Inconsistent health perceptions for US women and men with diabetes.
BACKGROUND
Two health status measures for adults with diabetes are compared in order to identify gender-based differences between norm-based scores for health status and self-rated health scores.


METHODS
Data were obtained from the 2001 and 2003 Medical Expenditure Panel Survey(MEPS). Diabetes was identified by self-report or ICD-9 code. Demographic and clinical (e.g., body mass index [BMI], comorbidities) parameters were included. Outcomes were norm-based measures of physical and mental health (SF-12 Physical and Mental Component Scores: SF-12 PCS and SF-12 MCS) and self-rated perception of health status. Sex-based differences in the three outcome measures, SF-12 PCS, SF-12 MCS, and self-rated health scores, were evaluated in univariate analyses and multivariate linear regression for survey data.


RESULTS
A cohort of 3640 respondents with diabetes was identified (2037 women, 1603 men). In unadjusted analyses, women were older than men (60.7 vs. 59.3 years, p<0.001), reported higher mean BMI (31.1 vs. 30.4), more comorbidities, depression, and physical limitations (all p<0.001), had poorer SF-12 MCS scores (p=0.01), and self-rated their health status significantly higher than did men (p<0.01). In adjusted analyses, female gender was associated with lower SF-12 MCS scores and higher self-rated health scores. No factors were positively associated with higher scores across all three measures; only cognitive limitations consistently predicted lower health status scores in all three measures.


CONCLUSIONS
Among adults with diabetes in a nationally representative sample of the U.S. adult population, discrepancies exist in health status measures. Despite being older, having more comorbidities and physical limitations, and lower norm-based scores for mental functional status, women self-rate their own health status higher than do men. Further research into the gender-based determinants and clinical implications of self-rated health status is warranted.
Department of Clinical Pharmacy, University of Colorado at Denver, and Health Sciences Center, Denver, Colorado, USA. marianne.mccollum@uchsc.edu
Marianne
M
McCollum
Laura B
LB
Hansen
Vahram
V
Ghushchyan
Patrick W
PW
Sullivan
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002908:Chronic Disease / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care; D012649:Self Concept; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D016387:Women's Health