ever thought of that before.
Fluff statements are epidemic on Scientific American. how about some actual 'science' reporting?
I would think disproving the hypochondriac theory is real science.
Reply | Report Abuse | Link to thisI have noticed sexist overtones to SciAm articles posted here over the last six month or year. The focus seems to be marginalizing men and defending women. As though there is a political agenda behind it. Subtle, but there. Let's forget about all these myths and generalizations and judge individuals on merit. Why? Because the human species can't afford to waste talent, skill, and intelligence regardless of what package it comes in. And these gender biased articles are putting politics before science. Get back to nuts and bolts of science.
Reply | Report Abuse | Link to thisIt's not addressing hypochondria in any way. It is addressing gender reporting of chronic conditions. Why? Men with chronic conditions don't matter? Women with no health complaints are superior? What's the point of this? It's gender rationalization.
Reply | Report Abuse | Link to thisPerhaps because they're bitchin' hyper-spoiled brats that can't deal with a taste of reality. Men deal with far more physical stress and strain throughout their lives. So, women, take a few Advil and shut up .
Reply | Report Abuse | Link to thisAww, 11:25 on New Year's Eve and drinking all alone. I guess that makes your misogyny understandable, but no less loathsome.
Reply | Report Abuse | Link to thisSorry judge, no, actually, many of us work on New Year's Day, so those presumptions were wrong.
Reply | Report Abuse | Link to thisI come from the George Carlin School of offense: if I smell and see BS, I often respond to it. I am also equally willing to recommend and/or praise. If I criticize men, which I do more often actually, them I'm a misandrogynist too, right? Fine. Label away.
SciAm is trying to sell itself, and knows any article like this will get more readers who may not be as interested in black holes, etc.
Women often confuse a trim body with a healthy one. Studies are coming out that a woman over 60 can even be too thin, that neither thin nor fat is good but a healthy middle ground. Women don't realize that New York runway fashion models, if used as role models, could promote unhealthy eating habits that could make life miserable in latter years. "I'll worry about that when the time comes" is shortsighted because when the time does come for every woman, she will live to regret poor eating and drinking choices.
Reply | Report Abuse | Link to thisI am male. I have underlying chronic problems. I basically never reported them for years. I finally got some sense and started reporting them.
Reply | Report Abuse | Link to thisMy problem is that now that I do, I pretty much get ignored because doctors have been trained that 'women get chronic problems not men'. I'd like to thank this latest social bigotry, thanks alot. I have to argue and visit specialists multiple times before I get any treatment. Always.
Alternative explanation: they're weaker AND whinier. :P
Reply | Report Abuse | Link to thisI am a chiropractor and here is why I think women may suffer more from those particular ailments than men: first, neck pain and headaches (most headaches are due to neck problems)probably due to women's lesser neck strength holding/supporting same weight head (women suffer greater damage from whiplash type injuries); second, low back pain due to pelvic imbalances (wider hips), high heel shoes, and having babies (can imbalance pelvis and any imbalance can cause asymmetric stress); the first and second eventually cause arthritis in overstressed joints with weaker muscle support; mental disorders---probably from 1) being in more pain 2)dealing with some men (like some who made some very weird comments about this article).
Reply | Report Abuse | Link to thisI am a chiropractor and here is why I think women may suffer more from those particular ailments than men: first, neck pain and headaches (most headaches are due to neck problems)probably due to women's lesser neck strength holding/supporting same weight head (women suffer greater damage from whiplash type injuries); second, low back pain due to pelvic imbalances (wider hips), high heel shoes, and having babies (can imbalance pelvis and any imbalance can cause asymmetric stress); the first and second eventually cause arthritis in overstressed joints with weaker muscle support; mental disorders---probably from 1) being in more pain 2)dealing with some men (like some who made some very weird comments about this article).
Reply | Report Abuse | Link to thisI'm pretty good had sniffing out BS myself and there is a strong aroma coming from your response.
Reply | Report Abuse | Link to thisYou claim your post wasn't misogynist, you were just offering a commentary on Scientific American's drift toward soft science at the expense of the hard sciences, is that it? Tell me, how does calling women "bitchin' hyper-spoiled brats that can't deal with a taste of reality" qualify as a critique of a magazine's editorial judgement? Instructing women to "take a few Advil and shut up" is just your way of expressing dissatisfaction with SA?
I don't think so.
I didn't label you. Your words did that.
"Truly the weaker sex?"
Reply | Report Abuse | Link to thisI guess that depends on how you define weaker, since women tend to have a lower mortality rate at every age from the womb to centenarians (90% of people in the world who are 110 or older are women). Women in the U.S. live on average more than five years longer than men and men have a higher mortality rate than women for almost every leading cause of death.
If women have a higher rate of chronic diseases, as reported in this article, yet still outlive men, some people might define that as the stronger sex.
