1 / 30

Gender and Health

Gender and Health. Vicki S. Helgeson Carnegie Mellon University. 2006 PMBC Summer Institute. Number of Deaths per 100,000 in 2003. Source: National Vital Statistics Reports (2006). Life Expectancies Over the Twentieth Century. Source: National Center for Health Statistics (2006)

chico
Download Presentation

Gender and Health

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Gender and Health Vicki S. Helgeson Carnegie Mellon University 2006 PMBC Summer Institute

  2. Number of Deaths per 100,000 in 2003 Source: National Vital Statistics Reports (2006)

  3. Life Expectancies Over the Twentieth Century Source: National Center for Health Statistics (2006) Note: The figures from 1900 to 1960 for black people reflect “black and other” people

  4. Sex Differences in Mortality ↑ Over the 20th Century What are the leading causes of death?

  5. Age-Adjusted Death Rates (per 100,000) for the Leading Causes of Death in 2003 Source: National Vital Statistics (2006)

  6. Paradox: Women live longer than men but… …women report worse health than men. Men have higher rates of mortality. Women have higher rates of morbidity.

  7. Classes of Explanations • Biology • Genes • Immune system • Hormones • Health behaviors • Stressful life events • Social roles

  8. Artifacts: Physician Bias • Depression • Women are 2x likely to be depressed as men • Clinicians more likely to classify symptoms as depression in women than men • Clinicians less likely to detect depression in men than women • PCP’s detection of depression compared to independent screening of 19,000 patients (Borowsky et al., 2000) • Clinicians more likely to provide medication to women than men, when symptoms are similar • Due to patient? • Due to provider?

  9. Also, response bias in the area ofdepression: Depression 14 12 10 8 6 4 2 0 Depression Hassles Depression Hassles Male Female Source: Adapted from Page & Bennesch (1993)

  10. Artifacts: Physician Bias • Coronary Heart Disease FACT: men have higher rates of heart disease than women FACT: heart disease is #1 killer of women, too FACT: onset of heart disease occurs later in women than men FACT: once diagnosed, women’s disease is more advanced than men even when controlling for age FACT: women have more complications from treatment and higher mortality rates than men

  11. Are women treated differently than men? • Same symptoms more likely to be attributed to CHD in men than women • Partly because men and women have different symptoms men have “classic” chest pain • Men more likely than women to be referred for: • Catheterization • Cholesterol-lowering medication • Invasive treatment (PTCA, CABG) These relations generally hold when controlling for age • Men fare better following invasive treatment than women

  12. Classes of Explanations…. Health Behaviors • Alcohol: men more • Smoking: men more (but…) • Diet: possibly women better (but…) • Exercise: men more • Preventive health care: women more • Sleep: ???

  13. Stressful Life Events • Meta-analysis (Davis, Matthews & Twamley, 1999) • Females > Males: d = .12 • Moderator: type of rating • Stress exposure: d = +.08 • Stress impact: d = +.18 • Moderator: type of event • Interpersonal: d = +.17 • Personal: d = +.07

  14. Sex Comparisons of Interpersonal Stress and Non-interpersonal Stress Among Preadolescents and Adolescents Interpersonal stress Non-interpersonal stress Source: Adapted from Rudolph & Hammen (1999)

  15. Differential Exposure? or Differential Vulnerability?

  16. Social Role: Men • Hazardous jobs • Drive more • Risk-taking behavior • Own guns • Leisure activities (hunting, skydiving, skiing, mountain climbing) • Participation in risky sports (football, wrestling) [and playing while injured]

  17. Encouragement of Risk-Taking Behavior in Boys • Parent watched video of boy/girl on playground (ages 6-10) • Stop tape and report what they would say • Verbalization during risk-taking Source: Morrongiello & Dawber (2000)

  18. Social Role: Women • Social network double-edged sword: • Provides support and potential to reduce stress • Provides people to take care of • Nurturant Role Hypothesis (Gove & Hughes, 1979) • Exposed to more infectious agents • Caretaking leads to fatigue and vulnerability to illness • Time spent caring for others leads to less time spent caring for self

  19. Gender-Related Traits: Female Focus on Others Overinvolved in Other’s Problems COMMUNION UNMITIGATED COMMUNION Self-Neglect ♀

  20. Links to Well-Being • Communion • Provides social support • Linked to social skills • Unrelated to psychological distress • Unmitigated communion • Linked to psychological distress • Linked to self-neglect • Linked to rumination about others • Linked to poor adjustment to disease • Linked to poor metabolic control ♀

  21. UC Laboratory Studies • Exposed to person who self-discloses problem • Study 1: Friend • Study 2: Stranger Fritz & Helgeson (1998)

  22. Adolescents with Diabetes • T1 interview • T2 interview (4 months later) • Early adolescents (13-14) • Middle adolescents (15-17) ß UC  T2 Distress .36 * .30 (control for T1) Sex  UC  Distress Metabolic Control Helgeson & Fritz (1996)

  23. Poor Metabolic Control __ Early Adolescence __ Middle Adolescence -1 SD +1 SD Unmitigated Communion

  24. Psychological Distress Unmitigated Communion Relationship Stressors Metabolic Control

  25. More on Adolescents with Diabetes • n = 132 adolescents with diabetes • n = 131 healthy adolescents • Average age = 12 (11-13) • Interviewed annually • UC → ↑ distress ↓ self-esteem ↓ metabolic control • UC → ↑ eating disturbances • UC → eating disturbances → distress self-esteem metabolic control Helgeson et al. (under revision)

  26. Gender-Related Traits: Male Distrust of Others Focus on Self UNMITIGATED AGENCY AGENCY Self-Absorption ♂

  27. Links to Well-Being • Agency • Linked to good health behavior (exercise) • Linked to self-efficacy, perceptions of control • Linked to high self-esteem • Linked to reduced stress • Unmitigated agency • Linked to psychological reactance • Linked to poor health behavior • Linked to noncompliance • Linked to problem behaviors (delinquency, smoking, etc.) • Linked to hostility ♂

  28. Change in Self-Efficacy Change in Mental Health Change in Prostate-specific Function -.29** .51*** .68*** UA .67 .66 -.30* Bowel Urine Intrusive thoughts .88 -.81 MCS Depression Helgeson & Lepore (2004)

  29. .31* Change in Prostate-specific Function Change in Self-Esteem Depression Agency .23* .48*** -.55*** .76 .61 Bowel Urine Helgeson & Lepore (2004)

  30. Which explanation accounts for the “Gender Paradox”? Health Behaviors  Men’s mortality Social Role Factors  Women’s morbidity

More Related