Fuller T D, Edwards J N, Sermsri S, Vorakitphokatorn S
Department of Sociology, Virginia Polytechnic Institute and State University, Blacksburg 24061.
J Health Soc Behav. 1993 Sep;34(3):252-71.
In Thailand, like the U.S., women's higher rates of illness and health service use imply that they are "sicker." But, as in the U.S., females live longer than males. Based on a large representative sample of Bangkokians, we find that married women report more sickness, are more likely to utilize health services and, according to self-reports, have poorer health. Western literature suggests five prominent explanations for gender differences in health: biological risks, acquired risks, psychosocial aspects of symptoms and care, health-reporting behavior, and prior health care and caretakers. However, analyses show that these explanations largely fail to account for morbidity differences between Thai men and women. The observed gender differences in health among Thais remain significant after eliminating pregnant women and new mothers, and after controlling for several aspects of acquired risk. Problems associated with the reproductive system among Thai women, along with greater psychological distress, appear to account for most of the gender differences in health. The theoretical implications of these findings are discussed. As for the apparent contradiction between gender differences in health and mortality in Thailand, the evidence indicates that Thai men, like their American counterparts, suffer from more serious chronic ailments that may explain their higher mortality rates.
在泰国,和美国一样,女性较高的疾病发生率和医疗服务利用率意味着她们“病得更重”。但是,和美国一样,女性的寿命比男性长。基于对曼谷人的一个具有广泛代表性的大样本,我们发现已婚女性报告的疾病更多,更有可能使用医疗服务,而且根据自我报告,她们的健康状况更差。西方文献提出了关于健康方面性别差异的五种主要解释:生物风险、后天获得的风险、症状和护理的社会心理方面、健康报告行为以及先前的医疗保健和护理人员。然而,分析表明,这些解释在很大程度上无法说明泰国男性和女性之间的发病率差异。在排除孕妇和新妈妈之后,以及在控制了后天获得风险的几个方面之后,泰国人在健康方面观察到的性别差异仍然显著。泰国女性生殖系统相关的问题,以及更大的心理困扰,似乎是健康方面性别差异的主要原因。本文讨论了这些发现的理论意义。至于泰国在健康和死亡率方面的性别差异之间明显的矛盾,证据表明泰国男性和美国男性一样,患有更严重的慢性疾病,这可能解释了他们较高的死亡率。