1 Psychology 320: Gender Psychology Lecture 52

2 Physical Health: 1. What factors account for sex differences in health? (continued)

3 What factors account for sex differences in health? (continued) 1. Biological Factors (b) Hormones  Research assessing the influence of estrogen on health has produced mixed findings:

4 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. 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).

5 Estrogen may also contribute to the development of breast cancer, endometrial cancer, and osteoarthritis among females. Oral contraceptives, many of which contain estrogen, increase blood pressure, cholesterol levels, and blood glucose levels.

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

7 Rheumatoid Arthritis Graves’ Disease

8 Lupus

9 (d) Cardiovascular Reactivity  Refers to increases in blood pressure and heart rate under conditions of stress.  Historically, research demonstrated that males exhibit greater cardiovascular reactivity than females (Matthews et al., 2001). The increased cardiovascular reactivity of males was proposed as an explanation for the higher rates of heart disease among males than females.

10  However, recent research suggests that sex differences in cardiovascular reactivity are influenced by the nature of the stressor: Males exhibit greater reactivity in response to “masculine” stressors, whereas females exhibit greater reactivity in response to “feminine” stressors. Stroud et al., 2002 Exposed males and females to gender congruent and incongruent stressors. Measured cortisol levels as an indicator of participants’ stress response:

11 Reactivity to Gender-Role Specific Stessors by Sex (Stroud et al., 2002)

12  Thus, at this point, it is unclear if sex differences in cardiovascular reactivity contribute to sex differences in health.

13 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).

14  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.

15  Notably, individuals who are homosexual are less likely than individuals who are heterosexual to seek and receive health care services. Lesbians and gay men report feeling uncomfortable dealing with a health care system that is not sensitive to homosexuality (Mann, 1996; Rankow & Tessaro, 1998).

16 (b) Smoking  Smoking rates have decreased over the last several decades. Today, 21.4% of Canadians smoke (Statistics Canada, 2009).  Males (24.3%) smoke more than females (18.5%), which may contribute to the higher mortality rate among males. However, the sex gap in smoking rates is decreasing:

17 Smoking Rates by Sex, 1977 to 2007 (Statistics Canada, 2003, 2009) Percent

18 Physical Health: 1. What factors account for sex differences in health? (continued)