Sex-Related Differences in Health and Illness

From Suet Pudding to Superhero: Representations of Men’s Health for Women

Men’s health has been receiving increasing attention in recent years, both in the media and in academic literature. In February 1998 a British Sunday newspaper, The Mail on Sunday, ran a three-week special feature on ‘A woman’s guide to men’s health’. Linguistic representations of health in popular media are revealing of social concerns regarding both the control of health and health care, therefore we critically analysed these texts using post-structuralist, discourse analytic techniques. Men’s health was constructed as ‘in crisis’ and men tended to be aligned with culture (and work) and women with nature (and health). Paradoxically, certain traditional gender dichotomies were both challenged and reinforced within the texts. However, within the five patterns of discourse we identified (men’s health in crisis, woman as nature/man as culture, the risk-taking superhero, man as infant and health for productivity), women’s current position in society was negatively portrayed and functioned to persuade women that it is in their interests to be responsible for men’s health, although without taking overt control. We conclude that the main representations of men’s health for women in this series reinforce unequal social relations which does little to benefit women or men.

Gender-Related Individual Differences and Mortality in the Terman Longitudinal Study: Is Masculinity Hazardous to Your Health?

Data were collected, refined, and analyzed on 654 men and 210 women in Lewis Terman’s “gifted children” longitudinal study to examine links between masculinity and mortality. Masculinity measures included gender diagnosticity (GD) scores, measuring the male-or female-typicality of occupational preferences in 1940 and masculinity-femininity (M-F) scores from the Strong Vocational Interest Blank (SVIB). Hazard analyses showed GD was significantly related to mortality for both men and women (interquartile relative hazard 1.25 for men and 1.62 for women), with masculine women and masculine men more likely to die at any given age. SVIB M-F was similarly related to mortality for both men and women (respective interquartile relative hazards = 1.26 and 1.36). The effects remained significant after controlling for certain health behaviors and Big Five traits.

Individuality in Vulnerability

The relation between personality traits, environmental stressors and their impact, coping behaviors, and health status was examined, as were pathways through which health is influenced by these individual difference variables. It was hypothesized that personality predicts susceptibility to stressors and coping mechanisms that modify the cognitive and affective reactions that influence health status. Two hundred and eighty- four university students completed self-report questionnaires. Ego resilience, low neuroticism, hardiness, internal locus of control, and extraversion loaded on a factor moderately related, indirectly, to health status. A path analysis testing sexes separately revealed that men with a vital personality (i.e. emotionally calm but flexible, self-reliant, and hardy) reported perceiving fewer environmental threats, using more efficacious coping behaviors, and experiencing lower levels of negative affect and better health status than did less self-possessed persons. Similar results emerged for women except that stressors predicted health status independently of personality influences. Moreover, the use of wishful thinking predicted health status directly for men but not for women. Personality appears to be related to poor health, through ineffective coping and consequent negative affect.

A study on Singaporean women's acceptance of using mobile phones to seek health information

OBJECTIVE

This paper is an exploratory study that investigates Singaporean women's acceptance of using mobile phones to seek health information.

METHOD

A mobile web containing health topics was developed to track Singaporean women's actual use of their mobile phones to seek health information. A survey questionnaire measured variables hypothesized to predict Behavioural Intention. The survey responses were then matched to the data collected on actual use. Correlation analysis and hierarchical regression were used to analyze the data collected.

RESULTS

Findings revealed that Perceived Usefulness and Self-efficacy positively predicted the intention to use mobile phones to seek health information. The study also confirmed the presence of an intention-behaviour gap among participants. The conversion of intention to actual behaviour hinges on technical concerns and design factors. Prior experiences with health information seeking reinforced women's evaluations of the usefulness of the mobile web application and helped them to feel more self-efficacious about using their mobile phones to seek health information. Using mobile phones to seek health information was found to be complementary to online health information seeking and can be regarded as an alternative source to the internet for seeking health information.

CONCLUSION

This study contributes to the existing literature by applying the Technology Acceptance Model (TAM) in the context of mobile health information seeking, for which there has been a lack of studies, and demonstrated that the inclusion of additional variables can enhance TAM's predictive power. The empirical presence of an intention-behaviour gap calls for future research to investigate the reasons behind the gap. Finally, the findings from this study can serve as input to promote women's use of mobile phones for better self-management of health.

