Perception or real illness? How chronic conditions contribute to gender inequalities in self-rated health. Address for correspondence (original) (raw)
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The Gender Pain Gap: gender inequalities in pain across 19 European countries
Scandinavian Journal of Public Health, 2021
Aims: Chronic pain is increasingly considered to be an international public health issue, yet gender differences in chronic pain in Europe are under-examined. This work aimed to examine gender inequalities in pain across Europe. Methods: Data for 27,552 men and women aged 25–74 years in 19 European countries were taken from the social determinants of health module of the European Social Survey (2014). Inequalities in reporting pain were measured by means of adjusted rate differences (ARD) and relative adjusted rate risks (ARR). Results: At the pooled pan-European level, a greater proportion of women (62.3%) reported pain than men (55.5%) (ARD 5.5% (95% confidence intervals (CI) 4.1, 6.9), ARR 1.10 (95% CI 1.08, 1.13)). These inequalities were greatest for back/neck pain (ARD 5.8% (95% CI 4.4, 7.1), ARR 1.15 (95% CI 1.12, 1.19)), but were also significant for hand/arm pain (ARD 4.6% (95% CI 3.5, 5.7), ARR 1.24 (95% CI 1.17, 1.30)) and foot/leg pain (ARD 2.6% (95% CI 1.5, 3.8), ARR 1....
The importance of gender in health problems
European Journal of General Practice, 2008
Objective: To investigate gender differences in health problems in general practice. Methods: We performed a study using data from the Continuous Morbidity Registration (CMR) Nijmegen. To study the distribution by gender we analysed overall morbidity per 1000 patients years over a period of 10 years. Secondly we calculated the influence of gender by diagnostic rubric. For each diagnosis in the rubric of musculoskeletal disorders, we calculated incidence and sex ratio related to socio econonomic status (SES). We did the same concerning the referral rates for cardiovascular disease (CVD). Results: Women had significantly more health problems than men, most striking in the age group 25Á44 years, due to screening and reproductive health problems. Concerning gender differences related to SES in muskulo skeletal disorders we found the lower the SES the more prevalent is osteoarthritis of the knee in women. The sex ratios in CVD showed men as leading sufferers. Decreasing SES resulted in increasing incidence of CVD and a lower referral rate to the cardiologist in women. Conclusion: Sex differences appear in the prevalence of health problems, risk factors and access to medical care. They also can influence the course of diseases. Health problems in men and women also vary according to socioeconomic status, meaning that gender is strongly intertwined as risk factor with socioeconomic status, ethnicity, and age.
Pain Medicine, 2010
Although previous research suggests women report more severe pain than men, evidence for sex-related differences in pain-related disability is conflicting. Also, the impact of psychological factors on sex differences in disability is uncertain. The purpose of this study is to assess sex differences in pain-related disability and evaluate whether they are accounted for by psychological factors. Analysis of baseline data from the Stepped Care for Affective disorders and Musculoskeletal Pain study. Participants included 241 male and 249 female primary care patients with moderately severe persistent pain of the back, hip, or knee. Multivariable log-linear models were used to determine the association between sex and pain-related disability and whether sex differences persisted after adjustment for psychiatric comorbidity and potential psychological mediators. Compared with men, women reported worse pain intensity, greater pain-related interference with function, and more disability days due to pain. They also had worse depression, anxiety, and self-efficacy. Sex differences in pain interference with function and pain disability days remained significant in multivariable models. Depression, poor self-efficacy, and fear of reinjury were independently associated with disability in both men and women. Women report greater pain-related disability than do men, even after controlling for depression, anxiety, and other psychological factors. Pain management strategies that target functional disability may be particularly important in the treatment of women with pain.
Gender Differences in Different Contexts, 2017
Research has found differences between women and men in some health indicators. Women's life expectancy is higher than men's, but research on differences in morbidity has proved less consistent than on the differences in mortality. These differences vary in terms of the type of health indicator used, the life cycle period analyzed, and even the country where research is conducted. Generally, men have more life-threatening chronic diseases at younger ages, including coronary heart disease, as well as more externalizing mental health problems and substance use disorders. Women present higher rates of chronic debilitating conditions such as arthritis, frequent or severe headaches, gallbladder conditions, and also more internalizing mental problems such as affective and anxiety disorders. Results of research on the differences between women and men in self-rated health have also highlighted the complexity of gender differences in health. Although several studies have shown that women have poorer self-rated health than men, this is not the case in all countries. Also, differences in self-rated health vary depending on other psychosocial and demographic variables. The present study reviews the main differences in women's and men's health as well as the most relevant factors that may account for them.
