Case Anne, Paxson Christina
Center for Health and Wellbeing, Princeton University, Princeton, NJ 08544, USA.
Demography. 2005 May;42(2):189-214. doi: 10.1353/dem.2005.0011.
Women have worse self-rated health and more hospitalization episodes than men from early adolescence to late middle age, but are less likely to die at each age. We use 14 years of data from the U.S. National Health Interview Survey to examine this paradox. Our results indicate that the difference in self-assessed health between women and men can be entirely explained by differences in the distribution of the chronic conditions they face. This is not true, however, for hospital episodes and mortality. Men with several smoking-related conditions--including cardiovascular disease and certain lung disorders--are more likely to experience hospital episodes and to die than women who suffer from the same chronic conditions, implying that men may experience more-severe forms of these conditions. While some of the difference in mortality can be explained by differences in the distribution of chronic conditions, an equally large share can be attributed to the larger adverse effects of these conditions on male mortality. The greater effects of smoking-related conditions on men's health may be due to their higher rates of smoking throughout their lives.
从青春期早期到中年后期,女性的自评健康状况比男性差,住院次数也更多,但在每个年龄段死亡的可能性较小。我们使用来自美国国家健康访谈调查的14年数据来研究这一矛盾现象。我们的结果表明,女性和男性在自我评估健康方面的差异可以完全由他们所面临的慢性病分布差异来解释。然而,对于住院次数和死亡率而言,情况并非如此。患有多种与吸烟相关疾病(包括心血管疾病和某些肺部疾病)的男性比患有相同慢性病的女性更有可能住院和死亡,这意味着男性可能经历这些疾病更严重的形式。虽然死亡率的一些差异可以由慢性病分布差异来解释,但同样大的一部分可归因于这些疾病对男性死亡率的更大不利影响。与吸烟相关疾病对男性健康的更大影响可能是由于他们一生中较高的吸烟率。