Prevalence, Risk Factors and Self-Reported Medical Causes of Seeing and Hearing-Related Disabilities Among Older Adults

On a examiné la prévalence, les facteurs de risque et les troubles médicaux associés aux déficiences de la vue et de l'ouïe chez les adultes canadiens de 55 ans et plus. On a établi un échantillonnage aléatoire à partir des recensements canadiens de 1986 et 1991 et on a demandé aux citoyens qui en faisaient partie de remplir le Sondage sur la santé et les limitations d'activité (ESLA) de 1986 et 1991. On a constaté que les aîné(e)s de 65 ans et plus présentaient plus de déficiences sensorielles que ceux de 55 à 64 ans. Les hommes signalaient plus de difficultés de l'ouîe que les femmes tandis que les femmes présentaient plus de difficultés de la vue que les hommes. On a constaté que l'incidence des difficultés sensorielles semblait augmenter avec l'âge et avec la diminution de revenu total de la maisonnée. Ce sont les cataractes et la surdité qui ont été le plus souvent mentionnées comme cause de restriction des activités de la vie quotidienne dans les deux groupes d'âge. Les difficultés sensorielles sont fréquentes chez les aîné(e)s. Les initiatives de santé publique devraient se pencher sur les difficultés de la vue et de l'ouïe, particulièrement chez les aîné(e)s, les femmes et les gens à faible revenu.

Measurement Invariance and the Role of Body Consciousness in Depressive Symptoms

The purposes of this article are threefold: (a) to test measurement invariance of the Objectified Body Consciousness Scale (OBCS), a central tool for testing objectification theory, across men and women, given that measurement invariance is a prerequisite for gender comparisons; (b) to examine the mediating role of body shame in the link between body surveillance and depressive symptoms for both men and women; and (c) to investigate whether body surveillance and subsequent body shame could explain, at least in part, gender differences in depressive symptoms. Two studies were conducted with two college samples ( N = 360 and 278). Results indicate that factor loadings of OBCS differed for the gender groups, revealing that body surveillance and body shame items for women and body control beliefs for men are more closely aligned with their intended latent factors. Our analyses also supported the proposed two mediation models: body shame mediated the relation between body surveillance and depressive symptoms for both gender groups; and body surveillance and related body shame mediated the gender difference in depressive symptoms. Overall our studies highlight that testing measurement invariance can expose differences in scale functioning for men and women, calling into question findings based on the use of those scales.

Depressive symptomatology and mental health help-seeking patterns of U.S.- and foreign-born mothers

OBJECTIVES

This report presents the national estimates of maternal depressive symptomatology prevalence and its socio-demographic correlates among major racial/ethnic-nativity groups in the United States. We also examined the relationship of mental health-seeking patterns by race/ethnicity and nativity.

METHODS

Using the Early Childhood Longitudinal Survey-Birth Cohort Nine-month data, we present the distribution of Center for Epidemiological Study-Depression (CES-D) score by new mothers' nativity and race/ethnicity. The mental health-seeking pattern study was limited to mothers with moderate to severe symptoms. Weighted prevalence and 95% confidence intervals for depression score categories were presented by race/ethnic groups and nativity. Multi-variable logistic regression was used to obtain the adjusted odds ratios of help-seeking patterns by race/ethnicity and nativity in mothers with moderate to severe symptoms.

RESULTS

Compared to foreign-born mothers, mothers born in the U.S. were more likely to have moderate to severe depressive symptoms in every racial/ethnic group except for Asian/Pacific Islanders. These US-born mothers were also more likely to be teenagers, lack a partner at home, and live in rural areas. Among Asians, Filipina mothers had the highest rate of severe depressive symptoms (9.6%), similar to those of US-born black mothers (10.2%). Racial/ethnic minorities and foreign-born mothers were less likely to consult doctors (OR: 2.2 to 2.5) or think they needed consultation (OR: 1.9 to 2.2) for their emotional problems compare to non-Hispanic White mothers.

CONCLUSION

Our research suggests that previous "global estimates" on Asian American mental health underestimated sub-ethnic group differences. More efforts are needed to overcome the barriers in mental health services access and utilizations, especially in minority and foreign-born populations.

Prediction of depressive distress in a community sample of women: the role of sexual orientation

OBJECTIVES

This study compared factors known or hypothesized to influence depressive symptomatology in a community sample of lesbians and heterosexual women.

METHODS

Data were collected in a multisite survey of lesbians' physical and mental health.

