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How robust is the evidence of an emerging or increasing female excess in physical morbidity between childhood and adolescence? Results of a systematic literature review and meta-analyses

Listed author(s):
  • MacLean, Alice
  • Sweeting, Helen
  • Egan, Matt
  • Der, Geoff
  • Adamson, Joy
  • Hunt, Kate
Registered author(s):

    For asthma and psychological morbidity, it is well established that higher prevalence among males in childhood is replaced by higher prevalence among females by adolescence. This review investigates whether there is evidence for a similar emerging female ‘excess’ in relation to a broad range of physical morbidity measures. Establishing whether this pattern is generalised or health outcome-specific will further understandings of the aetiology of gender differences in health. Databases (Medline; Embase; CINAHL; PsycINFO; ERIC) were searched for English language studies (published 1992–2010) presenting physical morbidity prevalence data for males and females, for at least two age-bands within the age-range 4–17 years. A three-stage screening process (initial sifting; detailed inspection; extraction of full papers), was followed by study quality appraisals. Of 11 245 identified studies, 41 met the inclusion criteria. Most (n = 31) presented self-report survey data (five longitudinal, 26 cross-sectional); 10 presented routinely collected data (GP/hospital statistics). Extracted data, supplemented by additional data obtained from authors of the included studies, were used to calculate odds ratios of a female excess, or female:male incident rate ratios as appropriate. To test whether these changed with age, the values were logged and regressed on age in random effects meta-regressions. These showed strongest evidence of an emerging/increasing female excess for self-reported measures of headache, abdominal pain, tiredness, migraine and self-assessed health. Type 1 diabetes and epilepsy, based on routinely collected data, did not show a significant emerging/increasing female excess. For most physical morbidity measures reviewed, the evidence broadly points towards an emerging/increasing female excess during the transition to adolescence, although results varied by morbidity measure and study design, and suggest that this may occur at a younger age than previously thought.

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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 78 (2013)
    Issue (Month): C ()
    Pages: 96-112

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    Handle: RePEc:eee:socmed:v:78:y:2013:i:c:p:96-112
    DOI: 10.1016/j.socscimed.2012.11.039
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    1. Sweeting, Helen & West, Patrick, 2003. "Sex differences in health at ages 11, 13 and 15," Social Science & Medicine, Elsevier, vol. 56(1), pages 31-39, January.
    2. Corinna Bisegger & Bernhard Cloetta & Ursula von Bisegger & Thomas Abel & Ulrike Ravens-Sieberer, 2005. "Health-related quality of life: gender differences in childhood and adolescence," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 50(5), pages 281-291, October.
    3. Connell, Raewyn, 2012. "Gender, health and theory: Conceptualizing the issue, in local and world perspective," Social Science & Medicine, Elsevier, vol. 74(11), pages 1675-1683.
    4. Sleskova, Maria & Salonna, Ferdinand & Madarasova Geckova, Andrea & van Dijk, Jitse P. & Groothoff, Johan W., 2005. "Health status among young people in Slovakia: comparisons on the basis of age, gender and education," Social Science & Medicine, Elsevier, vol. 61(12), pages 2521-2527, December.
    5. Lien, Lars & Dalgard, Florence & Heyerdahl, Sonja & Thoresen, Magne & Bjertness, Espen, 2006. "The relationship between age of menarche and mental distress in Norwegian adolescent girls and girls from different immigrant groups in Norway: Results from an urban city cross-sectional survey," Social Science & Medicine, Elsevier, vol. 63(2), pages 285-295, July.
    6. Torsheim, Torbjørn & Ravens-Sieberer, Ulrike & Hetland, Jorn & Välimaa, Raili & Danielson, Mia & Overpeck, Mary, 2006. "Cross-national variation of gender differences in adolescent subjective health in Europe and North America," Social Science & Medicine, Elsevier, vol. 62(4), pages 815-827, February.
    7. Sweeting, Helen, 1995. "Reversals of fortune? Sex differences in health in childhood and adolescence," Social Science & Medicine, Elsevier, vol. 40(1), pages 77-90, January.
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