Popay J, Bartley M, Owen C
Public Health Research and Resource Centre, Bolton, Salford, U.K.
Soc Sci Med. 1993 Jan;36(1):21-32. doi: 10.1016/0277-9536(93)90302-k.
Research has consistently reported a female excess of minor physical morbidity and affective disorders compared to men. Using data from a national cross sectional survey of British women and men aged 18-59, this paper explores three prominent explanations for these patterns: that the female excess is due to problems associated with menstruation and the menopause; that it is 'caused' by the social positions which women occupy in contemporary western societies; and that the excess of affective disorders is 'caused' by women's social positions but that their higher rate of physical illness is psychosomatic in origin. The analysis presented here suggests that problems with menstruation and the menopause cannot explain gender inequalities in minor illness. Similarly the argument that the female excess of minor physical illness is psychosomatic is not supported, indeed, there is evidence that women's experience of minor physical illness may 'cause' their higher rates of affective disorders. Finally, with a few exceptions, the relationship between minor illness and four dimensions of social positions--marital status, employment status, social class and income--were broadly the same for women and men but in each social position category, women report higher rates of both types of ill health than men. It is concluded that present measures of these social positions do not capture the differing experiences of women and men and that more gender sensitive measures are needed if gender inequalities in minor illness are to be understood.
研究一直表明,与男性相比,女性在轻微身体疾病和情感障碍方面的患病率更高。本文利用一项针对18至59岁英国男女的全国性横断面调查数据,探讨了对这些模式的三种主要解释:女性患病率较高是由于与月经和更年期相关的问题;是由女性在当代西方社会中所处的社会地位“导致”的;情感障碍患病率较高是由女性的社会地位“导致”的,但她们较高的身体疾病发生率源于身心问题。此处给出的分析表明,月经和更年期问题无法解释轻微疾病中的性别不平等现象。同样,女性轻微身体疾病患病率较高是身心问题这一观点也未得到支持,实际上,有证据表明女性在轻微身体疾病方面的经历可能“导致”她们情感障碍的患病率更高。最后,除了少数例外情况,轻微疾病与社会地位的四个维度——婚姻状况、就业状况、社会阶层和收入——之间的关系在男性和女性中大致相同,但在每个社会地位类别中,女性报告的两种健康问题的患病率都高于男性。研究得出结论,目前对这些社会地位的衡量未能反映出男性和女性的不同经历,如果要理解轻微疾病中的性别不平等现象,就需要更具性别敏感性的衡量标准。