Sex differentials in health

Health status and health behavior of males and females in the United States are compared; the data employed in the analysis are from community studies and the surveys of the National Center for Health Statistics. Females generally show a higher incidence of acute conditions, higher prevalence of minor chronic conditions, more short-term restricted activity, and more use of health services (especially outpatient services) and medicines. By contrast, males have higher prevalence rates for life-threatening chronic conditions, higher incidence of injuries, more long-term disability, and after about age 50, higher rates of hospitalization. These sex differences appear at all ages, except for early childhood when boys have a worse health profile than girls. The following interpretations are consistent with the data; they are hypotheses rather than demonstrated facts. Women are more frequently ill than men, but with relatively mild problems. By contrast, men feel ill less often, but their illnesses and injuries are more serious. These morbidity differences help to explain sex differentials in health behavior; frequent symptoms lead to more restricted activity, physician and dentist visits, and drug use for women; severe symptoms lead to more permanent limitations and hospitalization for men. But attitudes about symptoms, medical care, drugs, and self-care are also extremely important. Males may be socialized to ignore physical discomforts; thus, they are unaware of symptoms that females feel keenly. Also, men may be less willing and able to seek medical care for perceived symptoms. When diagnosis and treatment are finally obtained, men's conditions are probably more advanced and less amenable to control. Finally, men may be less willing and able to restrict their activities when ill or injured. Four important factors than underlie sex differentials in health are discussed: inherited risks of illness, acquired risks of illness and injury, illness and prevention orientations, and health reporting behavior. Statistics show that women ultimately have lower mortality rates than men--despite women's more frequent morbidity and possibly because of more care for their illnesses and injuries. The apparent contradiction between sex differences in morbidity and mortality (females are sicker but males die sooner) is explored.