RESULTS

Findings confirmed earlier reports suggesting that traumatic life events such as physical and sexual abuse, and individual traits and coping styles are risk factors for depressive distress. However, findings of higher rates of suicidal behavior and of several risk factors for depressive distress among lesbians suggest that risk for depression may differ among lesbians and heterosexual women.

CONCLUSIONS

Sexual orientation may represent an important but poorly understood risk factor for depressive distress as well as suicidal ideation and behavior.

Women's perceptions of their social roles after heart surgery and coronary angioplasty

OBJECTIVE

The goal of this study was to describe the influence of physical health on social role perceptions, role performance, and role balance in women after heart surgery and coronary angioplasty.

DESIGN

A cross-sectional descriptive survey was used.

SETTING

The study was undertaken at a Midwestern community hospital.

SAMPLE

The study considered 58 midlife and older women who had received heart surgery or coronary angioplasty.

OUTCOME MEASURES

The following measures were used: Inventory of Adult Role Behavior, Role Discrepancy Measure, Role Balance Measure, and Salient Social Roles Measure.

RESULTS

Women in poorer health had lower role performance and more negative role perceptions. In general, the balance of rewards and concerns in roles rated most important were not affected by health status.

CONCLUSION

Dimensions of women's social roles are related to physical health after heart surgery and angioplasty. Knowledge about the effect of physical health on women's social role experiences is important information for clinicians who care for women with heart disease. If a woman can be helped to achieve better functional health to perform role and daily living tasks, she may feel more positive about her current and future health states.

Portraits of menopause in the mass media

This examination of menopause as presented by the popular print media was conducted in the context of furthering our understanding of the development of attitudes toward menopause. All articles indexed under "menopause" in the Reader's Guide in the years 1981, 1982, 1985, 1986, 1989, 1990, 1993, and 1994 were located and examined. The data revealed that, although there has been an increase in the frequency of articles on menopause in the last 15 years, the media's portrayal of menopause is problematic in several respects: (a) in spite of the increased attention, the information available on menopause through the popular media is minimal and insufficient; (b) there was little variability in terms of perspective, discipline, or focus; almost all were focused on menopause as a negative experience or disease and in need of medical treatment; (c) there was considerable contradiction and inconsistency among the articles with respect to descriptions of menopause and intervention advice for menopausal women; (d) aging, stress, life-style factors, race and ethnicity, exercise and diet were, with few exceptions, ignored or trivialized.

Hearing loss, control, and demographic factors influencing hearing aid use among older adults

Preference for non-use of hearing aids among older adults who are candidates for amplification remains to be explained. Clinical studies have examined the contribution of consumer attitudes, behaviors, and life circumstances to this phenomenon. The present study extends the interests of earlier investigators in that it examines psychological control tendencies in combination with hearing loss and demographic variables among older adults who elected to accept (adherents) or ignore (nonadherents) advice from hearing professionals to acquire and use hearing aids. One hundred thirty-one individuals participated by completing measures of hearing, hearing handicap, psychological control, depression, and ego strength. Participants were asked to provide demographic information and personal opinions regarding hearing aid use. Adherence group and gender differences were noted on measures of hearing sensitivity, psychological control, and demographic factors. Female adherents demonstrated greater hearing loss and poorer word recognition ability but less hearing handicap, higher internal locus of control, higher ego strength, and fewer depressive tendencies than female nonadherents. They reported demographic advantages. Female adherents assumed responsibility for effective communication. Although male adherents and nonadherents did not differ significantly demographically, male adherents were more accepting of their hearing loss, took responsibility for communication problems, and found hearing aids less stigmatizing. Implications for clinical practice and future clinical investigations are identified and discussed. Results are expected to be of interest to clinicians, clinical investigators, and health care policymakers.

Older women's lives through time

This 6-year longitudinal study of 103 community-dwelling older women examined changes in physical and mental health and self conceptions and the relationships among self conceptions, physical health, and depression. Over time, physical health, personal growth, and purpose in life declined; depression increased; and positive relations and autonomy were stable. Regression analyses indicated declines in physical health rarely affected the self; increase in depression was related only to concurrent physical health; and prior depression did not predict subsequent physical health. Thus, positive self conceptions and physical health appear to be independent in elderly women, but declines in physical health are associated with depression.

