Sex differences in health and survival
In: Doblhammer, G., Gumà, J. (Eds.): A demographic perspective on gender, family and health in Europe, 65–100
Cham, Springer Open (2018)
Since health has multiple dimensions, several measures are needed to capture variations by gender. The use of multiple measures can help us better understand the underlying explanations for gender differences. Although life expectancy and mortality are the most extreme measures of health, relative to most other health metrics they are more amenable to accurate measurement, and are more comparable across countries and over time. Thus, in the first section of this chapter we review the existing literature on sex differences in survival. Following the World Health Organization’s (WHO, 1946) definition of health, which states that health “is a complete state of physical, mental and social well-being, not merely the absence of disease,” we review the empirical evidence on gender differences in objective and subjective health. Data on objective health are collected through physical performance tests or cognitive tests, or are based on medical diagnoses that are either recoded in administrative databases or collected through self-reports of diagnoses made by physicians. Subjective health measures strongly depend on individual perceptions that can be modified by contextual factors (socioeconomic, cultural, gender roles, etc.) and awareness of objective health status. We focus on three main subjective health indicators: self-perceived health, functional status, and health-related quality of life (HRQOL). These indicators have become core components of epidemiological, social, and economic research. Later in this chapter, we review the most frequently cited explanations for gender differences in health and mortality, grouping them into the following categories: biological (genetic and hormonal), lifestyle factors (tobacco and alcohol consumption, diet, and physical activity), and social profiles (education and employment). Finally, we conclude by providing possible directions for future research in this area.