Background Although women are less healthy than men with respect to physical health and depression, gender differences in morbidity and self-rated health (SRH) are less consistent. Female disadvantage in SRH has been partially explained by women’s preponderance to report poor health. Although more recent studies challenge gender stereotypical treatment-seeking behavior and reporting of specific health conditions, we know relatively little about gender differences in reporting of SRH. The present study investigates to which extent adjusting for differences in reporting styles modifies gender differences in SRH, whether these changes are due to gender-specific over- and/or under-reporting patterns, and whether these changes are consistent for reporting of poor and good health.
Methods We utilize the data collected in the wave 1 (2004) of the Survey of Health, Ageing and Retirement in Europe, a multidisciplinary panel survey of community-dwelling individuals aged 50+ in 12 countries. The analysis follows the method proposed by Jürges (2007) and Rebelo and Pereira (2014). Our dependent variable is a global evaluation of health 5 possible responses: excellent, very good, good, fair, and poor. SRH is our dependent variable and is modelled with a generalized ordered probit model. There are two types of independent variables: latent health (e.g. chronic conditions, physical limitations, and smoking) variables and threshold variables (gender, education level and country). Once the appropriate model is selected and fitted, health indexes and disability weights are calculated. They, in turn, are used to calculate SRH adjusted for reporting styles.
Results Our preliminary analyses suggest that when SRH is adjusted for differences in reporting styles, the gender gaps in the percentage of persons with both poor and good widen. Except the oldest age group, more men have reported poor health than they have, whereas less women have reported poor SRH than they have except the youngest women. These findings suggest that men over-report and women under-report poor health. At all ages less men have reported very good health than they have, whereas the fraction of women in very good health is higher on the original than on the adjusted scale. In other words, these findings suggest that men under-report and women over-report good health.
Conclusion Our preliminary findings challenge the prevailing assumption of women over-reporting and men under-reporting health problems and highlight the importance to attend to health problems reported by women and men equally carefully.
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