1. 1 Psychology 320: Gender Psychology Lecture 54

2. 2 Invitational Office Hour Invitations, by Student Number for March 11 th 11:30-12:30, 3:30-4:30 Kenny 2517 26581074 36470094 40784084 66654062 69153047

3. 3 Reminder Paper topic due date: March 11 (Option A or B, 2-3 sentence summary; send to David at dbking11@psych. ubc.ca).

4. 4 Physical Health: 1. Are there sex differences in mortality and morbidity? (continued) 2. What factors account for sex differences in health?

5. 5 By the end of today’s class, you should be able to: 1. describe the relationship between sex differences in morbidity and gender equality. 2. discuss sex differences in illness-related behaviour. 3. review biological factors that may contribute to sex differences in mortality and morbidity.

6. 6 4. distinguish between X-linked recessive diseases and autoimmune diseases. 5. review health behaviours that contribute to sex differences in mortality and morbidity.

7. 7  In childhood, morbidity is greater among males than females. The sex difference reverses in pre- adolescence, with females reporting increasing health problems.  Sex differences in morbidity are smaller in countries with a relatively high Gender Development Index. Are there sex differences in mortality and morbidity? (continued)

8. 8 Torsheim et al., 2006 Assessed health complaints among 125,732 adolescents aged 11-15 in 29 countries in Europe and North America. In all countries, girls reported more health complaints than boys:

9. 9 AgeLow GDIMedium GDIHigh GDI 11-year-olds1.561.171.18 13-year-olds1.881.701.56 15-year-olds2.271.911.88 Odds Ratio of Females Reporting More Health Symptoms than Males* (Torsheim et al., 2006) *Odds ratio: Higher numbers indicate that more females than males reported symptoms.

10. 10 Sex differences are smaller in countries with a relatively high Gender Development Index. Relationship Between GDI and Female/Male Odds Ratio of Health Complaints Among 11- Year-Olds (Torsheim et al., 2006)

11. 11  In addition to higher rates of reported illnesses, females report more illness-related behaviour than males: days in bed due to illness, use of prescription drugs, restriction of activities due to illness, and use of health care services.  In childhood, illness behaviour is greater among males than females. The sex difference reverses in adolescence, with females reporting increasing illness behaviour.

12. 12 Utilization of Health Care Services by Females and Males in 2004 (National Center for Health Statistics, 2004) Percent

13. 13 What factors account for sex differences in health? There are three groups of factors that account for the documented sex differences in health: Biological factors. Health behaviours. Gender-related factors.

14. 14 1. Biological Factors (a) Genes  XX vs. XY: Having a second X chromosome suppresses the expression of many disorders among females, making females less likely than males to exhibit some congenital diseases (e.g., haemophilia, Duchenne muscular dystrophy, X-linked agammaglobulinemia, Wiskott-Aldrich syndrome, Menkes disease, Fragile X syndrome).

15. 15 Wiskott-Aldrich Syndrome Menkes Disease Fragile X Syndrome

16. 16 (b) Hormones  Research assessing the influence of estrogen on health has produced mixed findings: Prior to menopause, the relatively high levels of estrogen among females appear to serve as a protective factor against heart disease by decreasing cholesterol levels.

17. 17 After menopause, however, hormone (e.g., estrogen) replacement therapy is associated with an increased risk of heart disease, breast cancer, and blood clots (Lowe, 2004; Shumaker et al., 2003). Oral contraceptives, many of which contain estrogen, increase blood pressure, cholesterol levels, and blood glucose levels.

18. 18 (c) Immune System  Females display greater immune responses to infection than males (Bouman et al., 2004; Rieker & Bird, 2005; Whitacre et al., 1999).  Females have higher immunoglobulin levels than males (Schuurs & Verheul, 1990).

19. 19  The heightened sensitivity of the immune system among females may account for the greater prevalence of autoimmune diseases among females than males (e.g., rheumatoid arthritis, lupus, graves disease, vasculitis).

20. 20 Rheumatoid Arthritis Graves’ Disease

21. 21 Lupus Vasculitis

22. 22 2. Health Behaviours (a) Preventive Health Care  Females are more likely than males to take vitamins, adopt a healthy diet, engage in self-exams, have a regular physician, obtain regular check-ups, take prescriptions as recommended, and return for follow- up appointments (Courtenay et al., 2002; Slesinski et al., 1996; Wardle et al., 2004).

23. 23  Females are more likely than males to have a regular physician due to reproductive issues (Helgeson, 2009).  Preventative health care coupled with early diagnosis and intervention due to regular physician visits may contribute to the relatively low mortality rate among females.

24. 24 Physical Health: 1. Are there sex differences in mortality and morbidity? (continued) 2. What factors account for sex differences in health?