Gender differences in the association between morbidity and mortality among middle-aged men and women.
OBJECTIVE
We examined gender differences in mortality, morbidity, and the association between the 2.


METHODS
We used health data from 2 studies of middle-aged men and women: the British Whitehall II cohort of employees from 20 civil service departments in London and the 1989 French GAZEL (this acronym refers to the French gas and electric companies) of employees of France's national gas and electricity company. Participants were aged 35 to 55 years when assessed for morbidity and followed up for mortality over 17 years.


RESULTS
Male mortality was higher than female mortality in Whitehall II (hazard ratio [HR] = 1.56; 95% confidence interval [CI] = 1.28, 1.91) and the GAZEL cohort (HR = 1.99; CI = 1.66, 2.40). Female excess morbidity was observed for some measures in the Whitehall II data and for 1 measure in the GAZEL data. Only self-reported sickness absence in the Whitehall II data was more strongly associated with mortality among men (P = .01).


CONCLUSIONS
Mortality was lower among women than among men, but morbidity was not consistently higher. The lack of gender differences in the association between morbidity and mortality suggests that this is not a likely explanation for the gender paradox, which refers to higher morbidity but lower mortality among women than among men.
Singh-Manoux
Archana
A
INSERM U687, Villejuif Cedex, France. archana.singh-manoux@st-maurice.inserm.fr
Guéguen
Alice
A
Ferrie
Jane
J
Shipley
Martin
M
Martikainen
Pekka
P
Bonenfant
Sébastien
S
Goldberg
Marcel
M
Marmot
Michael
M
D000041:Absenteeism; D000328:Adult; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008017:Life Expectancy / Q000639:trends; D008131:London / Q000453:epidemiology; D008297:Male; D008571:Men; D008875:Middle Aged; D009017:Morbidity / Q000639:trends*; D009026:Mortality / Q000639:trends*; D016016:Proportional Hazards Models; D012727:Sex Characteristics; D017678:Sex Distribution; D012737:Sex Factors; D014930:Women