American Journal of Epidemiology Vol. 130, No. 3: 601-610
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health
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SEX DIFFERENTIALS IN MORBIDITY AND MORTALITY RISKS EXAMINED BY AGE AND CAUSE IN THE SAME COHORT
1Department of Community and Family Medicine, University of Californi San Diego, La Jolla, CA.
2Human Population Laboratory, California Public Health Foundation Berkeley, CA.
3Human Population Laboratory, California Department of Health Services Berkeley, CA.
Reprint requests to Dr. Deborah L. Wingard, Department of Community and Family Medicine, M- 007, University of California, San Diego, La Jolla, CA 92093-0607.
Many studies indicate that women live longer than men but report more physical illness. This report is the first prospective study of sex ratios for morbidity and mortality due to a variety of causes in a single cohort a random sample of 5,239 adults, aged 30 years or older in 1965, who have been followed thraugh 1983 (19 years) by cause and age. For both cancer incidence and mortality there was a female excess before age 50 years, followed by a male excess peaking between ages 60 and 69 years. Sex ratios for ischemic heart disease mortality, on the other hand, indicated a male excess at virhrully all ages, and that these sex ratios declined with age. However, three measures of heart disease morbidity (selfreported chest pain, heart trouble, and high blood pressure) demonstrated a female excess that did not vary by age. All four measures of functional disabiltty (impaired selfcare, impaired mobility, cessation of work, and reduction of work) demonstrated a female excess that did not vary by age (wtth the exception of a male excess in impaired self-care in adutts aged 30 to 39 years). Further analyses of sex differences in heatth need to acknowledge the heterogeneity of the relation of sex to disease, and the complex age-sex interaction that varies remarkably wtth both cause and manifestation of outcome (morbidtty vs. mortality).
heart diseases; mortality; neoplasms; risk; sex ratio
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