Perception of medical symptoms according to gender of reporting person and type of symptom

Two hundred and eight male and female participants were given unanticipated memory and recognition tasks with which to recall and recognize medical symptoms, described on audiotapes by male and female individuals. Half of the presented symptoms were among those typically experienced by males; half were among those experienced mostly by females. Both memory and recall were better when the audiotaped reporting persons was male. Gender orientation of symptoms (male versus female orientation) was not associated with better recall or recognition, nor was the factor of subject gender. Although neither "male" nor "female" symptoms were seen generally as more serious overall, an interaction effect showed that symptoms were seen as more serious, especially in the case of the male audiotape, when they were incongruous with the gender of the reporting person. Some possible implications of the results are outlined. More research is required to assess the differential perception of medical and other types of symptoms.

Gender and support for mental health research in Ontario: 1992-94: a summary

Based on early research by Stark-Adamec (1981), the question was explored as to whether current mental health funding appeared to be more relevant to male or female concerns, or to neither specifically. Three data sets, consisting of a total of 117 grants and 43 Fellowships awarded by the Ontario Mental Health Foundation from 1992-1994, were coded in terms of these concerns. For both Grants and Fellowships, a high proportion were coded as being primarily concerned with neither gender specifically. Some additional data, in terms of DSM III-R categories and grant committee memberships, were also explored, with, in general, similar findings. From one perspective, therefore, these findings do not support the notion of "gender bias." From another perspective, however, it does lend current support to Stark-Adamec's earlier findings that the mental health concerns of women remain poorly represented in mental health funding. Some discussion, as well as implications and limitations of the findings, are outlined.

Older Women and Hearing

Health-related research and clinical management efforts only recently have begun to recognize gender differences. Women live longer than men, but are more likely to experience debilitating health conditions. Compounding their risk for poorer health and subsequent reduced quality of life are a variety of socio-cultural factors. In addition, hearing loss is commonly experienced by all older adults. Even moderate hearing loss may greatly reduce a person's ability to communicate effectively and to maintain a sense of competence. In spite of its handicapping potential, little is known about the impact of hearing loss among the increasing, older adult segment of the population. This paper reviews health and hearing-related factors, focusing particularly on older women, and identifies issues for hearing professionals to address in future research and clinical management.

Psychosocial correlates of women's health in middle adulthood

Psychosocial variables are not only highly salient to health, but also potentially modifiable if women receive accurate information from care providers. Employing a multivariate multitheoretical approach, psychosocial predictors of health (locus of control, well-being, role quality, stress, social network ties, and optimism) were examined in a secondary analysis of data collected by Baruch and Barnett on 238 midlife women. Mean age was 43.6 years; 60% were college educated; 76% were employed outside the home. The sample included women from four family statuses: never married (n = 50), married without children (n = 54), married with children (n = 88), and divorced with children (n = 46). These family statuses were crossed by employment status: half the married women were employed, as were all of the never married or divorced women. The employed women were equally distributed by occupational prestige into high, medium, and low groupings; unemployed women were classified according to the prestige of their husbands' occupations. Of the 134 women who were mothers, 23% had younger children (< or = 7 years), while 66% had no child under age eight at home and 11% had an "empty nest." Health was regressed on psychosocial and demographic predictors using a backward elimination procedure. Twenty-seven percent of the variance in self-reported health of mothers (whether married or divorced) was accounted for by stress (beta = -.29), optimism (beta = .17), employment outside the home (beta = .14), occupational prestige (beta = .18), and quality of experience in the maternal role (beta = .14). Twenty-two percent of the variance in health of wives was explained by stress (beta = -.36), quality of experience in the wife role (beta = -.12), employment (beta = .15) and occupational prestige (beta = .14). Using t tests, healthiest and least healthy women were compared. Women in better health in middle adulthood had fewer concerns regarding their roles as workers (t = -2.03, p = .04), wives (t = -4.57, p = .0001) and mothers (t = -3.89, p = .0002), as compared to their less healthy counterparts. Women in the least healthy group appeared to be more unsure of themselves as mothers, worrying more and having more arguments with their children. They also reported more conflicts with spouse about housework and children. To summarize, stress was the strongest predictor of health in this sample. Concerns reported by women in connection with their primary roles differentiated healthiest and least healthy women. Implications for research and practice were discussed.

Primary health care for women: What is it and who provides it?

