Gender disparities in trajectories of functional, mental, and self-rated health: An analysis of older adults

Recent research has shown the disadvantage women experience in functional, mental, and self-rated health is not as uniform as once thought. Furthermore, there is a lack of research on gender differences in mental health outcomes that characterize males. Most studies are based on cross-sectional data or data from two time-points and fail to examine trajectories of functional, mental, and self-rated health. This dissertation addresses these limitations to more thoroughly understand gender differences in health. Latent growth curve modeling is used to model trajectories of functional limitations, depressive symptoms, problem drinking, and self-rated health for males and females using longitudinal data from the Health and Retirement Study (HRS) and the Study of Assets and Health Dynamics Among the Oldest Old (AHEAD). The differential exposure and differential vulnerability explanations are used to examine the extent to which an extensive set of social structural, childhood background, behavioral, and health status factors explain gender differences in health. Females have higher odds of having functional limitations and depressive symptoms, as well as have more functional limitations and depressive symptoms compared to males. Males have higher odds of problem drinking. Different factors explain gender differences in problem drinking and depressive symptoms, and the factors that cause females to be depressed differ from those that cause males to drink problematically. This suggests depressive symptoms and problem drinking are not gender-comparable outcomes. There are no gender differences in self-rated health at baseline, but females have slightly higher odds of reporting good health over time. This provides evidence of a new health paradox, in which females have the same or better self-rated health compared to males regardless of more physical limitations, acute and non-fatal chronic health conditions, and depressive symptoms. The gender differences in depressive symptoms and self-rated health are fully explained by the factors in the analysis, while the differences in functional limitations and problem drinking are only partially explained. Findings confirm the differential exposure explanation, which suggests differences exist because males and females occupy different positions in society, as well as the differential vulnerability explanation, which suggests males and females react differently to their positions in society.

Health

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