Vader Sarah S, Lewis Shirley M, Verdonk Petra, Verschuren W M Monique, Picavet H Susan J
Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
Department of Medical Humanities, Amsterdam Public Health Research Institute, School of Medical Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Prev Med Rep. 2023 Apr 6;33:102202. doi: 10.1016/j.pmedr.2023.102202. eCollection 2023 Jun.
Both (biological) sex and (socio-cultural) gender are relevant for health but in large-scale studies specific gender measures are lacking. Using a masculine gender-score based on 'traditional masculine-connotated aspects of everyday life', we explored how masculinity may affect sex differences in the prevalence of chronic health problems. We used cross-sectional data (2008-2012) from the Doetinchem Cohort Study to calculate a masculine gender-score (range 0-19) using information on work, informal care, lifestyle and emotions. The sample consisted of 1900 men and 2117 women (age: 40-80). Multivariable logistic regressions including age and SES were used to examine the role of masculine gender on sex differences in the prevalence of diabetes, coronary heart disease, CVA, arthritis, chronic pain and migraine. Men had higher masculine gender-scores than women (12.2 vs 9.1). For both sexes, a higher masculine gender-score was associated with lower prevalence of chronic health problems. Diabetes, CHD, and CVA were more prevalent in men, and gender-adjustment resulted in greater sex differences: e.g. for diabetes the OR changed from 1.21 (95 %CI 0.93-1.58) to 1.60 (95 %CI 1.18-2.17). Arthritis, chronic pain, and migraine were more prevalent in women, and gender-adjustment resulted in smaller sex differences: e.g. for chronic pain the OR changed from 0.53 (95 %CI 0.45-0.60) to 0.73 (95 %CI 0.63-0.86). Gender measured as 'everyday masculinity' is associated with lower prevalence of chronic health problems in both men and women. Our findings also suggest that the commonly found sex differences in the prevalence of chronic health problems have a large gender component.
（生理）性别和（社会文化）性别均与健康相关，但在大规模研究中，缺乏特定的性别测量方法。基于“日常生活中传统男性化内涵的方面”计算男性性别得分，我们探究了男性气质如何影响慢性健康问题患病率的性别差异。我们使用了多廷赫姆队列研究（2008 - 2012年）的横断面数据，利用工作、非正式护理、生活方式和情绪方面的信息计算男性性别得分（范围0 - 19）。样本包括1900名男性和2117名女性（年龄：40 - 80岁）。使用包括年龄和社会经济地位的多变量逻辑回归来检验男性性别在糖尿病、冠心病、中风、关节炎、慢性疼痛和偏头痛患病率性别差异中的作用。男性的男性性别得分高于女性（12.2对9.1）。对于两性而言，较高的男性性别得分与较低的慢性健康问题患病率相关。糖尿病、冠心病和中风在男性中更为普遍，进行性别调整后导致更大的性别差异：例如，糖尿病的比值比从1.21（95%置信区间0.93 - 1.58）变为1.60（95%置信区间1.18 - 2.17）。关节炎、慢性疼痛和偏头痛在女性中更为普遍，进行性别调整后导致较小的性别差异：例如，慢性疼痛的比值比从0.53（95%置信区间0.45 - 0.60）变为0.73（95%置信区间0.63 - 0.86）。以“日常男性气质”衡量的性别与男性和女性较低的慢性健康问题患病率相关。我们的研究结果还表明，在慢性健康问题患病率中常见的性别差异有很大一部分是由性别因素造成的。
