Journal of Public Health Advance Access originally published online on November 2, 2007
Journal of Public Health 2008 30(1):111-113; doi:10.1093/pubmed/fdm072
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved
Correspondence |
Are men seeking medical advice too late? Contacts to general practitioners and hospital admissions in Denmark 2005
Knud Juel, Senior Researcher
National Institute of Public Health, University of Southern
Denmark, Øster Farimagsgade 5A, DK-1399 Copenhagen,
Denmark
E-mail: kj{at}niph.dk
Kaare Christensen, Professor
Epidemiology, Institute of Public Health
University of Southern Denmark,
Odense, Denmark
Population-based studies suggest that in many aspects men have better health than women. They are stronger, and they report fewer diseases and have fewer limitations in the activities of daily living at older ages. In health interviews women consistently report worse health status than men do, and there are higher rates of acute illness for females.1 However, female death rates are lower than male rates for all age groups, i.e. in terms of mortality women are better than men. Among the explanations for these sex differences, the most commonly proposed are: biological risks, risks acquired through social roles and behaviors, illness behavior, health reporting behavior, physicians' diagnostic patterns and differential health care access, treatment and use.1–5
A prominent hypothesis is that men seek medical advice very lately, and the stereotype is that men ‘overreact’ to small symptoms and ‘underreact’ to severe symptoms, the latter leading to a poorer prognosis. However, few data are available to support this hypothesis. Almost all studies of sex differences in morbidity have used data from samples of a population, and most studies are based on questionnaires, interviews or health examinations with the risk of selection bias. Here we have taken the advantage of the Danish nationwide health registers that cover all somatic hospital admissions and all contacts to general practitioners for the year 2005. In Denmark there is a free access to medical care and the hospital treatment is free.
We calculated age-specific rates for each sex for contacts to general practitioners and for hospital admissions and then calculated sex ratios by dividing the rates for females by the rates for males. For hospital data we calculated rates and ratios with and without sex-specific conditions (conditions related to male and female genital organs, breast cancer, abortion, pregnancy and delivery).
The analysis is based on a total of 35.8 million contacts to general practitioners, and 1.2 million hospitalizations in 2005. The figure shows that at all ages women have higher rates of contacts to general practitioners than men with a peak between ages 15 and 35. Between ages 15 and 50, women also have higher rates of hospital admissions. The difference in hospitalization rates for ages 15–49 is strongly influenced by women's hospitalization in connection with childbirth. Excluding these together with all sex-specific conditions makes the sex difference disappear. For age 50 and older, men have higher rates of hospitalization.
|
Our data, which are without any selection bias due to the Danish health care system and to the nationwide registers, show a male pattern with a lower contact rate to the general practitioner, but higher hospitalization and mortality rates. This is compatible with a scenario in which men react later to severe symptoms than women so that they are more likely to be hospitalized for or die from these conditions. The reason why men are reluctant to seek medical advice is probably rooted in biological and psychological factors as well as social traditions.1–5 New generations and new initiatives like "‘Men's Health Week’" might help to change the male reluctance toward using the health care system.
 |
Funding |
|---|
 TOP Funding AcknowledgmentsReferences |
|---|
This study was supported by a grant from the National Institute on Aging, US National Institutes of Health, grant No. P01 AG08761.
|
Acknowledgments |
|---|
|
TOPFundingAcknowledgmentsReferences |
|---|
The sponsors of the study had no role in the study design, data collection, data analysis, data interpretation or writing of this article.
|
References |
|---|
|
TOPFundingAcknowledgmentsReferences |
|---|
- Verbrugge LM, Wingard DL. Sex differentials in health and mortality. Health Matrix (1987) 5(2):3–19.[Medline]
- Wingard DL, Cohn BA, Kaplan GA, Cirillo PM, Cohen RD, et al. Sex differentials in morbidity and mortality risks examined by age and cause in the same cohort. Am J Epidemiol (1989) 130(3):601–10.
[Abstract/Free Full Text] - Fillingim RB. Sex, gender, and pain: women and men really are different. Curr Rev Pain (2000) 4:24–30.[Medline]
- Macintyre S, Ford G, Hunt K. Do women ‘over-report’ morbidity? Men's and women's responses to structured prompting on a standard question on long standing illness. Soc Sci Med (1999) 48(1):89–98.[CrossRef][Web of Science][Medline]
- Dunnell K, Fitzpatrick J, Bunting J. Making use of official statistics in research on gender and health status: recent British data. Soc Sci Med (1999) 48(1):117–27.[CrossRef][Web of Science][Medline]
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||