The male-female health-survival paradox: a survey and register study of the impact of sex-specific selection and information bias.

Full Abstract

PURPOSE: This study examined whether the health-survival paradox could be due partially to sex-specific selection and information bias in surveys. METHODS: The study is based on the linkage of three population-based surveys of 15,330 Danes aged 46-102 years with health registers covering the total Danish population regarding hospitalizations within the last 2 years and prescription medicine within 6 months before the baseline surveys. RESULTS: Men had higher participation rates than women at all ages. Hospitalized women and women taking medications had higher participation rate compared with nonhospitalized women (difference=0.7%-3.0%) and female nonusers (difference=0.8%-7.6%), respectively, whereas no consistent pattern was found among men according to hospitalization or medication use status. Men used fewer medications than women, but they underreported medication use to a similar degree as did women. CONCLUSIONS: Hospitalized women, as well as women using prescription medicine, were slightly overrepresented in the surveys. Hence, the study found some evidence that selection bias in surveys may contribute to the explanation of the health-survival paradox, but its contribution is likely to be small. However, there was no evidence for sex-specific reporting of medication use among study participants.

Author information

Author/s: Oksuzyan, Anna (A); Petersen, Inge (I); Stovring, Henrik (H); Bingley, Paul (P); Vaupel, James W (JW); Christensen, Kaare (K);

Affiliation: Max Planck Institute for Demographic Research, Rostock, Germany. oksuzyan(-atsign-)demogr.mpg.de

Grants: P01-AG08761 (Agency:NIA NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural

Journal: Annals of epidemiology (Ann Epidemiol), published in United States. (Language: eng)

Reference: 2009-Jul; vol 19 (issue 7) : pp 504-11

Dates: Created 2009/06/15; Completed 2009/09/08;

PMID: 19457685, status: MEDLINE (last retrieved date: 9/8/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.