Gender differences in health and mortality

According to the World Health Organization (WHO), the proportion of overweight and obese people is growing in developing countries, especially in the BRICS countries (Brazil, Russia, India, China, and South Africa). Recent results of researches show that obesity has become an epidemic in Brazil. Using data from the National Research on Social Inequalities (2008), this article examined association between religion and obesity in Brazil. Preliminary results showed a strong association between obesity and membership with mainline Protestant, Pentecostal, and Neopentecostal churches in Brazil, even after adjusting the factors that affect the Body Mass Index (BMI).

This paper investigates sex-consciousness among child desiring Indian women in context of child mortality levels on the basis of three waves of Indian national family health survey INFHS (1992-2006). All the states in NFHS-I have been classified into four mortality Zones identified by ‘under five mortality’ during 0-4 years prior to survey date. An index for measuring sex-preference based on ideal family size and its sex composition has been used to quantify the relation between sex preference and under five mortality. An analysis of Parity Progression Ratio reveals that with increase in the number of sons women are reluctant to additional children. It has been observed that intensity of preference for son in India as whole has declined over period. Though, in general, longing for ‘more sons than daughter’s quite strong among Indian women, there are some courageous women except Punjab who are positively desirous to have more daughters than sons. The study also reveal that throughout the periods from 1992-2006; urban women, women with a better education and employed women have relatively less desire of sons over daughters. Desire of having at least one son is found to be mind set-up irrespective of the socioeconomic condition of family.

Self-rated health (SRH) has consistently been associated with mortality, disability and morbidity. We investigated proximal determinants of SRH. Data come from baseline surveys of women (15-44y) and men (20-59y) in three (Ethiopia, Ghana and Uganda) of six sites of the Family Health and Wealth Study, an ongoing longitudinal study. We considered three proximal determinants of self-rated health: systolic blood pressure; non-communicable disease; and health problems. The effective analytic sample was as follows: Ethiopia (943 women; 959 men); Ghana (791 women; 747 men); and Uganda (463 women; 442 men); representing 91-99% of the total sample. Data were explored to observe patterns in the variables and relationships of interest and generate frequencies. Following estimation of ordinal logistic regressions, the presence of one or more health problems was the only proximal determinant that remained significantly associated with SRH in both men and women across the three sites. As these study cohorts are being followed over time, we expect that future findings will more fully inform the influence of proximal determinants on self-rated health.

Although academic investigation into sex mortality differentials dates back to the 17th century with pioneering work by John Grant, a fundamental unresolved question in demographic and public health research is the underlying causes of the higher mortality of boys in early ages. In this study, we address this question by estimating the distinct contributions of biology and unobserved preconception environmental factors to sex differences in infant mortality across institutional settings. We use a large sample of twins from sub-Saharan African countries. These countries are grouped into four main institutional regions, and each region is further divided into urban and rural areas. We find that regions with better institutions have lower levels of infant mortality and smaller sex differences in survival rates. Sex differences in biology and unobserved preconception factors contribute to excess male mortality in most institutions, but the effect of biology becomes small and statistically insignificant with improved institutions.The role played by these factors tends to be more important in settings with better institutions, which suggests that more research should be done in order to address each of them.

A recent study indicated an expansion of disability in France in the 50-65 age group, which went along with an increase in the sex differentials. Above differences in diseases, gender studies suggest a possible detrimental effect of situations related to gender social roles. Specific combinations of work and family loads might impact health and functioning. This paper describes gender-specific family/work situations and their impact on health using the French Gender and Generation Survey. The analyses are based on two health dimensions (mental wellbeing, activity limitations) and various social and family situations.

In the 2005 survey, 20% of men and 19% of women aged 35 to 79 years older report activity limitations and 12% and 26% report poor well-being. Women face more combinations of work and family loads which are expected to be associated with poor health. Generally these situations affect health in both sexes. Accounting for the gender-specific distribution of these situations tends to lower the OR of female over male health risks, but changes are not significant. This exploratory study show situations of vulnerability with a combination of isolation and family/work burden associated with poor health. Meanwhile, more research is needed to better define these situations and measure their link with health.

Level of poverty has been reduced substantially in past decades in India but the economic development has also raised the chance of women being overweight or obese. By using third National Family Health Survey (NFHS-3) data in this study an effort has been made to examine evidence of economic inequality in the vulnerability of underweight vis-à-vis overweight/obese women in reproductive ages in the Indian states. The macro evidences illustrate that the women from affluent families are associated with high prevalence of overweight/obesity and low economic status associated with escalating prevalence of underweight women. The micro evidences from multivariate analysis strengthens such causational patterns of greater prevalence of underweight among high parity women contrasted by significantly higher prevalence of overweight and obesity among low parity women. The results point out that under-nutrition is still a major problem; at the same time there is an emerging challenge of dealing with the problem of overweight and obesity. Declining fertility, rising income, changing occupational profile are possible contributors to such dramatic rise in double burden of malnutrition but these risk factors are disproportionately distributed, specially to the defenselessness of poor.

