Decreased risk of death from coronary heart disease amongst men with higher 'femininity' scores: a general population cohort study.
BACKGROUND
At all ages men have higher rates of coronary heart disease (CHD) than women, although similar proportions of men and women eventually die of CHD. Gender differences in CHD incidence and mortality are often explained in relation to biological (hormonal) and behavioural risk factors (e.g. smoking), but psychological factors and broader social constructions of gender are rarely considered.


OBJECTIVE
To examine the relationship between measures of gender role orientation at baseline in 1988 and mortality from CHD over 17 years (to June 2005).


METHODS
Prospective cohort study linked to national mortality reporting.


METHODS
Socially varied, mainly urban area centred on city of Glasgow in West Central Scotland, UK.


METHODS
In total, 1551 participants (704 men and 847 women) aged 55 years took part in detailed interviews with nurses trained in survey methods in 1988. These included a wide range of measures of physical development and functioning, self reported health and health behaviour, personal and social circumstances and a measure of gender role orientation (yielding scores for 'masculinity' and 'femininity').


METHODS
Mortality from CHD up to June 2005 (88 CHD deaths in men; 41 CHD deaths in women).


RESULTS
After adjusting for smoking, binge drinking, body mass index, systolic blood pressure, household income and psychological well-being, higher 'femininity' scores in men were associated with a lower risk of CHD death (hazards ratio per unit increase in 'femininity' score 0.65, 95% CIs 0.48-0.87, P = 0.004). No such relationship was observed amongst women. 'Masculinity' scores were unrelated to CHD mortality in either men or women.


CONCLUSIONS
These results suggest that social constructions of gender influence the risk of ill health, here death from CHD. Men who are less able to identify themselves with characteristics identified as 'feminine' or expressive (who have a more limited stereotypically masculine self-image) may be at increased risk of coronary disease. Further research on the link between social constructions of gender and health is needed.
Hunt
Kate
K
MRC Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow, Scotland, UK. k.hunt@msoc.mrc.gla.ac.uk
Lewars
Heather
H
Emslie
Carol
C
Batty
G David
GD
D001794:Blood Pressure; D015992:Body Mass Index; D003327:Coronary Disease / Q000401:mortality*; D004812:Epidemiologic Methods; D000431:Ethanol / Q000506:poisoning; D005260:Female; D005783:Gender Identity; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D012606:Scotland / Q000453:epidemiology; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data
D000431:Ethanol