Chapter 13 Health and Fitness
Headline: “Why Marriage Is Good Medicine for Men” 332
James Bond wouldn’t have lived past 40 something, not just because of the death traps
and vodka martinis but also because he wasn’t married. As an unmarried man he would be
vulnerable to both poorer health and a shorter life. Men’s health is benefited more by marriage
than women; however, women see the benefits more than men do. Women provide emotional
support and monitor their husbands both of which are important for health. Wives monitoring of
their husbands habits and urging them to seek medical attention when necessary is sometimes
called nagging and is the butt of many jokes but it actually benefits men’s health. The quality of
a marriage is related to health. Good marriages benefit the health of both partners. Bad marriages
may be detrimental to the health of both partners. Marriage itself is not the benefit; instead caring
relationships provide a framework for healthy living, including benefits for physical health and a
Mortality: No Equal Opportunity 333
The phrase women are sicker men die quicker means women have a higher morbidity but
a lower mortality. The longer life expectancy of women isn't a recent development, nor is it
restricted to .any one ethnic group. Figure 13.1 on page 334 highlights this difference (note the
difference in whites and nonwhites life expectancies as well). The female gender role permits
sickness to be acknowledged more than the male gender role, providing one possible explanation
for women’s higher morbidity rates. Women also tend to monitor their own health more
vigorously than men do and seek health care when they perceive a problem. Thus women seek
and receive more health care than men which may relate to their lower mortality rates- women
are better at prevention. Women also practice better health behaviours.
Cardiovascular Disease 333
Cardiovascular Disease (CVD): A group of diseases involving the heart and circulatory system,
some of which are life threatening; heart attack and stroke are the most common. Table 13.1 on
page 335 illustrates heart disease mortality for women and men doesn’t differ greatly across the
Risk Factor: Any condition or factor that increases the probability that an illness will develop.
Sex is a risk factor for CVD under the age of 65, with men being at greater risk.
Estrogen is believed to be protective against CVD but hormone replacement therapy
carries more risks than benefits for older women. If hormones were the main source of heart
disease, then the fender differences in CVD would apply at all times and all societies, which they
do not. The gender gap was much smaller during the 1800’s and began to widen during the
1920’s. These changes suggest social and behavioural factors are involved in the gender
difference. Lifestyle factors associated with the male gender role, smoking high fat diets, may be
a factor in this difference. In a study that statistically adjusted for lifestyle factors men were still
twice as likely as women to experience CVD. Women are under diagnosed when they present wit symptoms of CVD as are African
Americans leading African American women to be the most overlooked.
Cancer is a term applied to a variety of malignant neoplasms- tissues that undergo
uncontrolled growth that may form a tumour, as well as spread to other areas of the body.
Men have higher overall death rates for cancer then women do for most types of cancer
and at most ages. Table 13.2 represents the incidence and mortality rates for men and women for
various types of cancers among several ethnic groups in the United States. Incidence represents
how often people develop these cancers, whereas the mortality rates reflects how deadly each
type of cancer is.
Cigarette smoking is a major factor in cancer death rates, especially lung cancer. Until
recently men smoked at much higher rates than women, but women’s increased use of tobacco is
a factor in the narrowing of the gender gap in longevity.
The use of tobacco accounts for about 30% of cancers, ad the combination of diet,
physical inactivity and obesity for another 35%. High fat diets are indicated as a risk factor for
cancers of the digestive tract and breast cancer. On average, women eat lower fat diets so this
could account for the discrepancy in cancer death rates.
Occupational exposure accounts for 4% of all death rates and men are at an increased risk
for cancer due to workplace hazards.
Sexual behaviour and reproduction also contribute to the development of cancer. Women
who have sex at a young age and have many partners are more at risk for the human
paplomavirus (HPV), which causes cervical cancer. Women who complete pregnancies before
age 20 are at a decreased risk for breast cancer.
Gendered Voices; I Have Breast Cancer
Breast cancer affects more than 1,000 men in the United States. Robert Riter’s experience of
breast cancer was similar to a women’s, he had a mastectomy and chemotherapy. Unlike many
women, losing the breast was not as a traumatic even for him. His greatest distress came from
the survival statistic, surviving for 5 years 80% but for 10 60%. He would go into “women’s”
clinics for a mammogram and would have letters addressed to Ms. Robert Riter. He noted that
his experience with breast cancer taught him to be more empathetic towards women’s health
Violent Deaths 338
th th th
Unintentional injuries are the 5 , suicide the 11 , and homicide the 15 leading cause of
death. Added together these injuries account for 6% of all deaths in the U.S.. This number
represents a relatively high rate of violence compared to other industrialized, economically
developed countries. Violent death rates are lower in Australia, Canada, Japan, most other
countries in Western Europe, Scandinavia, and other countries scattered throughout the world.