Fagbamigbe A. F., Adebowale A. S., Alabi O.
Abstract
Infant mortality rate (IMR) is a demographic measure and important health and economic indicator. The Nigeria Demographic and Household Survey (NDHS, 2008) declared wide difference between IMR in North East (NE) and South West (SW). This study assessed the zonal differences and determined factors affecting IMR in the zones.
This is a cross sectional study of nationally representative NDHS, 2008 data using recoded data of 164,209 and 82,744 children from NE and SW Nigeria respectively. We censored and weighted the data and analyzed using descriptive, bivariate statistics and binary logistic regression with p-value=0.05.
Mean age of mothers at first birth was 17.84(3.40) and 20.65(4.25) years respectively (p<0.05) nearly 74% of children from NE are from uneducated mothers compared to 6.88% in the SW (p<0.05). Almost half (46.48%) of children from NE had poorest wealth index compared to 6.50% in SW (p<0.05). The IMR among children from teenager mothers is 21 and 9 per 1000 live births in NE and SW respectively, 10 for urban NE, 6 for urban NE, 12 for rural NE and 9 for rural SW (p<0.05).
Efforts should be directed at in reducing the IMR in NE through education, economic empowerment and delayed childbearing.
Key world: Infant Mortality Rate, NDHS, Wealth index

The process of population ageing probably represents one of the most daunting challenges in the 21st century. Previous studies have noted differential positive effects of marital status on physical and cognitive health status of elderly. This study attempts to test the hypothesis of poor cognitive status (elevated risk of depression and hypertension) among widowed/separated/single elderly men as compared to elderly women in selected Indian states. The data for the present study comes from the World Health Organization sponsored Global Ageing and Adult Health (SAGE-India) survey carried out by the International Institute for Population Sciences (IIPS), which covered 10,000 households. The sample size has been restricted to 3,294 elderly (men and women) aged 60+ years. The results suggest that widowed/divorced/separated elderly men were at an elevated risk of cognitive dysfunction as compared to elderly women. Large inequalities in access to material, health and social resources between elderly men and women are evident in India. Thus, there is a need for policies to specifically address the dimensions in the physical and mental health of aged.

Background: Self-rated health (SRH) reliability to predict mortality has already been shown. However, differences on SHR among gender have been found, and its importance was highlighted because mortality prediction seems different among male and female. This study aims to compare SRH and associated factors among men and women from a representative sample of Brazilian adults. Method: Data from individuals over 24 years who answered the Health supplement of National Household Sample Survey (PNAD 2008) was analyzed. Logistic models were constructed to predict poor SRH. Independent variables include gender, age, socio-demographics, chronic illness and disability. Results: Overall 29.6 (SE 0.2) of men and 34.6 (SE 0.2) reported a poor health. Independent variables associated with a poor SRH include: low income (OR 3.02 (CI 2.88-3.16)), depression (OR 3.24 (CI 3.07-3.43)), diabetes (OR 2.71 (CI 2.55-2.88)), daily activities (OR 2.21(CI 2.08-2.34)) and instrumental limitations (OR 2.25(CI 2.15-2.37)). Women usually have worst evaluation of health, but men with daily activities/ instrumental limitations have a higher chance of fair/poor SRH (OR 1.43 (CI 1.30-1.57) and OR 1.52(CI 1.41-1.63)). Conclusion: Data show an interaction among gender and disability on SRH which is important for the planning of health care.

The objective of this study is to estimate the period age-specific prevalence of disability. The period prevalence of disability is the proportion of disabled among the survivors of a fictitious cohort subject to the actual age-specific conditions of entering and exiting the disability state based on information from the Survey carried out in Thiruvananthapuram, Kerala, India between 2004 and 2006. The survey was designed to study the process of ageing, in particular the evolution of functional health. The same people were interviewed in a cross-longitudinal survey of 2 waves. The IMaCh program has been used to compute the morbidity transition on estimated life expectancy. The results show that the probability of dying is much higher among the unhealthy than the healthy. It was found that at the younger ages if a person is unhealthy there was change of being recovering from the unhealthy state. But as age increases the chance of recovering is very low. A person attaining the age 60 can expect to live 17.5 years in the healthy state, given the initial condition, but the expectation is reduced to 16.7 years if unhealthy at the age of 60. The corresponding health expectancies for the unhealthy state are 4.2 and 4.9 respectively. The life expectancy in healthy and unhealthy state for women were higher than that of men.