Background Chronic non-communicable diseases (NCDs) are considered the main cause of death worldwide. In China, in 2012, 87% of all deaths were caused by NCDs, which is 19% higher than the world average. In the West, it has been shown that a greater proportion of men have chronic illness than women; however, less evidence is available about the sex health gap in China. Therefore, the objective of this study is to describe sex differences in health and health-related behaviours in China.

Methods This is a cross-sectional study, a sub-study using 2013 data from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative longitudinal survey of 18,455 people of 45 years or older recruited from urban and rural areas in China that started in 2011. The study participants provided information on socio-demographic factors, self-reported health status (hypertension, dyslipidemia, heart disease, stroke, diabetes, chronic lung disease, cancer, arthritis and overall health) and health-related behaviours (physical activity, smoking status, alcohol consumption and diet). Chi-square tests and t-tests were used to describe sex differences in socio-demographic characteristics, health and health-related behaviours. Logistic regression analyses were used to describe the association of sex with health-related behaviours and health status adjusted for age, educational level, marital status, region in China, urban status, and reported health. The models with health status were additionally adjusted for physical activity, smoking, alcohol consumption, diet and treatment.

Results Odds ratios (95% CI) of heart disease 0.66 (0.54, 0.80), cancer 0.51 (0.27, 0.96), arthritis 0.71 (0.63, 0.80), and reported health status 0.82 (0.75, 0.90) were significantly lower in men compared to women. In contrast, odds of chronic lung disease were higher in men than in women 1.41 (1.19, 1.67). No sex differences were observed for hypertension, dyslipidaemia, stroke and diabetes. Odds of vigorous activity were higher 1.50 (1.34, 1.66), while those of moderate activity 0.85 (0.78, 0.92) and walking 0.92 (0.85, 0.99) were lower in men compared to women. Odds of current smoking 27.73 (24.02, 32.00) and alcohol consumption 7.42 (6.83, 8.06) were significantly higher in men compared to women. No sex difference in dietary behaviour was observed between men and women.

Conclusion The results of the study reveal significant differences in health and health behaviours between men and women in China. Longitudinal studies are needed to explore whether this gender difference changes over time.