Recent federal policy has highlighted historically underrecognized women's health issues. Women comprise the majority of the population, especially the elderly. Women's health care needs, utilization patterns, and outcomes vary from those of men, and often among each other. Primary health care services for women are multidisciplinary and emphasize prevention, education, and early intervention as well as treatment. Psychologists and other primary health care providers can collaborate to provide their services in a cost-effective manner that optimizes quality of care and comprehensive health care.

The self, health, and depression in elderly women

A short-term, longitudinal, survey study was conducted to examine relationships among actual and ideal self conceptions, physical health, and depression in 149 community-dwelling elderly women. Two theoretical perspectives regarding the self were compared, women's self-development and lifespan developmental theory. As predicted by theories of women's development, relationships with other emerged as a salient aspect of the self in elderly women. Regression analyses indicated that actual and ideal self-conceptions were predicted by depression, but not generally by physical health status. Thus, physical health problems were not global in their effects on the various dimensions of the self in elderly women, but depression was.

The relationship between physical health and psychological well-being in elderly women: a developmental perspective

Little is known about the physical health and psychological well-being of very old women, although they are one of the fastest growing segments of the population. The relationships among physical health, psychological well-being, and age were investigated using a developmental perspective and a multidimensional approach to the assessment of psychological well-being. Two hundred and forty-three elderly women completed multiple self-report measures of physical health status and psychological well-being. Multiple regression analyses indicated that older age was related to lower levels of purpose in life, personal growth, and positive relationships. Poor health, regardless of age, was associated with more depression and anxiety and lower levels of positive relationships and autonomy. Implications for the nursing care of elderly women are discussed.

Racial/ethnic variations in male testosterone levels: a probable contributor to group differences in health

Racial and ethnic variations in serum testosterone levels were investigated among a large sample of male Vietnam era veterans. Based on geometric means, significant average differences were found between 3,654 non-Hispanic white and 525 black individuals. The geometric mean for testosterone levels among 200 Hispanic individuals was similar to that of non-Hispanic white individuals. Regarding two other racial/ethnic groups (Asian/Pacific Islanders and Native Americans), no significant differences were found, due perhaps to small sample sizes. Results were interpreted as having considerable potential for explaining some of the race differences in the incidences of cardiovascular diseases, hypertension, and prostate cancer.

Measures of psychological well-being and treatment satisfaction developed from the responses of people with tablet-treated diabetes

Psychological outcome measures of Well-being and Treatment Satisfaction have been designed and developed for people with tablet-treated Type 2 diabetes. The Well-being scale includes three six-item sub-scales to measure Depression, Anxiety, and Positive Well-being. A prime consideration when selecting items for the psychological well-being measures was to minimize the confounding of diabetic symptomatology with the somatic symptoms of depression and anxiety. Cronbach's alpha indicated that each of the Well-being sub-scales and the Treatment Satisfaction scale was internally reliable (alphas ranged from 0.70 to 0.88) and evidence for construct validity was provided by predicted associations with other variables collected at the time of the study. For example, lower Well-being scores were associated with being overweight (Depression: p less than 0.05; Anxiety: p less than 0.001) while greater Satisfaction with Treatment was associated with lower HbA1 levels (p less than 0.001) and lower percent ideal body weight (p less than 0.01). These scales should prove particularly useful where measures of quality of life are required to complement metabolic variables when evaluating new treatments, education programmes, and other interventions, or in the routine auditing of established methods of treatment.

Gender, coping and psychosomatic symptoms

In this study gender differences in coping were explored, using the Ways of Coping Checklist (WCC; Folkman & Lazarus, 1980). In addition, the focus was on sex differences in the predictive value of coping strategies in relation to psychosomatic symptoms. Males preferred problem-focused coping strategies, planned and rational actions, positive thinking, personal growth and humour, day-dreaming and fantasies. Women preferred emotion-focused coping solutions, self-blame, expression of emotions/seeking of social support, and wishful thinking/emotionality. In spite of the gender differences the results of multiple regression analyses indicated congruous relationships between coping and complaints for both sexes. Stressors and coping factors contributed in much the same way to the explained variance of symptoms and the results were generally similar for males and females. The present data also emphasize the bidirectionality of the coping-symptoms link. This holds especially for self-blame, day-dreaming and fantasizing, and wishful thinking/emotionality. In contrast, distancing was found to be associated with self-reported psychosocial load. Future prospective studies should explicitly pay attention to this bidirectional relationship.