Females tend to be stronger in some aspects, males tend to be stronger in others. There is a huge overlap of equal strengths and a tremendous bell curve. But what does it matter? It shouldn't. I'm all for equality, equity, and allowing individuals to apply their intelligience, talent, and skills. Having said that, I do not understand the 'competition' that we americans are hung up on. Why do women seem to want to compete with men at every single level? Why are men even a marker? A goal to best? Men are not afforded the same opportunity. Why are non traditional men marginalized, and beat up (mainly by women) for not being a man? We expect men to be a winner or he's considered a loser. Whereas women are free to compete, or not, with no harm to their security, wealth, opportunity, or power. My point being, this article and others like it have no place. This article perpetuates the idea that women are treated unfairly when they perceive themselves to be equal, or even superior, to men in every single aspect of life and work. When many women point to a man that is doing better, they suddenly feel victimized, cheated. They are harkening to an era when equality did not exist. We should be at a performance and merit based perspective now. As individuals, we should not be competing with each other. We should focusing on developing our own strengths. No room for finger pointing between men and women.
Reply | Report Abuse | Link to this@tellok - Spoken like a person who has no idea of the amount of stress gestation and childbirth puts on every system of a woman's body. Not to mention all of the ailments related to sleep deprivation... it is not a coincidence that the number of men with chronic fatigue and fibromyalgia is increasing at about the same rate as the number of men who are taking on the role of primary caretaker of children.
Reply | Report Abuse | Link to thisBearing even one child increases your chances of just about every chronic disease not related to ticks. Being the primary parent who has to take care of the child/children raises those chances even more.
Or it could be the drinking that is causing the chronic illness's. Women do have much lower tolerances to alcohol than men do. Of course men are not burdened by the whole pregnancy thing so the moral is that women should just focus on giving birth, what god intended, rather than trying to be like men
Reply | Report Abuse | Link to thisIn addition to the problems with self-report are the considerations that women in many cultures and traditions are less active than in the long period in which we did most evolution.
Reply | Report Abuse | Link to thisAnimals are motile or sessile, and our species along with related species move quite a lot, except in the case of relatively recent cultures, in which females were sequestered. This leads to personal physical, mental, and reproductive problems.
Add to this the fact that evolution has prepared females of many species to be more aware of threats to themselves and offspring, and we have yet more viable evolutionary bases for women to feel threatened and insecure.
Another facet of the present overwhelming cultural attribute of marketing insecurity especially to women, their health, and other vulnerabilities, and you have practical bases for overemphasis on problems and pain,
which of course may remind us of numerous studies which have shown that women are more pain-sensitive.
This article reports another piece in the endless puzzle of scientific inquiry, and is, of course, fascinating when one studies the immense research in several disciplines.
As such, the politicization and pretensions of bias occurring in the unedited comments above are utterly inappropriate.
I suggest that SA more severely monitor comment, and prevent it from descending into the rant we here observe.
Bias is diminished through the history of successive peer review, and not by hate speech, derogation, and inappropriate complaint by those who never cared to sufficiently educate themselves before defending or attacking imaginary products of their own experience or imaginations.
Thank you in advance for ceasing to comment.
"My point being, this article and others like it have no place. This article perpetuates the idea that women are treated unfairly when they perceive themselves to be equal, or even superior, to men in every single aspect of life and work." - rshoff
Reply | Report Abuse | Link to thisYou are reading far more into the article than is there. This study is not about finger pointing or competition between the sexes or feelings of unfair treatment by women. I'm not sure where you are getting all of that, but it is certainly not supported by a simple study that shows women experience more chronic health problems than do men.
As to the article and others like it having no place, you could not be more wrong. In the short history of Western medicine women have been regularly and systematically marginalized and overlooked, both by primary care physicians, who often did not take their issues seriously and by the medical research community, which rarely, if ever, took into account that women are biologically different from men in medical and pharmaceutical studies.
In the 19th c. one of the most common medical diagnosis for women was "hysteria" (the very word comes from the Greek for womb), an indication of how little respect doctors had for real female illnesses.
It is only recently that drug companies have begun to include women in drug trials. Traditionally most drugs were tested predominantly on men, and then results applied to both sexes, without regard to the fact that men and women can react very differently to drugs.
You make very good and compelling points. One thing I'd like to address though is that the editor (?) of the article chose to focus on gender fairness by using what I consider inflammatory precursors in the title of the article. I see the words "Women...than... Men" while in the sub header I see they choose the word "whiner". Those are key words that divert attention from the rational analysis the study may represent. If I interjected feelings of inappropriate bias in my comments, it's because the language of the article introduced it. But language aside, I value all of your points and appreciate that you responded to my earlier reply.
Reply | Report Abuse | Link to thisWell spoken.
Reply | Report Abuse | Link to this