Severity of musculoskeletal pain: relations to socioeconomic inequality
Social Science & Medicine, 2002
The main aim of the study was to investigate possible associations between severity of non-inflammatory musculoskeletal pain and residential areas of contrasting socioeconomic status. A 4-page questionnaire inquiring about musculoskeletal pain, and also physical disability, mental health, life satisfaction and use of health services was sent to 10,000 randomly selected adults in Oslo, Norway. For the purpose of this study, we analysed data from respondents living in two socioeconomically contrasting areas of the city.
Gender inequalities in health and health care services use in Catalonia (Spain
Journal of Epidemiology and Community Health, 1999
Background and objectives-While socioeconomically derived diVerences in health and health services use have long been a subject of study, diVerences based on gender, considered as the explicative variable, have scarcely been quantified from population-based data. The aim of this investigation was to analyse inequalities in health and health care services utilisation between men and women in Catalonia (Spain). Design, setting, participants, and measures-Data from the Catalan Health Interview Survey, a cross sectional survey conducted in 1994, were used. A total of 6604 women and 5641 men aged 15 years or over were included for analysis. Health related variables studied were self perceived health, restriction of activity (past two weeks), and presence of chronic conditions; health services use variables analysed were having visited a health professional (past two weeks), an optometrist (12 months), or a dentist (12 months); and hospitalisation (past 12 months). Age standardised proportions were computed according to gender, and prevalence odds ratios (OR) were derived from logistic regression equations. Main results-Women more frequently rated their health as fair or poor than men (29.8% v 21.4%; OR=1.22; 95% CI: 1.10, 1.34). More women than men reported having restricted activity days (OR=1.86; 95% CI: 1.59, 2.18) and chronic conditions (OR=1.74; 95% CI: 1.60, 1.89). The proportion of women visiting a health professional was slightly greater than that for men (OR=1.20; 95% CI: 1.09, 1.31), as was the proportion of women visiting an optometrist (OR=1.21; 95% CI: 1.11, 1.33), and a dentist (OR=1.43; 95% CI: 1.31, 1.55). The proportion of hospitalisation was lower in women (6.6%) than in men (7.7%; OR=0.73; 95% CI: 0.63, 0.85). When health services use was analysed according to self perceived health, women declaring good health reported a greater probability of consulting a health professional (OR=1.35; 95% CI: 1.20, 1.52). There were no diVerences in respect to hospitalisation, visits to the optometrist and to the dentist. Conclusions-These results indicate a pattern close to the inverse care law, as women, who express a lower level of health and thus would need more health care, are not, however, using health services more frequently than men.
Pain Medicine, 2020
Objectives To assess the prevalence of chronic neck pain (CNP), chronic low back pain (CLBP), and migraine headache (MH) in the Spanish population and to identify sociodemographic and health-related variables associated with CNP, CLBP, and MH. Design Observational study. Setting Spain. Subjects A total of 22,511 persons 18 years of age or older (10,304 males and 12,207 females) who participated in the 2017 Spanish National Health Survey. Methods Stratified three-stage sampling was applied. CNP, CLBP, and MH were the dependent variables. The analysis was conducted separately by gender. Sociodemographic features, self-perceived health status, lifestyle habits, comorbidities, and pain features were analyzed by using logistic regression models. Results Females reported a higher prevalence of CNP, CLBP, and MH (P < 0.001) than males. For both sexes, anxiety and/or depression and poor self-rated health were associated with a significantly increased prevalence of CNP, CLBP, and MH. For ...
Sex Differences in Presentation, Course, and Management of Low Back Pain in Primary Care
The Clinical Journal of Pain, 2008
Objective: Epidemiologic surveys frequently show that women more often and are more affected by low back pain (LBP). The aim of this secondary analysis of a randomized controlled study was to explore whether presentation and course of LBP of women is different from men, and if sex affects the use of healthcare services for LBP.