Violent deaths are the leading cause of death among adolescents and young adults, men
are also about 3x more likely to die from a violent death than women. The. gender difference in
risky behaviours account for the differences in violent deaths with men tending to behave in
ways that increase their risk. Women are more likely to attempt suicide but men are more likely to actually commit
suicide. The main reason for men’s higher rates of completed suicides is the tendency to choose
more lethal methods.
Men are more likely to commit crimes, especially violent ones. The increase in
lawbreaking among women in past decades hasn’t changed these figures. Women’s increase
reflects primarily nonviolent crimes.
. Table 13.3 on page 339 shows U.S. death rates from accidents and violence among different
The Health Care System 340
Women’s reproduction and its medicalized treatment account for increased use of
medical services among women. Women could also just be sicker on the whole then men but
their health problems aren’t life threatening producing the combination of poorer health and
longer lives. A third explanation involves the difference in gender roles related to seeking and
receiving health care.
Gender Roles and Health Care 341
Traditional and female gender roles differ in the amounts of vulnerability each is allowed
and the permissibility of seeking help. one facet of the masculine role, the Sturdy Oak, holds that
men are stung and invulnerable; this aspect of the role causes men to refrain from showing signs
of physical illness or seeking medical care. The traditional female role on the other hand, allows
and even encourages weakness and vulnerability for emotional and physical problems.
Gender and Seeking Health Care
The decision to seek medical care is influenced by many factors, including the perception
of symptoms and beliefs about the consequences of seeking or failing to seek treatment. People
who feel healthy may or may not go to routine exams; they may find it easy to ignore checkups
and screenings as long as they feel well. Men are more likely to ignore regular care; men are less
likely to have regular physicians than women. As many cancers don't shoe symptoms in the early
stages the belief that if they feel fine they are fine can be fatal.
Women, on the other hand, find it more difficult to avoid the health care system
regardless of how well they may feel.
The factors that influence reluctance to seek medical care either may not affect men and women
equally. Women are more likely then men to be outside the paid workforce and to be employed
on a part-time basis; whereas men are more likely to have the types of jobs that offer health
insurance benefits. Women only have access to their husband’s health care if they have a good
plan; they can lose it through a divorce as can their children.
Gender and Receiving Health Care
Once someone is a part of the health care system gender becomes a factor in treatment, gender
stereotypes influence the behaviour of both the patient and practitioner. Some patient practitioner
relationtips are collaborative the traditional roles have been the subordinate patient and ontrolling
practitioner. This combination of gender roles puts women at a disadvantage both as a patient
and a practitioner. Men seem to have more trouble adopting the patient role than women do. Gender is not a
reliable predictor of patient compliance but the combination of the demographic factors of
gender, age, ethnic background, cultural norms, religion, and education level relates to patients’
compliance with physicians’ treatment advice.
The medical profession has been criticized for its treatment of women. The most radical
form is women have historically been healers and now put in the subordinate position as nurses.
Others criticisms have claimed that negative stereotypes of female patients have let to poorer
levels of medical care.
Medical school educational standards have promoted the view that women are emotional
and incapable of providing accurate information about their bodies. The view of “emotional
females” may lead physicians to discount the information provided by female patients and to
believe that women cannot participate in decisions concerning their own health and treatment. In
a study looking at this problems were the same for both male and female patients thus any
difference that appeared in attributions by physicians would be due to the use of stereotype of
women and men in making judgements. People saw women’s health problems as the result of
relatively uncontrollable biological and emotional factors but judged men’s problems as the
result of relatively controllable behavioural and situational factors. These attributions have the
potential to make big differences in health care.
Another criticism is aimed at the more subtle type of discrimination in which men are the
standard by which to measure all health concerns. In addition, holding men as a standard in
medicine, medical research once routinely omitted female participants. During the 1980;s the
practice of omitting women as research participants received increasing criticism, and pressure
mounted to give women’s health additional emphasis. Out of this the Office of Research on
Women’s Health was created. This office ensures that women and minorities are included in
research. This group made headlines when the research they were sponsoring regarding hormone
replacement therapy was halted due to increased risk for disease. Until this time hormone
replacement therapy was thought to be beneficial, instead it increased the likelihood for blood
clots, breast cancer, heart disease and stroke. It also increased the likelihood of Alzheimer’s
disease and other types of cognitive dementia in older women.
During childhood parents are more likely to take their sons to the doctor than their
daughter’s but once men become in charge of going to the doctor they often avoid it.
Prostate cancer kills almost as many men as breast cancer kills women, yet funding for breast
cancer research is many times greater than for prostate cancer. Men’s advocacy influenced the
development of gender specific